π¨n.b. #postprint π¨
v10 of our #LivingReview is live on @qeios
We have reviewed 345 studies. 52 of sufficient quality for #MetaAnalysis to explore the association of #Smoking and #COVID19 #infection, #hospitalisation, #severity and #mortality.
qeios.com/read/UJR2AW.11
v10 of our #LivingReview is live on @qeios
We have reviewed 345 studies. 52 of sufficient quality for #MetaAnalysis to explore the association of #Smoking and #COVID19 #infection, #hospitalisation, #severity and #mortality.
qeios.com/read/UJR2AW.11
No dramatic changes from v9 posted in November.
Most studies from πΊπΈ, π¨π³ & π¬π§ but from 39 countries. 65% hospital based, 8% purely community. Median of 461 individuals per study.
Smoking remains poorly recorded, only 29% of studies categorise as current π¬, former and never π
Most studies from πΊπΈ, π¨π³ & π¬π§ but from 39 countries. 65% hospital based, 8% purely community. Median of 461 individuals per study.
Smoking remains poorly recorded, only 29% of studies categorise as current π¬, former and never π
6 studies report on alternative nicotine products.
Large amounts of missing data in many studies on π¬ status introducing bias.
Huge reliance on #ElectronicHealthRecords and all the limitations that brings. See our recent #PrePrint if interested (doi.org/10.1101/2020.1β¦)
Large amounts of missing data in many studies on π¬ status introducing bias.
Huge reliance on #ElectronicHealthRecords and all the limitations that brings. See our recent #PrePrint if interested (doi.org/10.1101/2020.1β¦)
Current smoking prevalence is generally less than expected in included studies.
Not adjusted for age, sex, socio-economic position or comorbidities. All important confounders.
Not adjusted for age, sex, socio-economic position or comorbidities. All important confounders.
Former smoking prevalence is more similar to expected. But included less often in reported descriptive statistics.
Not adjusted for age, sex, socio-economic position or comorbidities. All important confounders.
Not adjusted for age, sex, socio-economic position or comorbidities. All important confounders.
Three studies reporting on access to testing broken down by smoking status. Current and former π¬ more likely to access or seek a #COVID test.
63 studies reporting on #COVID infection and π¬.
25 included in #MetaAnalysis
Current smokers were at reduced risk of testing positive for SARS-CoV-2 compared with never smokers (RR = 0.69, 95% Credible Interval (CrI) = 0.58-0.82, Ο = 0.36)
25 included in #MetaAnalysis
Current smokers were at reduced risk of testing positive for SARS-CoV-2 compared with never smokers (RR = 0.69, 95% Credible Interval (CrI) = 0.58-0.82, Ο = 0.36)
Former compared with never smokers were at increased risk of testing positive, but data were inconclusive (RR = 1.03, 95% CrI = 0.94-1.13, Ο = 0.18). The probability of former smokers being at increased risk of infection (RR β₯1.1) compared with never smokers was 7.8%.
41 studies reporting on #COVID #hospitalisation and π¬
13 in meta-analysis
Evidence for current π¬ were inconclusive, favouring no important association. The probability of current π¬ being at increased risk of hospitalisation (RR β₯1.1) compared with never smokers was 31%
13 in meta-analysis
Evidence for current π¬ were inconclusive, favouring no important association. The probability of current π¬ being at increased risk of hospitalisation (RR β₯1.1) compared with never smokers was 31%
Former smokers were at increased risk of hospitalisation (RR = 1.18, CrI = 1.07-1.31) compared with never smokers.
65 studies reported on disease severity, typically among hospitalised patients. 8 studies in meta-analysis.
Current (RR = 1.26, CrI = 0.86-1.94) and former π¬ (RR = 1.52, CrI = 1.12-2.06) were at increased risk of severe disease. Probability or RR >1.1 80% and 98%, respectively
Current (RR = 1.26, CrI = 0.86-1.94) and former π¬ (RR = 1.52, CrI = 1.12-2.06) were at increased risk of severe disease. Probability or RR >1.1 80% and 98%, respectively
77 studies reported mortality. 16 in meta-analysis.
Current (RR = 1.05, 95% CrI = 0.77-1.41) and former π¬ (RR = 1.40, 95% CrI = 1.2-1.64) were at increased risk of mortality. Inconclusive for current π¬ with 38% probability of risk > 1.1 above never π
Current (RR = 1.05, 95% CrI = 0.77-1.41) and former π¬ (RR = 1.40, 95% CrI = 1.2-1.64) were at increased risk of mortality. Inconclusive for current π¬ with 38% probability of risk > 1.1 above never π
Interpretation of results from studies conducted during the the SARS-CoV-2 pandemic is complex and we discuss this in depth.
tl;dr Across 345 studies, recorded current but not past π¬ prevalence was generally lower than national prevalence estimates. Current π¬ were at reduced risk of testing positive for SARS-CoV-2 and former π¬ were at increased risk of hospitalisation, disease severity and mortality
As always
Code available π github.com/DidDrog11/smokβ¦
Report available π
diddrog11.github.io
Data available π
docs.google.com/spreadsheets/dβ¦
v7 published and peer reviewed in @AddictionJrnl π
doi.org/10.1111/add.15β¦
Code available π github.com/DidDrog11/smokβ¦
Report available π
diddrog11.github.io
Data available π
docs.google.com/spreadsheets/dβ¦
v7 published and peer reviewed in @AddictionJrnl π
doi.org/10.1111/add.15β¦
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