Evidence map›Paper›PMID 40814093›Full record

SynthesisBMC public health2025

Association between e-cigarette use and COVID-19 diagnosis: a systematic review and meta-analysis.

Ying Xie, Xinmei Zhou, Dengmin Huang, Han Yao, Zheng Su, Zhao Liu, Anqi Cheng, Zhenxiao Huang, Jinxuan Li, Rui Qin and 6 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. The triple-hit hypothesis: exploring pulmonary e-cigarette, PMEuropean respiratory review : an official journal of the European Respiratory Society · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Ying XieSchool of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Xinmei ZhouNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China.
Dengmin HuangSchool of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Han YaoSchool of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Zheng SuNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China.
Zhao LiuNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China.
Anqi ChengNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China.
Zhenxiao HuangSchool of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Jinxuan LiNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China.
Rui QinNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China.
Yi LiuNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China.
Xin XiaNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China.
Qingqing SongNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China.
Liang ZhaoNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China.
Dan XiaoNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, China. danxiao@263.net.
Chen WangSchool of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. wangchen@pumc.edu.cn.

Funding

Innovative Medicine CAMS 2021-I2M-1-010Science and Technology Project of Heilongjiang Province of China 2022ZXJ03C02
6 · The paper itself

Abstract

backgroundThe impact of e-cigarettes on COVID-19 remains unclear. This study aims to assess the relationship between e-cigarette use and COVID-19 diagnosis and other related outcomes.

methodsThis systematic review and meta-analysis searched studies from 2019 to April 2nd, 2024, in Medline (via OVID), EMBASE, Scopus and the Cochrane Central Register of Controlled Trials for eligible observational studies.

resultsAmong the initially identified 1116 items, a total of 20 studies met the inclusion criteria. The meta-analysis revealed that e-cigarette use was significantly associated with higher odds of COVID-19 diagnosis (N = 14, adjusted odds ratio, OR 1.25, 95% confidence interval, CI 1.07 to 1.47, I2 = 62%). This association was more pronounced among the youth (N = 4, adjusted OR 1.78, 95% CI 1.17 to 2.72, I2 = 75%) and current e-cigarette users (N = 14, adjusted OR 1.30, 95% CI 1.10 to 1.55, I2 = 55%). Though the association was not significant among cohort or case-control studies at first, the robust results were shown excluding low-quality studies (N = 3, adjusted OR 1.25, 95% CI 1.03 to 1.50, I2 = 0%). The results remained consistent in leave-one-out analyses. Drawing from the available but limited research, no significance was observed between e-cigarette use or other COVID-19 outcomes including severe COVID-19, COVID-19-related death, symptoms or hospital admission. Heterogeneity and risk of bias should be noticed when explaining our results.

conclusionsE-cigarette use was associated with an increased risk of COVID-19 diagnosis, particularly among youth and current users. Further high-quality evidence is needed to assess the overall health effects of e-cigarettes, with a particular focus on the youth and current users.

Indexed as

COVID-19Electronic Nicotine Delivery SystemsVapingHumansCOVID-19E-cigarettesMeta-analysisTobacco

Identifiers

PMID40814093
PMCPMC12351969

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.