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Intern. Med."],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>COVID\u201019 is a new pneumonia. It has been hypothesized that tobacco smoking history may increase severity of this disease in the patients once infected by the underlying coronavirus SARS\u2010CoV\u20102 because smoking and COVID\u201019 both cause lung damage. However, this hypothesis has not been tested.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Current study was designed to focus on smoking history in patients with COVID\u201019 and test this hypothesis that tobacco smoking history increases risk for severe COVID\u201019 by damaging the lungs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>This was a single\u2010site, retrospective case series study of clinical associations, between epidemiological findings and clinical manifestations, radiographical or laboratory results. In our well\u2010characterized cohort of 954 patients including 56 with tobacco smoking history, smoking history increased the risk for severe COVID\u201019 with an odds ratio (OR) of 5.5 (95% CI: 3.1\u20139.9; <jats:italic>P<\/jats:italic>\u00a0=\u00a07.3\u00a0\u00d7\u00a010<jats:sup>\u22128<\/jats:sup>). Meta\u2010analysis of ten cohorts for 2891 patients together obtained an OR of 2.5 (95% CI: 1.9\u20133.3; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.00001). Semi\u2010quantitative analysis of lung images for each of five lobes revealed a significant difference in neither lung damage at first examination nor dynamics of the lung damage at different time\u2010points of examinations between the smoking and nonsmoking groups. No significant differences were found either in laboratory results including D\u2010dimer and C\u2010reactive protein levels except different covariances for density of the immune cells lymphocyte (<jats:italic>P<\/jats:italic>\u00a0=\u00a03.8\u00a0\u00d7\u00a010<jats:sup>\u221264<\/jats:sup>) and neutrophil (<jats:italic>P<\/jats:italic>\u00a0=\u00a03.9\u00a0\u00d7\u00a010<jats:sup>\u221246<\/jats:sup>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tobacco smoking history increases the risk for great severity of COVID\u201019 but this risk is achieved unlikely by affecting the lungs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.13190","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T15:38:57Z","timestamp":1607009937000},"page":"574-583","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Tobacco smoking confers risk for severe COVID\u201019 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