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Are men who smoke at higher risk for a more severe case of COVID-19 than women who smoke? A Systematic Review

Background: The novelty of the Covid-19 pandemic is reflected in the lack of literature available for the impact of smoking on the intensity of the COVID-19 clinical manifestations. Our study tries to address this gap. Method: Six cohorts from China were analysed and a crude odds ratio was manually calculated. Results: Patients with a smoking history were approximately 2 times (95% CI= 1.036-1.883) as likely to suffer from severe clinical manifestations of COVID-19 compared to patients without a smoking history. A higher percentage of males suffer more severe symptoms of COVID-19 in comparison to females, but this could be associated with the gender specific smoking trends observed in China. Conclusion: The gender specific smoking trends could be associated with the increased severity of COVID-19 disease manifestations in the male population.