Review Article

The Impact of Tobacco Use on COVID-19 Outcomes: A Systematic Review

Table 1

Early and later reviews on tobacco use and COVID-19.

AuthorDateStudiesConclusionsNotable limitations

Vardavas et al.March 20205 from ChinaSmoking likely had a negative impact on COVID-19 disease progression and outcomesVery small sample, very early data
Berlin et al.April 20206 from ChinaMore evidence is needed if tobacco use may be a risk factor for both transmission and negative outcomesSmall sample, early data
Farsalinos et al.May 202013 from ChinaSmokers are underrepresented among hospitalized patients; former smokers have higher odds of adverse outcomes than current smokers; nicotine may be protectiveRelies on early data exclusively from China; unadjusted for confounding factors including sociodemographic factors
Gulsen et al.June 202014 from China, 2 from ItalyHistory of smoking is associated with severe COVID-19Relies heavily on early data from China; classifications of both smokers and COVID-19 patients varied
Patanavanich et al.Sept 2020, preprint47 from 16 countriesSmoking is an independent risk factor for COVID-19 severity and deathDoes not include research published after May 25, 2020; includes studies with very small (>0) smoking populations; no requirement regarding COVID-19 diagnosis
Salah et al.Oct 202010 from various countries (China, UK, Thailand)Smoking doubles the risk of mortality in COVID-19 patientsUsed only PubMed; included mortality as an outcome
Gupta et al.Nov 202023 from various countries (China, US, Italy)Tobacco use is associated with comorbidities which increase the likelihood of negative COVID-19 outcomesLiterature review; not systematic
Umnuaypornlert et al.Feb 202140 from 8 countriesTobacco use increases the risk of disease severity and death in COVID-19 patientsNo requirement regarding COVID-19 as diagnosis; no minimum number of smokers to be included in studies