By Dr Farsalinos
One of the main issues that many people, especially vapers, are discussing concerning the coronavirus epidemic is about the effects of e-cigarette use (and smoking) on the vulnerability to, and severity of coronavirus infection. Recently, New York City (NYC) Mayor Bill de Blasio mentioned in a news briefing that smokers of vapers are at increased risk. Miraculously, this statement was even reported by Reuters. I wonder, what is the reason for considering valid and reporting statements made by people who have zero background on public health issues?
A link between smoking and coronavirus infection was first suggested because more men were infected than women. One (unproven) hypothesis was that this was due to the much higher prevalence of smoking among Chinese men (48.4%) than among women (1.9%). Source: Statista. A small study of just 78 patients with COVID-19-induced pneumonia was published in the Chinese Medical Journal. Of those, 67 (85.9%) showed improvement/stabilization after 2 weeks, while 11 (14.4%) showed disease progression. The study found that history of smoking was associated with 14-fold higher odds of disease progression. But there were only 5 smokers included in the study sample, and just 3 had disease progression. The data are too weak to make any recommendation. Characteristically, the odds ratio of smoking history leading to disease progression was 14.285 but the confidence intervals were huge (1.157-25.000), showing the level of uncertainty.
Another study that can be used INDIRECTLY to examine the effects of smoking was an analysis of 1099 cases published in New England Journal of Medicine. Interestingly, only 12.6% of cases were current smokers, and 1.9% were former smokers. The number is really low considering two factors:
1. 99.1% of cases were ≥ 15 years old, thus they represent a population group that smokes tobacco cigarettes.
2. 58.1% of cases were male.
Farsalinos Konstantinos M.D. – March 9, 2020.