Navas Alcantara, Maria SierraMontero Rivas, LorenaGuisado Espartero, Maria EstherRubio-Rivas, ManuelAyuso Garcia, BlancaMoreno Martinez, FranciscoAusin Garcia, CristinaTaboada Martinez, Maria LuisaArnalich Fernandez, FranciscoMartinez Murgui, RaulMolinos Castro, SoniaRamos Munoz, Maria EstherFernandez-Garces, MarCarreno Hernandez, Mari CruzGarcia Garcia, Gema MariaVazquez Piqueras, NuriaAbadia-Otero, JesicaLajara Villar, LourdesSalazar Monteiro, CristinaPascual Perez, Maria de los ReyesPerez-Martin, SantiagoCollado-Aliaga, JavierAnton-Santos, Juan-MiguelLumbreras-Bermejo, CarlosSEMI-COVID-192025-01-072025-01-072022-08-300025-7753https://hdl.handle.net/10668/26655Introduction: Smoking can play a key role in SARS-CoV-2 infection and in the course of the disease. Previous studies have conflicting or inconclusive results on the prevalence of smoking and the severity of the coronavirus disease (COVID-19).Methods: Observational, multicenter, retrospective cohort study of 14,260 patients admitted for COVID-19 in Spanish hospitals between February and September 2020. Their clinical characteristics were recorded and the patients were classified into a smoking group (active or former smokers) or a non-smoking group (never smokers). The patients were followed up to one month after discharge. Differences between groups were analyzed. A multivariate logistic regression and Kapplan Meier curves analyzed the relationship between smoking and in-hospital mortality.Results: The median age was 68.6 (55.8-79.1) years, with 57.7% of males. Smoking patients were older (69.9 [59.6-78.0 years]), more frequently male (80.3%) and with higher Charlson index (4 [2-6]) than non-smoking patients. Smoking patients presented a worse evolution, with a higher rate of admission to the intensive care unit (ICU) (10.4 vs 8.1%), higher in-hospital mortality (22.5 vs. 16.4%) and readmission at one month (5.8 vs. 4.0%) than in non-smoking patients. After multivariate analysis, smoking remained associated with these events.Conclusions: Active or past smoking is an independent predictor of poor prognosis in patients with COVID-19. It is associated with higher ICU admissions and in-hospital mortality.(c) 2021 Elsevier Espana, S.L.U. All rights reserved.enCOVID-19SARS-CoV-2SmokingMortalityHospitalizedresearch article34895891open access10.1016/j.medcli.2021.10.0111578-8989https://doi.org/10.1016/j.medcli.2021.10.011862801600002