Objective: This study aimed to compare the serious adverse risk of smoking versus diabetes co-morbid and outcomes of patients with COVID-19. Methods: We designed a cross-sectional, observational follow-up for 284 COVID-19 patients involved healthy patients, smoker, diabetic, and diabetic plus smoker recruited from the first of May 2020 to the twenty-fifth of June 2020. The clinical features, severity, duration and outcome of the disease were analyzed. Results: Of the 284 COVID-19 patients, the median age was 48 years (range 18-80), and 33.80% were female. Common symptoms included fever (85.56%), SOB (49.65%), cough (45.42%), and headache (40.86%). Patients with more than one co-morbidity (diabetes and smoking) presented as severe-critical cases comparing to healthy patients, diabetic, and smoker. Smokers presented in a lower rate of death in comparison to diabetic patients and diabetic + smoking, furthermore, smoking was less risky than diabetes. Although the mortality rate was high in patients with smoker comparing to healthy patients (4.22%, HR 1.358, 95% CI: 1.542-1.100, p = 0.014), it was less than diabetic (7.04%, HR 1.531, 95% CI: 1.668-1.337, p = 0.000), and diabetic plus smoker (10.00%, HR 1.659, 95% CI: 1.763-1.510, p= 0.000). Conclusion: Multiple co-morbidity is closely related to the severity of COVID-19 disease progression and higher mortality rate. Smokers presented as mild cases comparing to diabetic and diabetic + smoking patients, which presented as sever to critical cases. Although a higher death rate in smokers was seen compared to healthy patients, but are less probably comparing to diabetic and diabetic + smoking patients.
Keywords: COVID-19, smoking, diabetic, co-morbidity, mortality rate.
Abbreviations: COVID-19, coronavirus disease; HR, hazard ratio; 95% CI, confidence interval.