Simons, D;
Shahab, L;
Brown, J;
Perski, O;
(2021)
Smoking and COVID Living Review (v11): a bayesian analysis.
Qeios
10.32388/ujr2aw.12.
(In press).
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Abstract
Aims: To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity, and iv) mortality from SARS-CoV-2/COVID-19 disease. Design: Living rapid review of observational and experimental studies with random-effects hierarchical Bayesian meta-analyses. Published articles and pre-prints were identified via MEDLINE and medRxiv. Setting: Community or hospital. No restrictions on location. Participants: Adults who received a SARS-CoV-2 test or a COVID-19 diagnosis. Measurements: Outcomes were SARS-CoV-2 infection, hospitalisation, disease severity and mortality stratified by smoking status. Study quality was assessed (i.e. ‘good’, ‘fair’ and ‘poor’). Findings: v11 (searches up to 2021-02-16) included 405 studies with 62 ‘good’ and ‘fair’ quality studies included in unadjusted meta-analyses. 121 studies (29.9%) reported current, former and never smoking status with the remainder using broader categories. Recorded smoking prevalence among people with COVID-19 was generally lower than national prevalence. Current compared with never smokers were at reduced risk of SARS-CoV-2 infection (RR = 0.71, 95% Credible Interval (CrI) = 0.61-0.82, τ = 0.34). Data for former smokers were inconclusive (RR = 1.03, 95% CrI = 0.95-1.11, τ = 0.17) but favoured there being no important association (4% probability of RR ≥1.1). Former compared with never smokers were at increased risk of hospitalisation (RR = 1.19, CrI = 1.1-1.29, τ = 0.13), greater disease severity (RR = 1.8, CrI = 1.27-2.55, τ = 0.46) and mortality (RR = 1.56, CrI = 1.23-2, τ = 0.43). Data for current smokers on hospitalisation, disease severity and mortality were inconclusive (RR = 1.1, 95% CrI = 0.99-1.21, τ = 0.15; RR 1.26, 95% CrI = 0.92-1.73, τ = 0.32; RR = 1.12, 95% CrI = 0.84-1.47, τ = 0.42, respectively) but favoured there being no important associations with hospitalisation and mortality (49% and 56% probability of RR ≥1.1, respectively) and a small but important association with disease severity (83% probability of RR ≥1.1). Conclusions: Compared with never smokers, current smokers appear to be at reduced risk of SARS-CoV-2 infection while former smokers appear to be at increased risk of hospitalisation, greater disease severity and mortality from COVID-19. However, it is uncertain whether these associations are causal.
| Type: | Article |
|---|---|
| Title: | Smoking and COVID Living Review (v11): a bayesian analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.32388/ujr2aw.12 |
| Language: | English |
| Additional information: | All Articles, Original Definitions (i.e.novel Definitions which have never been posted anywhere) and Peer Reviews are made available under the terms of the Creative Commons Attribution 4.0 (CC BY 4.0) license. All Data are made available under the terms of the Creative Commons Public Domain (CC0 license), as outlined below (see "Data Availability"). |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10123757 |
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