Tobacco and Waterpipe Use Increases the Risk of COVID-19
What are the possible relations between tobacco use and the COVID19 pandemic?
Tobacco use may increase the risk of suffering from serious symptoms due to COVID-19 illness. Early research indicates that, compared to non-smokers, having a history of smoking may substantially increase the chance of adverse health outcomes for COVID-19 patients, including being admitted to intensive care, requiring mechanical ventilation and suffering severe health consequences  .
Smoking is already known to be a risk-factor for many other respiratory infections, including colds, influenza, pneumonia and tuberculosis . The effects of smoking on the respiratory system makes it more likely that smokers contract these diseases, which could be more severe  . Smoking is also associated with increased development of acute respiratory distress syndrome, a key complication for severe cases of COVID-19 , among people with severe respiratory infections  .
Any kind of tobacco smoking is harmful to bodily systems, including the cardiovascular and respiratory systems  . COVID-19 can also harm these systems. Evidence from China, where COVID-19 originated, shows that people who have cardiovascular and respiratory conditions caused by tobacco use, or otherwise, are at higher risk of developing severe COVID-19 symptoms . Research on 55 924 laboratory confirmed cases show that the crude fatality rate for COVID-19 patients is much higher among those with cardiovascular disease, diabetes, hypertension, chronic respiratory disease or cancer than those with no pre-existing chronic medical conditions . This demonstrates that these pre-existing conditions may increase the vulnerability of such individuals to COVID-19.
Tobacco use has a huge impact on respiratory health and is the most common cause of lung cancer . It is also the most important risk-factor for chronic obstructive pulmonary disease (COPD), which causes the swelling and rupturing of the air sacs in the lungs, reducing the lung’s capacity to take in oxygen and expel carbon dioxide, and the build-up of mucus, resulting in painful coughing and breathing difficulties   . This may have implications for smokers given that the virus that causes COVID-19 primarily affects the respiratory system often causing mild to severe respiratory damage , which could result in fatality. However, given that COVID-19 is a newly identified disease, the link between tobacco use and the disease needs further documentation and research.
In addition, there is an increased risk of more serious symptoms and death among COVID-19 patients who have underlying conditions, including cardiovascular diseases (CVDs)  . The virus that causes COVID-19 (SARS-CoV-2) is from the same family as MERS-CoV and SARS-CoV, both of which have been associated with cardiovascular damage (either acute or chronic)  . There is also evidence that COVID-19 patients that have more severe symptoms often have heart-related complications . This relationship between COVID-19 and cardiovascular health is important because tobacco use and exposure to second-hand smoke are major causes of CVDs globally . The effect of COVID-19 on the cardiovascular system could thus make pre-existing cardiovascular conditions worse. Additionally, a weaker cardiovascular system among COVID-19 patients with a history of tobacco use could make such patients more vulnerable to severe symptoms, thereby increasing the risk for those patients .