Smoking is associated with constant cough which is resistant to
oseltamivir therapy for suspected COVID-19
Abstract
Background: Smoking depresses pulmonary immune function and is
a risk factor contracting more serious outcomes among people who become
infected. The association between smoking and persistent respiratory
symptoms which are resistant to oseltamivir for suspected coronavirus
disease 2019 (COVID-19) was evaluated. Methods: A total of 22
COVID-19 suspected medical personnel and their cohabitation families
without hypoxia and lung diseases, who came to the adult fever clinic
from March to September 2020 were studied. All patients received
oseltamivir and antibacterial therapy together. And four patients
suffering from constant cough were started on inhaled ciclesonide 400μg
twice a day for a week. Results: Most of the infected patients
were female [13 (59%)], 2 had diabetes (9%) and 4 hypertension
(18%). The median age was 40 years (interquartile range [IQR]
25–47 years). The study patients were divided into 2 groups;
individuals who currently smoke in 11 patients (current smokers) and
never smoked in 11 (never smokers). Four (36%) of 11 current smokers
experienced constant cough even after oseltamivir administration,
compared with 0% of never smokers (χ 2=4.90;
p<0.05). The cough score decreased from 1.5±0.5 at baseline to
0.3±0.5 during the one week after ciclesonide administration
(p<0.001) and constant cough disappeared in three cases out of
four current smokers. Conclusion: Because current smokers are
at a higher risk to develop constant cough which is resistant to
oseltamivir therapy for suspected COVID-19 as compared to never smokers,
smoking cessation should be recommended at an early stage. Ciclesonide
may improve the constant cough in suspected COVID-19.