Mehmet Murat SAYIN, Eda MACİT AYDIN, Funda ATAR, Savaş ALTINSOY, Julide ERGİL, Hakan DAYANIR

COVID-19 Yoğun Bakım Hastalarında Sigara Alışkanlığının Morbidite ve Mortaliteye Etkisi

Sigara içenlerde, bozulmuş mukosiliyer aktivite, hava yolları epitelinde artmış geçirgenlik ve inflamasyon nedeniyle COVID-19 daha ağır seyredebilir. Ancak, COVID-19 pnömonisi olan hastalarda sigara kullanımının etkisine ilişkin veriler çelişkilidir. Çalışmanın amacı yoğun bakım ünitesine (YBÜ) yatan COVID-19 hastalarında sigara içiciliğinin laboratuvar parametreleri, yoğun bakım yatış süresi, hastane yatış süresi ve mortalite üzerine etkilerini değerlendirmektir. Yöntem: Ocak -Eylül 2021 tarihleri arasında YBÜ’de COVID-19 nedeni ile takip edilen 576 hastanın tıbbi kayıtları retrospektif olarak analiz edildi. Hastaların demografik verileri, komorbiditeleri, laboratuvar parametreleri (hemoglobin, beyaz küre (WBC), lenfosit, nötrofil, trombosit, AST, ALT, CRP, D-dimer, ferritin, BNP, albümin), YBÜ ve hastane yatış süreleri kaydedildi. Hastalar sigara içip içmemelerine göre 2 gruba ayrıldı. Bulgular: Çalışmada 576 hastanın verileri değerlendirildi. Hastaların %53,8’i erkek olup yaş ortalaması 69±14,8 yıldı. Sigara içme oranı %30 olup, erkeklerde %76,9 oranındaydı. Sigara içiciliği olan hastaların yoğun bakım yatış yaşı, içmeyenlere göre daha düşüktü (p=0,01). Sigara içenlerde koroner arter hastalığı, kronik obstruktif akciğer hastalığı ve malignite varlığı anlamlı şekilde daha yüksek bulundu. Laboratuvar parametrelerinden beyaz kan hücre sayımı ve nötrofil sigara içenlerde daha yüksek bulundu (p=0,01). Sigara içenlerde yoğun bakım ile hastane yatış süreleri ve mortalite arasında bir ilişki yoktu (p= 0,769, p=0,699, p=0,852; sırasıyla). Sonuç: Sigara içiciliği ile COVID-19 mortalitesi arasında belirgin bir ilişkili göremedik. Sigara içiciliği olan COVID-19 nedeniyle YBÜ’de yatan hastalarda, klinisyenlerin kritik hastalığa olası ilerleme belirteçleri olarak WBC sayısını, nötrofil sayısını yakından izlemelerini öneririz.

The Effect of Smoking Habit on Morbidity and Mortality in COVID-19 Intensive Care Patients

Objective: In smokers, COVID-19 may have a more severe course due to impaired mucociliary activity, increased permeability, and inflammation of the airway epithelium. However, data on the impact of smoking in patients with COVID-19 pneumonia are conflicting. The study aimed to evaluate the effects of smoking on laboratory parameters, intensive care unit (ICU) length of stay, length of hospital stay, and mortality in COVID-19 patients hospitalized in the intensive careunit. Methods: Medical records of 576 patients who were followed up in the ICU for COVID-19 between January and September 2021 were analyzed retrospectively. Demographic data, comorbidities, laboratory parameters (hemoglobin, white blood cell (WBC), lymphocyte, neutrophil, thrombocyte, AST, ALT, CRP, D-dimer, ferritin, BNP, albumin), ICU and hospital stay of the patients were recorded. The patients were divided into 2 groups according to whether they smoked or not. Results: The data of 576 patients were evaluated in the study. The mean age of the patients was 69±14.8 years, and 53.8% were male. The smoking rate was 30%, and the smoking rate in men was 76.9%. The intensive care unit admission age of smokers was lower than non-smokers (p=0.01). The presence of coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), and malignancy was significantly higher in smokers. Among the laboratory parameters, white blood cell count (WBC) and neutrophil were higher in smokers (p=0.01). There was no relationship between ICU length of stay, length of hospital stay, and mortality in smokers (p=0.769, p=0.699, p=0.852, respectively). Conclusion: We did not find any significant association between smoking and COVID-19 mortality. We recommend clinicians to monitor WBC and neutrophil count closely as markers of possible progression to critical illness in patients hospitalized in the ICU due to smoking COVID-19.

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