Long COVID and smoking: magnitude of the problem in an outpatient respiratory unit
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Servicio de Neumología, Hospital Universitario de La Princesa, Madrid, Spain
Institut Català d’Oncologia, Barcelona, Spain
Publication date: 2023-04-25
Corresponding author
Joan B. Soriano   

Servicio de Neumología, Hospital Universitario de La Princesa, Madrid, Spain
Tob. Prev. Cessation 2023;9(Supplement):A130
Up to 16% of patients continue to have symptoms one year after overcoming acute COVID-19. It is estimated there are 400,000 to 800,000 Long COVID patients in Spain. Although the relationship between COVID-19 and smoking was initially highly controversial, the evidence that smoking is a risk factor for infection, increased severity, and mortality in COVID-19 is now overwhelming. However, the role of current- and former-smoking in patients with Long COVID is unknown. Our main objective is to determine the prevalence of current- and former smokers, and the effect of associated variables, in patients with Long COVID.

Material and Methods:
Cross-sectional study of patients with Long COVID enrolled for a prospective follow-up. All were identified in the post-COVID Outpatient Consultation of the Respiratory Department of Hospital de La Princesa, in Madrid, Spain. Smoking status was assessed via standardised questionnaires. Socio-demographic variables, comorbidities, and laboratory biomarkers at baseline, plus treatments and COVID-related use of health services, were also assessed.

Out of 473 patients with Long COVID, 28 (5.9%) were active smokers and 121 (25.6%) were ex-smokers. Compared with never-smokers, Long COVID patients who were current-smokers were younger (62.2 y) and more frequently male (64.3%) (both p<0.001), but with no significant differences in body mass index. Current-smokers had more COPD (32.1%), malnourishment (14.3%), rheumatism (7.1%), and solid tumours (7.1%) compared to never-smokers (all p<0.05); they also had higher D-dimer 4.9±15.6 (p=0.012), and C-Reactive Protein 15.4±9.1 (p=0.005), and a variable use of health services during hospitalization, but with no differences in drugs received.

Smoking is frequent in Long COVID patients, 5.9% active smokers and 25.6% ex-smokers in our series, and it is associated with largely negative consequences in the acute and long-term care of these patients.

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