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March 23, 2020

Smokers have greater risk of severe coronavirus complications, research shows

People with COPD are more likely to be hospitalized or need ICU care

Illness Coronavirus
Smokers are at greater risk of severe illness with COVID-19, researchers find Robina Weermeijer/Unsplash

Smokers and people with lung diseases have a greater risk of developing severe coronavirus cases, according to research from China, where the COVID-19 pandemic originated. The virus attacks the lungs, making it particularly dangerous for people who smoke tobacco or marijuana, according to the National Institute on Drug Abuse.

As scientists compile more data on the ways COVID-19 affects the body, one thing has become clear: smokers and people living lung disease have a greater risk of developing severe illness.

Early studies out of China, where the coronavirus pandemic originated, show a higher fatality rate among people with respiratory disease. One study conducted by the Chinese Center for Disease Control found a 6.3% fatality rate among people with chronic respiratory disease compared to a 2.3% fatality rate among all patients infected with the virus.

Another study published in the Chinese Medical Journal found that smokers were 14 times more likely to have serious complications than nonsmokers.

Because the coronavirus attacks the lungs, it can be particularly dangerous for people who smoke tobacco or marijuana, or those who vape, according to the National Institute on Drug Abuse.

Smokers are already at greater risk for pneumonia – a complication related to COVID-19 – than the general population because the habit weakens the lung's ability to fight off infection. They are also more likely to develop chronic obstructive pulmonary disease, an umbrella term for various progressive lung diseases, including emphysema and chronic bronchitis.

A study published on the MedRxiv scientific study site helps connect the dots between smoking, COPD and COVID-19 complications.

Shortness of breath, a common characteristic of COPD and a coronavirus symptom, has been continuously linked to more severe coronavirus cases. While patients with shortness of breath were 3.7 times more likely to have severe COVID-19 than those without it, patients with COPD were 6.4 times more likely.

Vageesh Jain of University College London's Institute for Global Health, pooled data from seven smaller studies from China, analyzing data on more than 1,813 patients hospitalized with COVID-19. Those who suffered from shortness of breath, formally known as dyspnoea, tended to have more severe cases. 

"Whilst dyspnoea was not a particularly common symptom in COVID-19 patients, its significant association with both severe disease and ICU admission may help clinicians discriminate between severe and non-severe COVID-19 cases," Jain said in a statement.

So what is the takeaway from all this data? Health experts are encouraging smokers to make quitting a priority. And they are urging people with lung disease to carefully monitor any changes to their health. 

"It is vital to heed public health warnings on social distancing and avoiding public places when possible," The American Lung Association advises. "If you are at-risk, be attentive to any possible symptoms – fever, increased cough or shortness of breath from your baseline and be more communicative with your caregivers. Stay on your medication as directed and be careful to make sure you don't run out."

Locally, Trinity Health is instituting new measures to help smokers. 

"Trinity Health has prioritized reducing tobacco use across our 22-state health system through a commitment to tobacco screening and referral connecting patients to cessation resources, and advocacy for anti-tobacco policies at the federal, state and local levels," Dr. Daniel Roth, chief clinical officer and Dr. Mouhanad Hammami, senior vice president of community health and well being, said in a statement.

The Philadelphia Department of Public Health also has resources at SmokeFreePhilly.

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