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As more Americans eagerly await their turn to get the COVID-19 vaccine, people are finding that smokers are one of the priority groups for vaccination.
Some disagree with the advice and have expressed their frustrations on social media. But health experts say the rationale is clear.
“I could see why people would think it would be unfair, but smokers are generally at a higher risk of getting sicker when they develop COVID-19,” said Dr. Samuel Kim, thoracic surgeon at Northwestern Medicine in Chicago. .
A study, published Jan.25 in the peer-reviewed journal JAMA Internal Medicine, found that people who smoke or who have smoked in the past are more likely to be hospitalized or die from COVID-19 than people who did not smoke.
“The finding that smoking is associated with an increased risk of poor COVID-19 outcomes is not surprising,” said study co-author Dr. Joe Zein, pulmonologist at the Cleveland Clinic. “Smoking induces structural changes in the airways and compromises people’s ability to develop appropriate immune and inflammatory responses (against infections).”
Smokers are also more likely to suffer from other illnesses such as high blood pressure, coronary heart disease and chronic obstructive pulmonary disease, or COPD, which further increases their risk of poor outcomes, he added.
The Cleveland Clinic study found that COVID-19 patients who smoked more than 30 pack-years (a figure obtained by multiplying the number of packs per day by years of smoking) were 2.25 times more likely hospital admissions and were 1.89 times more likely to die than those who never smoked.
Zein said it was difficult to grasp the link between smoking and worse outcomes from COVID-19 because electronic medical records can misclassify patients. Instead of seeing a patient as a “former smoker” they are sometimes classified as “never smokers”.
Researchers at the University of California, Los Angeles found how smoking worsens COVID-19 infections in a smoker’s airways in a November study published in the peer-reviewed journal Cell Stem Cell.
The group infected cultures exposed to cigarette smoke and identical cultures that were not exposed and saw between two and three times as many infected cells in cultures of smokers.
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Smoking is a major risk factor for bacterial and viral infections. Zein said smoking was associated with a 2-4-fold risk of invasive pneumococcal infection. The risk and severity of influenza are also significantly higher in smokers than in non-smokers, and in developing countries, smoking has been associated with an increased risk of tuberculosis.
“If you think of the airways as the high walls that protect a castle, smoking cigarettes is like creating holes in those walls,” said Dr. Brigitte Gomperts, professor of pulmonary medicine and UCLA Jonsson Comprehensive Cancer member. Center. “Smoking reduces the natural defenses and allows the virus to take hold.”
Kim of Northwestern Medicine said some studies have shown that smoking can also impact the immune system, so the body can’t clear the infection as well as a normal person would. If the COVID-19 infection progresses to severe disease and lung damage, some patients require lung transplantation.
“When you look at these lungs,” he said of the extreme cases of COVID-19, “these are worse than any other lung disease I have ever seen.
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
Patient health and safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial contributions.
This article originally appeared on USA TODAY: CDC prioritizes smokers for COVID vaccine. Health experts explain why.
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