Smoking Status and Factors associated with COVID-19 In-Hospital Mortality among US Veterans.
Smoking Status and Factors associated with COVID-19 In-Hospital Mortality among US Veterans.
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DOI：
10.1093/ntr/ntab223
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发表时间：
2022-03-26
期刊：
影响因子：
--
通讯作者：
Amos CI
中科院分区：
文献类型：
--
作者：
Razjouyan J;Helmer DA;Lynch KE;Hanania NA;Klotman PE;Sharafkhaneh A;Amos CI
吸烟在COVID-19患者死亡风险中的作用尚不清楚。我们在美国退伍军人健康管理局（VHA）中研究了COVID-19住院死亡率与吸烟状况和其他因素之间的关系。这是一项观察性、回顾性队列研究，使用了2020年2月1日至9月11日VHA COVID-19共享数据资源。将经VHA治疗的SARS-CoV-2检测呈阳性入院的退伍军人分为从未吸烟者（作为参考，NS）、曾经吸烟者（FS）和目前吸烟者（CS）。主要结局为住院死亡率。控制因素是通过一系列机器学习确定的最重要的变量（在所有可用变量中）。我们报告了逻辑回归模型的校正优势比（aOR）和95%置信区间（95% ci），在我们的初步分析中纳入了缺失吸烟状况。在8 667 996名VHA参与者中，505 143人接受了SARS-CoV-2检测（NS = 191 143; FS = 240 336; CS = 117 706；未知= 45 533）。假定吸烟状况下，FS与NS的住院死亡率的aOR为1.16 (95%CI 1.01, 1.32)， CS与NS的aOR为0.97 （95%CI 0.78, 1.22; p < 0.05）。在其他因素中，住院前使用法莫替丁和非甾体抗炎药（NSAID）与较低的风险相关，而糖尿病合并并发症、肾脏疾病、肥胖和高龄与较高的住院死亡率相关。在因SARS-CoV-2感染而入院的患者中，我们的数据显示FS比NS有更高的住院死亡率。然而，在CS中没有看到这种模式，这突显出需要用高质量的吸烟状况数据进行更细致的分析，以进一步阐明我们对吸烟风险和covid -19相关死亡率的理解。合并症和高龄的存在也与院内死亡风险增加有关。与从不吸烟的退伍军人相比，曾经吸烟的退伍军人住院死亡的风险更高。目前吸烟者和从不吸烟者的住院死亡率相似。住院前使用法莫替丁和非甾体抗炎药（NSAIDs）与较低的风险相关，而未控制的糖尿病、高龄、肾脏疾病和肥胖与较高的住院死亡率相关。
The role of smoking in risk of death among patients with COVID-19 remains unclear. We examined the association between in-hospital mortality from COVID-19 and smoking status and other factors in the United States Veterans Health Administration (VHA). This is an observational, retrospective cohort study using the VHA COVID-19 shared data resources for February 1 to September 11, 2020. Veterans admitted to the hospital who tested positive for SARS-CoV-2 and hospitalized by VHA were grouped into Never (as reference, NS), Former (FS), and Current smokers (CS). The main outcome was in-hospital mortality. Control factors were the most important variables (among all available) determined through a cascade of machine learning. We reported adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) from logistic regression models, imputing missing smoking status in our primary analysis. Out of 8 667 996 VHA enrollees, 505 143 were tested for SARS-CoV-2 (NS = 191 143; FS = 240 336; CS = 117 706; Unknown = 45 533). The aOR of in-hospital mortality was 1.16 (95%CI 1.01, 1.32) for FS vs. NS and 0.97 (95%CI 0.78, 1.22; p > .05) for CS vs. NS with imputed smoking status. Among other factors, famotidine and nonsteroidal anti-inflammatory drugs (NSAID) use before hospitalization were associated with lower risk while diabetes with complications, kidney disease, obesity, and advanced age were associated with higher risk of in-hospital mortality. In patients admitted to the hospital with SARS-CoV-2 infection, our data demonstrate that FS are at higher risk of in-hospital mortality than NS. However, this pattern was not seen among CS highlighting the need for more granular analysis with high-quality smoking status data to further clarify our understanding of smoking risk and COVID-19-related mortality. Presence of comorbidities and advanced age were also associated with increased risk of in-hospital mortality. Veterans who were former smokers were at higher risk of in-hospital mortality compared to never smokers. Current smokers and never smokers were at similar risk of in-hospital mortality. The use of famotidine and nonsteroidal anti-inflammatory drugs (NSAIDs) before hospitalization were associated with lower risk while uncontrolled diabetes mellitus, advanced age, kidney disease, and obesity were associated with higher risk of in-hospital mortality.
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影响因子：
13.6
作者：
Levin AT;Hanage WP;Owusu-Boaitey N;Cochran KB;Walsh SP;Meyerowitz-Katz G
通讯作者：
Meyerowitz-Katz G
影响因子：
4.6
作者：
Bhargava, Ankur;Kim, Tae;Hauser, Ronald George
通讯作者：
Hauser, Ronald George
影响因子：
5.6
作者：
Luo J;Jeyapalina S;Stoddard GJ;Kwok AC;Agarwal JP
通讯作者：
Agarwal JP
DOI：
10.1183/16000617.0199-2020
发表时间：
2020-12-31
期刊：
European respiratory review : an official journal of the European Respiratory Society
影响因子：
--
作者：
Higham A;Mathioudakis A;Vestbo J;Singh D
通讯作者：
Singh D
影响因子：
3.1
作者：
Azur, Melissa J.;Stuart, Elizabeth A.;Frangakis, Constantine;Leaf, Philip J.
通讯作者：
Leaf, Philip J.