Læknablaðið - des. 2020, Blaðsíða 21

L ÆK N A BL AÐIÐ 2020/106 579
R A N N S Ó K N
doi 10.17992/lbl.2020.12.611
INTRODUCTION: The COVID-19 pandemic has caused public health and economic
turmoil across the globe. Severe COVID-19 disease most often presents with pneu-
monia and complications in acutely ill patients often stem from the lungs. The as-
sociations of lung disease, smoking and e-cigarette use with the incidence and
severity of COVID-19 are unclear on a population level.
METHODS: Data on 1761 patients from the Icelandic outpatient Landspitali COV-
ID-19 Clinic were used. The prevalence of smoking, e-cigarette use and underlying
lung diseases was calculated in the cohort, with stratification based on age groups
and a clinical classification of symptom severity. It was tested whether these prev-
alences differed between age groups and classes of symptom severity.
RESULTS: Most patients were in the age group between 35-54 years of age and a
large majority had mild symptoms at diagnosis. The prevalence of smoking was
6% with the highest prevalence among 35-54 year olds. The prevalence of e-cig-
arette use was 4%. It was most prevalent in the age group between 18-34 years.
There was no difference in the prevalence of smoking or e-cigarette use between
classes of symptom severity. The prevalence of lung disease was 9%. It was higher
among older patients and patients with more severe symptoms.
CONCLUSION: The age distribution and prevalence of lung disease and their risk
factors are described in the context of COVID-19 incidence and symptom severity
in a whole-nation cohort of Icelanders. The cohort is younger and had less severe
symptoms than in many previosly published studies of COVID-19. Interestingly, the
prevalences of smoking and e-cigarette use were lower than in the Icelandic gen-
eral population and they were not associated with symptom severity at diagnosis.
To conclude, the results presented here indicate that underlying lung diseases are
prevalent among people with severe COVID-19 symptoms but fail to demonstrate
an association between cigarette smoking or e-cigarette smoking with COVID-19
severity.
E N G L I S H S U M M A R Y
Gísli Þór Axelsson1,2
Elías Sæbjörn Eyþórsson2
Hrönn Harðardóttir3
Gunnar Guðmundsson1,3
Sif Hansdóttir3
The impact of lung diseases, smoking and e-cigarette use on
the severity of COVID-19 illness at diagnosis
1University of Iceland, Faculty of Medicine 2 Landspitali National University
hospital, Department of Internal Medicine 3.Landspitali National University
Hospital, Department of Respiratory Medicine
Correspondence: Sif Hansdóttir, sifhan@landspitali.is
Key words: COVID-19, Lung diseases, Smoking, Electronic cigarettes
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