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Smokers More Likely to Report Symptoms Suggestive of COVID-19

FRIDAY, Jan. 15, 2021 -- Current smokers are more likely to report symptoms suggesting a diagnosis of COVID-19, according to a study published online Jan. 6 in Thorax.

Nicholas S. Hopkinson, Ph.D., from Imperial College London, and colleagues examined the association between current tobacco smoking, the risk for developing symptomatic COVID-19, and the severity of illness. Participants were U.K. users of the Zoe COVID-19 Symptom Study app and were asked to log their condition daily. Those who did not feel physically normal were asked to complete a series of questions, including 14 potential COVID-19 symptoms. Development of classic symptoms of COVID-19, defined as fever, new persistent cough, and breathlessness, was the main study outcome.

Data were available for 2,401,982 participants between March 24 and April 23, 2020. The researchers found that overall smoking prevalence was 11.0 percent. Thirty-five percent of participants reported being unwell and entered at least one symptom. The likelihood of reporting symptoms suggesting a diagnosis of COVID-19 was increased for current smokers: adjusted hazard ratios, 1.14, 1.29, and 1.50 for classic symptoms, more than five symptoms, and more than 10 symptoms, respectively. There was no variation noted in the pattern of association between reported symptoms for smokers and nonsmokers.

"Our results provide compelling evidence for an association between current smoking and individual risk from COVID-19, including self-reported symptom burden and risk of attending hospital," the authors write. "Smoking cessation should be incorporated into public health campaigns and other efforts to address the COVID-19 pandemic."

Several authors disclosed financial ties to Zoe Global Ltd, which developed the app.

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