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Abstract Background: It is unclear whether smoking increases the risk of COVID-19 hospitalisation. We aimed to i) examine the association of smoking status with hospitalisation for COVID-19 compared with hospitalisation for other respiratory virus infections a year previous; ii) compare current smoking in cases with age- and sex-matched London prevalence; and iii) examine concordance between smoking status recorded on the electronic health record (EHR) and the medical notes. Methods: This retrospective case-control study enrolled adult patients (446 cases and 211 controls) at a single National Health Service trust in London, UK. London smoking prevalence was obtained from the representative Annual Population Survey. The outcome variable was type of hospitalisation (COVID-19 vs. another respiratory virus). 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 on the Open Science Framework. Findings: Patients hospitalised with COVID-19 had lower odds of being current smokers than patients admitted with other respiratory viruses (ORadj=0.55, 95% CI=0.31-0.96, p=.04). Odds were equivocal for former smokers (ORadj=1.08, 95% CI=0.72-1.65, p=.70). Current smoking in cases was significantly lower than expected from London prevalence (9.4% vs. 12.9%, p=.02). Smoking status recorded on the EHR deviated significantly from that recorded within the medical notes ({chi}2(3)=226.7, p<.001). Interpretation: In a single hospital trust in the UK, patients hospitalised with COVID-19 had reduced odds of being current smokers compared with patients admitted with other respiratory viruses a year previous. Funding: UK BBSRC, Cancer Research UK, UKPRP.
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10.1101/2020.11.26.20238469
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document_parses/pdf_json/db5f899ee9bcda8be4479cbf8cbeae1149e06c9e.json
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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
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