The harms of tobacco use are well-established. Tobacco causes 8 million deaths every year from cardiovascular diseases, lung disorders, cancers, diabetes, and hypertension.1 Smoking tobacco is also a known risk factor for severe disease and death from many respiratory infections.2-4 In the COVID-19 pandemic, questions have been asked about clinical outcomes for smokers, and whether they are equally susceptible to infection, and if nicotine has any biological effect on the SAR-CoV-2 virus (the virus that causes COVID-19).5-7 At the time of writing, one clinical trial to test the effects of nicotine has been announced, but no trial registration record was found as of 12 May 2020.
This review, therefore, assesses the available peer-reviewed literature on the association between smoking and COVID-19, including 1) risk of infection by SARS-CoV-2; 2) hospitalization with COVID-19; and 3) severity of COVID-19 outcomes amongst hospitalized patients such as admission into intensive care units (ICU), use of ventilators and death.
