Nations with high smoking rate have low SARS-CoV-2 infection and low COVID-19 mortality rate

Nations with high smoking rate have low SARS-CoV-2 infection and low COVID-19 mortality rate

Authors

  • Giovanni Landoni Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Via Olgettina, 60, 20132, Milan, Italy
  • Alberto Zangrillo Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Via Olgettina, 60, 20132, Milan, Italy
  • Carolina Soledad Romero García Hospital General Universitario de Valencia. Avda Tres Cruces 2, 46014, Valencia, Spain
  • Carolina Faustini Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Via Olgettina, 60, 20132, Milan, Italy
  • Martina Di Piazza Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Via Olgettina, 60, 20132, Milan, Italy
  • Francesca Conte Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Via Olgettina, 60, 20132, Milan, Italy
  • Simone Gattarello Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute. Via Olgettina, 60, 20132, Milan, Italy
  • Artem Kuzovlev Federal Research and Clinical Center of Resuscitation and Rehabilitation, Moscow, Russia
  • Valery Likhvantsev V. Negovsky Reanimatology Research Institute, Petrovka str, 25, b.2, Moscow, Russia
  • Riccardo Puglisi Department of Social and Political Sciences, Università Degli Studi di Pavia, 27100, Pavia, Italy

Keywords:

COVID-19; tobacco; smoking; critical care; intensive care, mortality

Abstract

Background and aim of the work

The effect of tobacco smoking on COVID-19 disease is debated with common sense and experts suggesting a deleterious effect and manuscripts worldwide reporting a low prevalence of active tobacco smokers among intensive care unit patients.

Methods

We categorized countries worldwide into three groups with <25%; 25-45%; >45% of active male smokers with data expressed as median and interquartile range [IQR] and extracted data on SARS-CoV-2 infections and COVID-19 deaths per million inhabitants. We also applied multivariate regression techniques to adjust for several epidemiological factors.

Results

COVID-19 mortality was 13 (5-24) per million inhabitants in countries with male smokers >45% and 33 (4-133) in countries where male smokers were <25%. SARS-CoV-2 infection rates were 436 (217-954) and 1139 (302-4084) with data confirmed when dividing data for each continent and when controlling for confounding factors.

Conclusions

We found a counterintuitive low COVID-19 mortality and SARS-CoV-2 infection in countries with high prevalence of male smokers at the global level and within each continent, suggesting that active smoking habit is protective. Further research should urgently investigate which is the possible mechanism of action.

References

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Published

10-11-2020

Issue

Section

ORIGINAL INVESTIGATIONS/COMMENTARIES - SPECIAL COVID19

How to Cite

1.
Landoni G, Zangrillo A, Romero García CS, Faustini C, Di Piazza M, Conte F, et al. Nations with high smoking rate have low SARS-CoV-2 infection and low COVID-19 mortality rate. Acta Biomed [Internet]. 2020 Nov. 10 [cited 2024 Jul. 17];91(4):e2020168. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/10721