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COVID-19 Severity by Smoking Status

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There has been recent conversation about the role that smoking status may play in severity of COVID-19 disease. To investigate this role, we examined the relationship between smoking status, as documented in the electronic health record, and general outcome severity of COVID-19 in a large national cohort of adult COVID-19 positive patients.

Figure 1. COVID-19 worst severity by smoking status and age group. Some rows may not add to 100% due to rounding.

The following analysis includes 132,288 patients 19+ years old who are COVID-19 positive. 81% had a smoking status recorded in their electronic health record as of May 4, 2020. Data are pooled from 31 health systems representing 300 hospitals spanning 18 states and covering 135 million patients.

Figure 1 shows the distribution of patients’ worst severity by smoking status and age for COVID-19 positive patients with a smoking status on file. There does not currently appear to be a clear pattern in worse outcomes for any smoking status. This may be due to the large number of patients who have not had COVID-19 long enough to have an outcome. Another possible reason is that there is no pattern to detect. COVID-19 outcomes by smoking status are shown for additional age groups in Table 1.

Until more patients have known outcomes, it remains unclear whether or not smoking status is related to COVID-19 outcomes. Researchers who are investigating smoking and COVID-19 may find this information useful as they continue to examine this relationship.

Table 1. COVID-19 outcomes by smoking status for additional age groups. Some rows may not add to 100% due to rounding.

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