Abstract
Introduction
Smoking can cause muco-ciliary clearing dysfunction and poor pulmonary immunity, leading to more severe infection. We performed this study to explore the association between smoking and mortality of coronavirus disease 2019 (COVID-19) patients utilizing a quantitative meta-analysis on the basis of adjusted effect estimates.
Methods
We conducted a systematic search of the online databases including PubMed, Web of Science, Scopus and Embase. Only articles reporting adjusted effect estimates on the association between smoking and the risk of mortality among COVID-19 patients in English were included. Newcastle-Ottawa scale (NOS) was fitted to assess the risk of bias. A random-effects model was applied to calculate the pooled effect with the corresponding 95% confidence interval (CI).
Results
A total of 73 articles with 863,313 COVID-19 patients were included in this meta-analysis. Our results indicated that smoking was significantly associated with an increased risk for death in patients with COVID-19 (pooled relative risk = 1.19, 95% CI = 1.12-1.27). Sensitivity analysis indicated that our results were stable and robust.
Conclusion
Smoking was independently associated with an increased risk for mortality in COVID-19 patients.
Keywords: COVID-19, smoking, mortality, adjusted effect estimates, meta-analysis
Supplementary Material
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