Impact of smoking on COVID-19 outcomes: a HOPE Registry subanalysis.

BACKGROUND: Smoking has been associated with poorer outcomes in relation to COVID-19. Smokers have higher risk of mortality and have a more severe clinical course. There is paucity of data available on this issue, and a definitive link between smoking and COVID-19 prognosis has yet to be established. METHODS: We included 5224 patients with COVID-19 with an available smoking history in a multicentre international registry Health Outcome Predictive Evaluation for COVID-19 (NCT04334291). Patients were included following an in-hospital admission with a COVID-19 diagnosis. We analysed the outcomes of patients with a current or prior history of smoking compared with the non-smoking group. The primary endpoint was all-cause in-hospital death. RESULTS: Finally, 5224 patients with COVID-19 with available smoking status were analysed. A total of 3983 (67.9%) patients were non-smokers, 934 (15.9%) were former smokers and 307 (5.2%) were active smokers. The median age was 66 years (IQR 52.0-77.0) and 58.6% were male. The most frequent comorbidities were hypertension (48.5%) and dyslipidaemia (33.0%). A relevant lung disease was present in 19.4%. In-hospital complications such sepsis (23.6%) and embolic events (4.3%) occurred more frequently in the smoker group (p<0.001 for both). All cause-death was higher among smokers (active or former smokers) compared with non-smokers (27.6 vs 18.4%, p<0.001). Following a multivariate analysis, current smoking was considered as an independent predictor of mortality (OR 1.77, 95% CI 1.11 to 2.82, p=0.017) and a combined endpoint of severe disease (OR 1.68, 95% CI 1.16 to 2.43, p=0.006). CONCLUSION: Smoking has a negative prognostic impact on patients hospitalised with COVID-19.

Quiste de colédoco / Cyst of colédoco

Expone que los quistes de colédoco son una patología muy poco frecuente en cuyos portadores se presenta asociado con otras patologías. La enfermedad quística es rara en países occidentales, prevaleciendo en países orientales como Japón y China., (la dilatación quística de la vía biliar es una patología poco frecuente en nuestro país). Puede ser detectada por ultrasonido, tomografía computada y resonancia magnética, sin embargo, la colangiografía directa percutánea en endoscópica es el método de elección para hacer el diagnóstico. Los síntomas que presentan estos pacientes consisten en dolor en el abdomen superior, a menudo simulando el cólico biliar, ictericia y presencia de un tumor en el hipocondrio derecho a menudo no es factible determinar la presencia de masas abdominales por el intenso peritonismo.