Observational studies suggest smoking, cannabis use, alcohol consumption, and substance use disorders (SUDs) may impact risk for respiratory infections, including coronavirus 2019 (COVID-2019). However, causal inference is challenging due to comorbid substance use. Using summary-level European ancestry data (>1.7 million participants), we performed single-variable and multivariable Mendelian randomization (MR) to evaluate relationships between substance use behaviors, COVID-19 and other respiratory infections. Genetic liability for smoking demonstrated the strongest associations with COVID-19 infection risk, including the risk for very severe respiratory confirmed COVID-19 (odds ratio (OR) = 2.69, 95% CI, 1.42, 5.10, P -value = 0.002), and COVID-19 infections requiring hospitalization (OR = 3.49, 95% CI, 2.23, 5.44, P -value = 3.74 × 10 −8 ); these associations generally remained robust in models accounting for other substance use and cardiometabolic risk factors. Smoking was also strongly associated with increased risk of other respiratory infections, including asthma-related pneumonia/sepsis (OR = 3.64, 95% CI, 2.16, 6.11, P -value = 1.07 × 10 −6 ), chronic lower respiratory diseases (OR = 2.29, 95% CI, 1.80, 2.91, P -value = 1.69 × 10 −11 ), and bacterial pneumonia (OR = 2.14, 95% CI, 1.42, 3.24, P -value = 2.84 × 10 −4 ). We provide strong genetic evidence showing smoking increases the risk for COVID-19 and other respiratory infections even after accounting for other substance use behaviors and cardiometabolic diseases, which suggests that prevention programs aimed at reducing smoking may be important for the COVID-19 pandemic and have substantial public health benefits. Rosoff, Yoo, and Lohoff perform a large-scale genetic epidemiological analysis using Mendelian Randomization to evaluate possible relationships between smoking and substance use behaviours and risk of respiratory infections. They observed a highly significant association between smoking and several respiratory infections, including COVID-19 infection risk.
【저자키워드】 Risk factors, Influenza virus, Addiction, 【초록키워드】 COVID-19, respiratory infections, public health, Hospitalization, Pneumonia, mendelian randomization, COVID-19 pandemic, Genetic, risk, Substance use disorder, Substance use, smoking, alcohol, observational study, COVID-2019, COVID-19 infection, Respiratory disease, epidemiological, infection risk, Coronavirus 2019, Cardiometabolic risk factors, Bacterial, association, Evidence, Analysis, Odds ratio, Participants, 95% CI, increased risk, other respiratory infections, cardiometabolic diseases, European, robust, multivariable, performed, evaluate, remained, increase, reducing, demonstrated, other respiratory infection, with COVID-19, 【제목키워드】 COVID-19, increased risk, significantly, other respiratory infection,