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All Studies   Meta Analysis    Recent:   

Smoking Status and Factors associated with COVID-19 In-Hospital Mortality among US Veterans

Razjouyan et al., Nicotine & Tobacco Research, doi:10.1093/ntr/ntab223
Oct 2021  
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Mortality 27% Improvement Relative Risk Famotidine for COVID-19  Razjouyan et al.  Prophylaxis Is prophylaxis with famotidine beneficial for COVID-19? Retrospective 10,074 patients in the USA Lower mortality with famotidine (p=0.006) c19early.org Razjouyan et al., Nicotine & Tobacco R.., Oct 2021 Favorsfamotidine Favorscontrol 0 0.5 1 1.5 2+
Famotidine for COVID-19
26th treatment shown to reduce risk in October 2021
 
*, now with p = 0.00028 from 30 studies, recognized in 2 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,800+ studies for 98 treatments. c19early.org
Retrospective 10,074 hospitalized veterans with COVID-19 in the USA, showing lower mortality with existing famotidine use.
risk of death, 27.0% lower, OR 0.73, p = 0.006, treatment 93, control 9,981, adjusted per study, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Razjouyan et al., 25 Oct 2021, retrospective, USA, peer-reviewed, 7 authors.
This PaperFamotidineAll
Smoking Status and Factors associated with COVID-19 In-Hospital Mortality among US Veterans
Ph.D Javad Razjouyan, MD Drew A Helmer, Kristine E Lynch, MD Nicola A Hanania, MD Paul E Klotman, MD Amir Sharafkhaneh, PhD Christopher I Amos
Nicotine & Tobacco Research, doi:10.1093/ntr/ntab223
Introduction: The role of smoking in risk of death among patients with COVID-19 remains unclear. We examined the association between in-hospital mortality from COVID-19 and smoking status and other factors in the United States Veterans Health Administration (VHA). Methods: This is an observational, retrospective cohort study using the VHA COVID-19 shared data resources for February 1 to September 11, 2020. Veterans admitted to the hospital who tested positive for SARS-CoV-2 and hospitalized by VHA were grouped into Never (as reference, NS), Former (FS), and Current smokers (CS). The main outcome was in-hospital mortality. Control factors were the most important variables (among all available) determined through a cascade of machine learning. We reported adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) from logistic regression models, imputing missing smoking status in our primary analysis. Results: Out of 8 667 996 VHA enrollees, 505 143 were tested for SARS-CoV-2 (NS = 191 143; FS = 240 336; CS = 117 706; Unknown = 45 533). The aOR of in-hospital mortality was 1.16 (95%CI 1.01, 1.32) for FS vs. NS and 0.97 (95%CI 0.78, 1.22; p > .05) for CS vs. NS with imputed smoking status. Among other factors, famotidine and nonsteroidal anti-inflammatory drugs (NSAID) use before hospitalization were associated with lower risk while diabetes with complications, kidney disease, obesity, and advanced age were associated with higher risk of in-hospital mortality. Conclusions: In patients admitted to the hospital with SARS-CoV-2 infection, our data demonstrate that FS are at higher risk of in-hospital mortality than NS. However, this pattern was not seen Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2021. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Supplementary Material A Contributorship Form detailing each author's specific involvement with this content, as well as any supplementary data, are available online at https:// academic.oup.com/ntr. Declaration of Interests The authors do not have any competing interest.
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We examined the association between in-hospital mortality from COVID-19 and ' 'smoking status and other factors in the United States Veterans Health Administration ' '(VHA).</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>This is an observational, retrospective cohort study using the VHA ' 'COVID-19 shared data resources for February 1 to September 11, 2020. Veterans admitted to the ' 'hospital who tested positive for SARS-CoV-2 and hospitalized by VHA were grouped into Never ' '(as reference, NS), Former (FS), and Current smokers (CS). The main outcome was in-hospital ' 'mortality. Control factors were the most important variables (among all available) determined ' 'through a cascade of machine learning. We reported adjusted odds ratios (aOR) and 95% ' 'confidence intervals (95%CI) from logistic regression models, imputing missing smoking status ' 'in our primary analysis.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>Out of 8 667 996 VHA enrollees, 505 143 were tested for SARS-CoV-2 ' '(NS = 191 143; FS = 240 336; CS = 117 706; Unknown = 45 533). The aOR of in-hospital ' 'mortality was 1.16 (95%CI 1.01, 1.32) for FS vs. NS and 0.97 (95%CI 0.78, 1.22; p &amp;gt; ' '.05) for CS vs. NS with imputed smoking status. Among other factors, famotidine and ' 'nonsteroidal anti-inflammatory drugs (NSAID) use before hospitalization were associated with ' 'lower risk while diabetes with complications, kidney disease, obesity, and advanced age were ' 'associated with higher risk of in-hospital mortality.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Conclusions</jats:title>\n' ' <jats:p>In patients admitted to the hospital with SARS-CoV-2 infection, our ' 'data demonstrate that FS are at higher risk of in-hospital mortality than NS. However, this ' 'pattern was not seen among CS highlighting the need for more granular analysis with ' 'high-quality smoking status data to further clarify our understanding of smoking risk and ' 'COVID-19-related mortality. Presence of comorbidities and advanced age were also associated ' 'with increased risk of in-hospital mortality.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Implications</jats:title>\n' ' <jats:p>Veterans who were former smokers were at higher risk of in-hospital ' 'mortality compared to never smokers. Current smokers and never smokers were at similar risk ' 'of in-hospital mortality. 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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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