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Oliveira FESD, Oliveira MCL, Martelli DRB, Trezena S, Sampaio CA, Colosimo EA, A Oliveira E, Martelli Júnior H. The impact of smoking on COVID-19-related mortality: a Brazilian national cohort study. Addict Behav 2024; 156:108070. [PMID: 38796931 DOI: 10.1016/j.addbeh.2024.108070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/30/2024] [Accepted: 05/19/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Current evidence suggests the potential heightened vulnerability of smokers to severe coronavirus disease (COVID-19) outcomes. AIMS This study aimed to analyze the clinical outcomes and mortality related to tobacco use in a cohort of hospitalized Brazilian COVID-19 patients. METHODS This retrospective cohort study analyzed adults hospitalized for COVID-19 in Brazil using the SIVEP-Gripe database (official data reported by public and private healthcare facilities for monitoring severe acute respiratory syndrome cases in Brazil). The inclusion criteria were patients over 18 years of age with a positive RT-qPCR test for SARS-CoV-2. The analysis focused on in-hospital mortality, considering smoking as an exposure variable, and included covariates such as age, gender, and comorbidities. Smoking history was collected from the self-reported field in the database. Statistical analyses included descriptive statistics, crude Odds Ratios, and multivariable binary logistic regression. RESULTS This study included 2,124,285 COVID-19 patients, among whom 44,774 (2.1 %) were smokers. The average age of the smokers was higher than that of the never-smokers (65.3 years vs. 59.7 years). The clinical outcomes revealed that smokers had higher rates of intensive care unit admission (51.6 % vs. 37.2 % for never-smokers), invasive ventilatory support (31.5 % vs. 20.2 % for never-smokers), and higher mortality (42.7 % vs. 31.8 % for never smokers). In the multivariable analysis, smokers demonstrated a heightened risk of death (aOR 1.23; 95 % CI 1.19-1.25). CONCLUSIONS This large populational-based cohort study confirms the current evidence and underscore the critical importance of recognizing smoking as a substantial risk factor for adverse outcomes in COVID-19 patients.
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Affiliation(s)
| | - Maria Christina L Oliveira
- Department of Pediatrics, Health Sciences Postgraduate Program, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
| | | | - Samuel Trezena
- Postgraduate Program in Health Sciences, Unimontes, Montes Claros, Minas Gerais, Brazil.
| | | | - Enrico A Colosimo
- Department of Statistics, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
| | - Eduardo A Oliveira
- Department of Pediatrics, Health Sciences Postgraduate Program, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Department of Pediatrics, Rady Children's Hospital, University of California, San Diego, United States.
| | - Hercílio Martelli Júnior
- Postgraduate Program in Health Sciences, Unimontes, Montes Claros, Minas Gerais, Brazil; Postgraduate Program in Primary Health Care, Unimontes, Montes Claros, Minas Gerais, Brazil.
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Brandibur TE, Kundnani NR, Boia M, Nistor D, Velimirovici DM, Mada L, Manea AM, Boia ER, Neagu MN, Popoiu CM. Does COVID-19 Infection during Pregnancy Increase the Appearance of Congenital Gastrointestinal Malformations in Neonates? Biomedicines 2023; 11:3105. [PMID: 38137326 PMCID: PMC10740856 DOI: 10.3390/biomedicines11123105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND COVID-19 was an infection that was capable of bringing the entire world to a standstill position within a period of days to months. Despite the advancements in the medical sector, the contagion was difficult to control and costed the lives of millions of people worldwide. Many short- and long-term effects are witnessed even to date in people that contracted the disease. Pregnant females had to suffer not only the devastating effects of the virus, but also the psycho-social impact of the lockdown. The impact of COVID-19 infection during pregnancy causing decreased antenatal care or hypoxemic episodes due to severe respiratory distress and whether it could lead to the appearance of congenital gastrointestinal malformation in neonates is still unclear. The aim of our study was to analyze if COVID-19 infection during pregnancy could increase the incidence of gastric malformations in neonates born from these women. MATERIALS AND METHODS We sifted the files of all neonates admitted into our hospital between January 2022 and December 2022, and based on inclusion and exclusion criteria, we included the cases having gastrointestinal congenital malformations during the COVID-19 pandemic. We performed a single-center, retrospective, observational descriptive study. We further divided the patients based on the anatomical location of the malformation. We also took down details of the evolution of pregnancy and whether the mother had contracted a SARS-CoV-2 infection during the pregnancy. Details regarding the Apgar score, days of intensive care admission, sex, and nutrition were the key findings studied. RESULTS A total of 47 neonates were found to have digestive anomalies, among which, based on the anatomical locations, the number of malformation cases found at the level of the esophagus were 15, while 16 occurred at the level of the pylorus; we found 12 cases of malformation of the duodenum, and four cases had malformation of the rectum. Out of these 47 neonates, 38.3% were females and 61.7% were males. A total of 58% were preemies, among which 9% had intra-uterine growth retardation (IUGR), and 42% were full-term newborns, among which 4% had intra-uterine growth retardation (IUGR). A total of 45% of the births were primiparous pregnancies and 55% were from multiparous females. A total of 14 mothers were found to have tested positive for COVID-19 during the course of pregnancy (p-value = 0.23); many had mild symptoms but were not tested. CONCLUSIONS COVID-19 can affect the wellbeing of the pregnant female and their fetus. Larger studies can help gain extensive knowledge as to whether COVID-19 also has the potential to result in congenital gastrointestinal anomalies in children born from COVID-19 positive mothers. In our study, only a few infants born with this pathology were found to be born from COVID-19 positive mothers. Hence, it is difficult to conclude or exclude a direct correlation between the infection and the congenital malformations.
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Affiliation(s)
- Timea Elisabeta Brandibur
- Department of Neonatology and Puericulture, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Neonatology and Puericulture, “Louis Ţurcanu” Children Emergency Hospital, 300011 Timisoara, Romania
| | - Nilima Rajpal Kundnani
- Discipline of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Marioara Boia
- Department of Neonatology and Puericulture, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Neonatology and Puericulture, “Louis Ţurcanu” Children Emergency Hospital, 300011 Timisoara, Romania
| | - Daciana Nistor
- Discipline of Physiology, Department of Functional Sciences, Physiology, Center of Immuno-Physiology and Biotechnologies (CIFBIOTEH), “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Centre for Gene and Cellular Therapies in Cancer, 300723 Timisoara, Romania
| | - Daniel Milan Velimirovici
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania (L.M.)
| | - Leonard Mada
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania (L.M.)
- Syonic SRL, 300254 Timisoara, Romania
| | - Aniko Maria Manea
- Department of Neonatology and Puericulture, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Neonatology and Puericulture, “Louis Ţurcanu” Children Emergency Hospital, 300011 Timisoara, Romania
| | - Eugen Radu Boia
- Department of Oto-Rhino-Laryngology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marioara Nicula Neagu
- Discipline of Physiology, Faculty of Bioengineering of Animal Resources, University of Life Sciences “King Mihai I”, 300645 Timisoara, Romania
| | - Calin Marius Popoiu
- Department XI of Pediatric Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
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