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?:abstract
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Dramatic outcomes of Covid-19 pandemia in Italy, in particular in the North, must be discussed. Maybe a bad strategy and lack of timely intervention togheter with concurrent social events, comorbidities of oldest persons, bed rest, inadequate nutritional support and drugs\' side effects and infection of health professionals proved fatal for many.
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Dramatic outcomes of Covid-19 pandemia in Italy, in particular in the North, must be discussed. Maybe a bad strategy and lack of timely intervention togheter with concurrent social events, comorbidities of oldest persons, bed rest, inadequate nutritional support and drugs’ side effects and infection of health professionals proved fatal for many. (www.actabiomedica.it)
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INTRODUCTION: COVID-19 pandemic burst onto the international scene as a new disease disproportionately affecting certain patient groups; hence it has risen many questions yet to be clarified. The aim of this study was to outline the main issues that led tobacco smoking being discussed as a potential risk factor associated with COVID-19. METHODS: articles from MEDLINE and pre-prints published from January to April 2020 were identified. RESULTS: data from China showed that men had more severe outcomes of COVID-19 than women. Since smoking prevalence is very high among Chinese men in comparison to women, it was hypothesized that smoking could be a risk factor for poor prognosis. This was also supported by the higher prevalence of comorbidities, many of which tobacco-related diseases, in patients with severe COVID-19, who were also more likely to have a smoking history. A meta-analysis confirmed these results, reporting an OR=2.25 (95% CI: 1.49-3.39) for developing severe COVID-19 among patients with a smoking history. Some authors, noticing that reported smoking prevalence among hospitalized patients was substantially lower than smoking prevalence in the source populations, speculated a protective role of nicotine. However, it is likely that low prevalence among hospitalized patients are partially due to many smokers misclassified as nonsmokers. Tobacco smoking seems to cause a dose-dependent upregulation of angiotensin-converting-enzyme-2 (ACE2), the virus cellular entry receptor, which could explain the higher risk of severe COVID-19 in smokers. CONCLUSIONS: There is need for further independent studies to clarify the role of smoking on COVID-19 incidence, progression and mortality. (www.actabiomedica.it)
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