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Current smoking and COVID-19 risk: results from a population symptom app in over 2.4 million people

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Title: Current smoking and COVID-19 risk: results from a population symptom app in over 2.4 million people
Authors: Hopkinson, N
Rossi, N
El-Sayed Moustafa, JS
Laverty, A
Quint, J
Freidin, MB
Visconti, A
Murray, B
Modat, M
Ourselin, S
Small, K
Davies, R
Wolf, J
Spector, TD
Steves, CJ
Falchi, M
Item Type: Journal Article
Abstract: Background: The association between current tobacco smoking, the risk of developing symptomatic COVID-19 and the severity of illness is an important information gap. Methods: UK users of the Zoe COVID Symptom Study App provided baseline data including demographics, anthropometrics, smoking status and medical conditions, and were asked to log their condition daily. Participants who reported that they did not feel physically normal were then asked by the app to complete a series of questions, including 14 potential COVID-19 symptoms and about hospital attendance. The main study outcome was the development of “classic” symptoms of COVID-19 during the pandemic defined as fever, new persistent cough and breathlessness and their association with current smoking. The number of concurrent COVID-19 symptoms was used as a proxy for severity and the pattern of association between symptoms was also compared between smokers and non-smokers. Results: Between 24th March 2020 to 23rd April 2020, data were available on 2,401,982 participants, mean(SD) age 43.6(15.1) years, 63.3% female, overall smoking prevalence 11.0%. 834,437 (35%) participants reported being unwell and entered one or more symptoms. Current smokers were more likely to report symptoms suggesting a diagnosis of COVID-19; classic symptoms adjusted OR[95%CI] 1.14[1.10 to 1.18]; >5 symptoms 1.29[1.26 to 1.31]; >10 symptoms 1.50[1.42 to 1.58]. The pattern of association between reported symptoms did not vary between smokers and non-smokers. Interpretation: These data are consistent with people who smoke being at an increased risk of developing symptomatic COVID-19.
Issue Date: 15-Jun-2021
Date of Acceptance: 27-Nov-2020
URI: http://hdl.handle.net/10044/1/84412
DOI: 10.1136/thoraxjnl-2020-216422
ISSN: 0040-6376
Publisher: BMJ Publishing Group
Start Page: 714
End Page: 722
Journal / Book Title: Thorax
Volume: 76
Copyright Statement: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
Sponsor/Funder: Medical Research Council (MRC)
Funder's Grant Number: n/a
Keywords: clinical epidemiology
respiratory infection
tobacco and the lung
viral infection
Respiratory System
1103 Clinical Sciences
Publication Status: Published
Open Access location: https://doi.org/10.1136/thoraxjnl-2020-216422
Online Publication Date: 2021-01-05
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine
Imperial College London COVID-19
School of Public Health