Tütün Bağımlılığının COVID-19 Ağırlığı Üzerine Etkisi

Amaç: Pandemi sürecinin ilk 2 ayında COVİD kliniğinde takip edilen COVİD-19 tanılı hastaların genelözelliklerini, sigara kullanımı ile hastalığın semptomları ve klinik seyri arasındaki ilişkiyi araştırmayı amaçladık.Yöntem: On sekiz yaş üzerinde ve COVİD-19 tanısı alan hastalar retrospektif olarak dâhil edildi. Hastalarındemografik verileri, semptomları, ek hastalıkları, tütün ve tütün ürünü kullanım durumları, hastalık ciddiyeti, hastanın serviste veya yoğun bakımda takip durumları ve ek tedaviye gereksinim durumları ve tütünkullanımı ile hastalık ciddiyet arasındaki ilişki incelendi.Bulgular: Çalışmaya yaş ortalaması 57 yıl olan, %40.6’sını kadın hastaların oluşturduğu toplam 224 hastadâhil edildi. Hastaların %32,6’sı aktif sigara içicisi, %27,6’sı sigarayı bırakmış, %13,4 ‘ü pasif içici ve %26,3hiç sigara içmemiş olgulardı. Sigarayı bırakan hastaların (n=62) 17’si (%27.4’ü) sigarayı pandemi sürecinde bırakmıştı. En yüksek sigara kullanma oranı 18-49 yaş aralığındaki hastalarda (%44,7) saptandı. Aktifsigara içen hastalarda dispne (%45,2), koku alamama (%31,5), tat alamama (%21,9), üşüme- titreme(%16,9) daha yüksek saptandı. Hastalık şiddeti aktif sigara içenlerde oransal olarak daha yüksek bulunmasına rağmen fark saptanmadı. Hastaların takipleri sırasında destek tedavilere duyulan gereksinimler karşılaştırıldığında; oksijen tedavisi kullanımı aktif sigara kullanan ve tütün kullanımını bırakmış olan hastalardaanlamlı düzeyde daha yüksek saptanırken, diğer tedaviler benzer oranlarda saptandı. Tütün kullanmadurumları ve ölüm oranları karşılaştırıldığında aktif tütün kullananlarda oransal olarak daha yüksek ölümoranı saptandı ancak fark bulunmadı.Sonuç: Çalışmamızda, tütün kullanımının hastalık ciddiyeti ve ölüm oranları üzerine anlamlı bir etkisi saptanmazken, COVİD-19 hastalarında özellikle nefes darlığı semptomunun sigara içenlerde daha fazla olduğu veoksijen tedavisine gereksinimin tütün kullanımına bağlı olarak anlamlı olarak artabileceği görülmektedir.

The Effect of Tobacco Addiction on Severity of COVID-19 Disease

Objective: We aimed to investigate the relationship between smoking status and the general characteristics, symptoms and clinical course of patients diagnosed with COVID-19 who were followed-up in the COVID ward in the first 2 months of the pandemic. Method: Patients over the age of 18 and diagnosed with COVID-19 disease were retrospectively included in the study.The demographic data, symptoms, comorbidities of the patients, use of tobacco products, disease severity, the patient’s follow-up status in the ward or intensive care unit, the need for supportive treatment, and the relationship between tobacco use and disease severity were evaluated. Results: A total of 224 patients (female, 40.6%, and male 59.4%) with a mean age of 57 years were included in the study. The study population consisted of active smokers (32.6%), ex-smokers (27.6%), passive-smokers (13.4%) and never-smokers (26.3%). Seventeen ex-smokers (17/62:27.4%) quitted smoking during the pandemic. The highest smoking rate was found in patients between the ages of 18-49 (44.7%). Dyspnea (45.2%), loss of smelling (31.5%), inability to taste (21.9%), chills-and-shivering (16.9%) were statistically higher in active smokers. The disease progressed more severely in active smokers but without any significant difference between groups. The need for both supportive treatments during the follow-up, and oxygen therapy was found to be significantly higher in active smokers , and ex-smokers, while the rates of other treatments were comparable between groups. When the smoking status and mortality rates of the patients were compared, a proportionally higher mortality rate was found in active-tobacco users, but without any statistically significant intergroup difference. Conclusion: While any effect of tobacco use on disease severity and mortality was not detected, significant difference on the effect of in our study, it is observed that the symptom of shortness of breath was higher in smokers among COVID-19 patients. Additionally, the need for oxygen treatment may increase significantly due to tobacco use.

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