• María Sierra Navas Alcántara, Lorena Montero Rivas, María Esther Guisado Espartero, Manuel Rubio-Rivas, Blanca Ayuso García, Francisco Moreno Martinez, Cristina Ausín García, Taboada MartínezMaría LuisaMLServicio de Medicina Interna, Hospital de Cabueñes, Gijón, Asturias, España., Francisco Arnalich Fernández, Raúl Martínez Murgui, Sonia Molinos Castro, Maria Esther Ramos Muñoz, Mar Fernández-Garcés, Mari Cruz Carreño Hernandez, Gema María García García, Nuria Vázquez Piqueras, Jesica Abadía-Otero, Lourdes Lajara Villar, Cristina Salazar Monteiro, María de Los Reyes Pascual Pérez, Santiago Perez-Martin, Javier Collado-Aliaga, Juan-Miguel Antón-Santos, Carlos Lumbreras-Bermejo, and en nombre del grupo SEMI-COVID-19.
• Servicio de Medicina Interna, Hospital Infanta Margarita, Cabra, Córdoba, España.
• Med Clin (Barc). 2022 Sep 9; 159 (5): 214223214-223.

IntroductionSmoking can play a key role in SARS-CoV-2 infection and in the course of the disease. Previous studies have conflicting or inconclusive results on the prevalence of smoking and the severity of the coronavirus disease (COVID-19).MethodsObservational, multicenter, retrospective cohort study of 14,260 patients admitted for COVID-19 in Spanish hospitals between February and September 2020. Their clinical characteristics were recorded and the patients were classified into a smoking group (active or former smokers) or a non-smoking group (never smokers). The patients were followed up to one month after discharge. Differences between groups were analyzed. A multivariate logistic regression and Kapplan Meier curves analyzed the relationship between smoking and in-hospital mortality.ResultsThe median age was 68.6 (55.8-79.1) years, with 57.7% of males. Smoking patients were older (69.9 [59.6-78.0 years]), more frequently male (80.3%) and with higher Charlson index (4 [2-6]) than non-smoking patients. Smoking patients presented a worse evolution, with a higher rate of admission to the intensive care unit (ICU) (10.4 vs 8.1%), higher in-hospital mortality (22.5 vs. 16.4%) and readmission at one month (5.8 vs. 4.0%) than in non-smoking patients. After multivariate analysis, smoking remained associated with these events.ConclusionsActive or past smoking is an independent predictor of poor prognosis in patients with COVID-19. It is associated with higher ICU admissions and in-hospital mortality.Copyright © 2021 Elsevier España, S.L.U. All rights reserved.

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