The association of smoking status with hospitalisation for COVID-19 compared with other respiratory viruses a year previous

A case control study performed at a single NHS trust

David Simons (The Royal Veterinary College, London, UK)https://www.rvc.ac.uk
April 06, 2021

Hospitalised patients case-control study

We performed a case-control study at University College Hospital London NHS Foundation Trust to explore the association of smoking and hospitalisation with COVID-19 compared to other respiratory viruses from the year prior to the pandemic. This work used data extracted from the Electronic Healthcare Records of 657 in-patients. This work has been submitted for peer-review and publication. It is currently registered as a pre-print on medRxiv (Simons et al. 2021) the publication is available here.

I presented an interim analysis of this work at the 21st Annual SRNT-E Conference the recorded talk is available below.

Abstract

Background It is unclear whether smoking increases the risk of COVID-19 hospitalisation. We examined i) the association of smoking status with hospitalisation for COVID-19 compared with hospitalisation for other respiratory viral infections a year previous; and ii) concordance between smoking status recorded on the electronic health record (EHR) and the contemporaneous medical notes.

Methods This case-control study enrolled adult patients (446 cases and 211 controls) at a single National Health Service trust in London, UK. The outcome variable was type of hospitalisation (COVID-19 vs. another respiratory virus a year previous). The exposure variable was smoking status (never/former/current smoker). Logistic regression analyses adjusted for age, sex, socioeconomic position and comorbidities were performed. The study protocol and analyses were pre-registered in April 2020 on the Open Science Framework.

Results Current smokers had lower odds of being hospitalised with COVID-19 compared with other respiratory viruses a year previous (ORadj=0.55, 95% CI=0.31-0.96, p=.04). There was no significant association among former smokers (ORadj=1.08, 95% CI=0.72-1.65, p=.70). Smoking status recorded on the EHR (compared with the contemporaneous medical notes) was incorrectly recorded for 168 (79.6%) controls (χ2(3)=256.5, p=<0.001) and 60 cases (13.5%) (χ2(3)=34.2, p=<0.001).

Conclusions In a single UK hospital trust, current smokers had reduced odds of being hospitalised with COVID-19 compared with other respiratory viruses a year previous, although it is unclear whether this association is causal. Targeted post-discharge recording of smoking status may account for the greater EHR- medical notes concordance observed in cases compared with controls.

Simons, David, Olga Perski, Lion Shahab, Jamie Brown, and Robin Bailey. 2021. “The Association of Smoking Status with Hospitalisation for COVID-19 Compared with Other Respiratory Viruses a Year Previous: A Case-Control Study at a Single UK National Health Service Trust.” medRxiv, March, 2020.11.26.20238469. https://doi.org/10.1101/2020.11.26.20238469.

References

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Citation

For attribution, please cite this work as

Simons (2021, April 6). David Simons: The association of smoking status with hospitalisation for COVID-19 compared with other respiratory viruses a year previous. Retrieved from wwww.dsimons.org/posts/2021-04-06-smoking-covid-hospitalised/

BibTeX citation

@misc{simons2021the,
  author = {Simons, David},
  title = {David Simons: The association of smoking status with hospitalisation for COVID-19 compared with other respiratory viruses a year previous},
  url = {wwww.dsimons.org/posts/2021-04-06-smoking-covid-hospitalised/},
  year = {2021}
}