Smoking and COVID 19: Analysing this controversy in a Brazilian COVID-19 Reference Centre

Authors

  • Thiago P. Bartholo Departamento de Pneumologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
  • Luís C. Pôrto Departamento de Histologia e Embriologia, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
  • Claudia H. Costa Departamento de Pneumologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
  • Agnaldo José Lopes Departamento de Pneumologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
  • Nadja P. Graça Serviço de Pneumologia, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
  • Fernanda O. Chibante Serviço de Pneumologia, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
  • Elizabeth J. C. Bessa Serviço de Pneumologia, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
  • Alessandra S. Nunes Departamento de Enfermagem, Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
  • Rogério R. Rufino Departamento de Pneumologia, Faculdade de Ciências Médicas, Universi

DOI:

https://doi.org/10.12957/bjhbs.2021.63961

Keywords:

COVID-19, SARS-CoV-2, Smoking, Risk factor.

Abstract

Introduction: Due to the COVID-19 pandemic, it is extremely
important to determine the risk factors that define
patients who are more susceptible to the severe form of
the disease; however, the observation of supposedly protective
factors is also of great relevance. Smoking has been
the subject of controversy as to whether it is a protective
factor or a risk factor for COVID-19. Objective: To assess
how smokers behave within the context of the COVID-19
pandemic. Patients and methods: The participants in this
study were a spontaneously recruited sample from the Rio
de Janeiro State University COVID-19 Reference Centre,
between March and May 2020. All patients underwent
clinical, laboratory, and nasal swabs for the Sars-Cov-2 PCR
investigation. Whenever it was the necessary case, patients
were referred to hospitalization. Results: A total of 4,636
patients with suggestive symptoms of COVID were evaluated.
There was 230 (4.9%) smokers in this group; there is
a 10.3% smoking prevalence in the state of Rio de Janeiro
as described in 2018. A number of 2,246 patients (48.6% of
the total sample) were diagnosed with COVID-19, only 82
of these (3.7% of the total positive COVID) were smokers.
Only 1 (0.01%) of the smokers with COVID-19 needed
hospitalization. As far as the assessed symptoms, smokers
showed fewer symptoms during the disease. Conclusion:
The study suggests that smokers have fewer symptoms
(mild or asymptomatic symptoms) and that there is a need
to expand specific testing for that group.

Downloads

Download data is not yet available.

Author Biographies

Thiago P. Bartholo, Departamento de Pneumologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Departamento de Pneumologia, Faculdade de Ciências Médicas,
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ,
Brasil.

Luís C. Pôrto, Departamento de Histologia e Embriologia, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Departamento de Histologia e Embriologia, Instituto de Biologia
Roberto Alcantara Gomes, Universidade do Estado do Rio de
Janeiro. Rio de Janeiro, RJ, Brasil.

Claudia H. Costa, Departamento de Pneumologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Departamento de Pneumologia, Faculdade de Ciências Médicas,
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ,
Brasil.

Agnaldo José Lopes, Departamento de Pneumologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Departamento de Pneumologia, Faculdade de Ciências Médicas,
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ,
Brasil.

Nadja P. Graça, Serviço de Pneumologia, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Serviço de Pneumologia, Hospital Universitário Pedro Ernesto,
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Fernanda O. Chibante, Serviço de Pneumologia, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Serviço de Pneumologia, Hospital Universitário Pedro Ernesto,
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Elizabeth J. C. Bessa, Serviço de Pneumologia, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Serviço de Pneumologia, Hospital Universitário Pedro Ernesto,
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Alessandra S. Nunes, Departamento de Enfermagem, Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Departamento de Enfermagem, Policlínica Piquet Carneiro,
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

Rogério R. Rufino, Departamento de Pneumologia, Faculdade de Ciências Médicas, Universi

Departamento de Pneumologia, Faculdade de Ciências Médicas,
Universi

References

Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics

of Coronavirus Disease 2019 in China. N Engl J Med.

;382(18):1708-1720. doi:10.1056/NEJMoa2002032

Pascarella G, Strumia A, Piliego C, et al. COVID-19 diagnosis

and management: a comprehensive review. J Intern Med.

;288(2):192-206. doi:10.1111/joim.13091

Hu Y, Sun J, Dai Z, et al. Prevalence and severity of corona

virus disease 2019 (COVID-19): A systematic review and

meta-analysis. J Clin Virol. 2020;127:104371. doi:10.1016/j.

jcv.2020.104371

Singhal T. A Review of Coronavirus Disease-2019 (COVID-19).

Indian J Pediatr. 2020;87(4):281-286. doi:10.1007/s12098-020-

-6

Harapan H, Itoh N, Yufika A, et al. Coronavirus disease

(COVID-19): A literature review. J Infect Public Health.

;13(5):667-673. doi:10.1016/j.jiph.2020.03.019

Brake SJ, Barnsley K, Lu W, et al. Smoking Upregulates

Angiotensin-Converting Enzyme-2 Receptor: A Potential

Adhesion Site for Novel Coronavirus SARS-CoV-2 (Covid-19). J

Clin Med. 2020;9(3):841. doi:10.3390/jcm9030841

Miyara M, Tubach F, Pourcher V, et al. Low incidence of

daily active tobacco smoking in patients with symptomatic

COVID-19. Qeios. 2020. https://doi.org/10.32388/WPP19W.3

Jha P, Ramasundarahettige C, Landsman V, et al. 21st-century

hazards of smoking and benefits of cessation in the United

States. N Engl J Med. 2013;368(4):341-350. doi:10.1056/

NEJMsa1211128

Tsigaris P, Teixeira da Silva JA. Smoking Prevalence and

COVID-19 in Europe. Nicotine Tob Res. 2020;22(9):1646-1649.

doi:10.1093/ntr/ntaa12

Vardavas CI, Nikitara K. COVID-19 and smoking: A

systematic review of the evidence. Tob Induc Dis. 2020;18:20.

doi:10.18332/tid/119324

Cai G, Bossé Y, Xiao F, et al. Tobacco Smoking Increases

the Lung Gene Expression of ACE2, the Receptor of SARSCoV-

Am J Respir Crit Care Med. 2020;201(12):1557-1559.

doi:10.1164/rccm.202003-0693LE

Leung JM, Niikura M, Yang CWT, et al. COVID-19

and COPD. Eur Respir J. 2020;56(2):2002108.

doi:10.1183/13993003.02108-2020.

World Health Organization. Smoking and COVID-19. Scientif

Brief World Health Organization [cited 2020 May 26] Available

from: https://apps.who.int/iris/bitstream/handle/10665/332182/

WHO-2019-nCoV-Sci_Brief-Smoking-2020.1-eng.pdf

Emami A, Javanmardi F, Pirbonyeh N, et al. Prevalence of

Underlying Diseases in Hospitalized Patients with COVID-19: a

Systematic Review and Meta-Analysis. Arch Acad Emerg Med.

;8(1):e35.

Farsalinos K, Barbouni A, Niaura R. Systematic review of the

prevalence of current smoking among hospitalized COVID19

patients in China: could nicotine be a therapeutic option?

Internal and Emergency Medicine. 2020. May 9;1-8. https://

doi:10.1007/s11739-020-02355-7

Zheng Z, Peng F, Xu B, et al. Risk factors of critical &

mortal COVID-19 cases: A systematic literature review and

meta-analysis. J Infect. 2020;81(2):e16-e25. doi:10.1016/j.

jinf.2020.04.021

Guo FR. Active smoking is associated with severity of

coronavirus disease 2019 (COVID-19): An update of a metaanalysis.

Tob Induc Dis. 2020;18:37. doi:10.18332/tid/121915

Zhao Q, Meng M, Kumar R, et al. The impact of COPD and

smoking history on the severity of COVID-19: A systemic

review and meta-analysis. J Med Virol. 2020;10.1002/

jmv.25889. doi:10.1002/jmv.25889

Le Bert N, Tan AT, Kunasegaran K, et al. SARS-CoV-2-

specific T cell immunity in cases of COVID-19 and SARS,

and uninfected controls. Nature. 2020;584(7821):457-462.

doi:10.1038/s41586-020-2550-z

Downloads

Published

2022-03-04

How to Cite

1.
Bartholo TP, Pôrto LC, Costa CH, Lopes AJ, Graça NP, Chibante FO, et al. Smoking and COVID 19: Analysing this controversy in a Brazilian COVID-19 Reference Centre. BJHBS [Internet]. 2022 Mar. 4 [cited 2025 May 3];20(2):105-8. Available from: https://www.e-publicacoes.uerj.br/bjhbs/article/view/63961

Issue

Vol. 20 No. 2 (2021)

Section

Original Papers

License

After the final approval, authors must send the copyright transfer agreement signed by the first author representing each additional author. In this agreement must be stated any conflicts of interest.

Brazilian Journal of Health and Biomedical Sciences de http://bjhbs.hupe.uerj.br/ is licensed under a License Creative Commons - Attribution-NonCommercial 4.0 International.   Licença Creative Commons 

Most read articles by the same author(s)