Fundamentals of Mental Health

Fundamentals of Mental Health

Evaluation of substance abuse and cigarette smoking in patients with COVID-19 and non-COVID-19 disease in Kashan-Iran

Document Type : Research Paper

Authors
Amir Ghaderi 1
Zahra Pilevar 2
Zahra Rasoolian 2
Shaghayegh Keyvandarian 2
Kiomars Cheraghi 2
Mohammd-Javad Azadchehr 3
Fateme Padoei 2
Peyman Mamsharifi 4
Bahador Nemati 2
Heshmatollah Moradpour Ghalerashidi 2
Mohammad Hadi Farahzadi 5
Hamid Reza Banafshe 6
Peyman Esmaili-Shahzade-Ali-Akbari 7
1 Department of Addiction Studies, School of Medical and Clinical Research Development Unit-Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran.
2 Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran.
3 Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.
4 Department of Psychology, Allameh Tabataba'i University, Tehran, Iran.
5 Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
6 Department of Addiction Studies, School of Medical and Clinical Research Development Unit-Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran. Department of Pharmacology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
7 Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran. Department of Addiction Studies, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
10.22038/jfmh.2023.23046
Abstract
Introduction: Coronavirus is one of the biggest health problems in the world. The studies show that smokers or addicts are more vulnerable to the virus. The present study evaluated the frequency of smoking and substance abuse among patients with COVID-19 and other patients.
 
Materials and Methods: In this cross-sectional study in 2021, 1400 participants (Kashan, Iran) were included (700 patients in COVID-19 group and 700 people in non-COVID-19 group). Then, they fulfilled the Addiction Diagnosis Questionnaire (ASSIST), and their addiction was tested with a diagnostic kit. The data were analyzed through independent t-test, Chi-square, Fisher's exact test, and SPSS v.17.
 
Results: The prevalence of smoking and substance abuse in the COVID-19 group was 19.4% and 4.4%, respectively (23.0% and 9.2% in non-COVID-19 group, respectively). No significant differences in smoking frequency were observed between the two groups (P= 0.229). The results showed that the frequency of substance abusers was significantly lower in the COVID-19 group (P= 0.008).
 
Conclusion: The present results showed that the prevalence of smoking among patients with COVID-19 is not significantly different from other patients. Interestingly, the prevalence of substance abuse among participants with COVID-19 was significantly lower than other patients. Since the number of smokers or substance abusers was expected to be higher among patients with COVID-19, the cause of this paradox is unclear, and more studies are needed to clarify its various dimensions.
Keywords
Addiction
COVID-19
Smoking
  1. Hu B, Guo H, Zhou P, Shi Z-L. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol 2021; 19(3): 141-54.
  2. Wei PF, National Health Commission and National Administration of Traditional Chinese Medicine. Diagnosis and treatment protocol for novel coronavirus pneumonia (trial version 7). Chin Med J (Engl) 2020; 133(9): 1087-95. 
  3. Alimohamadi Y, Sepandi M, Taghdir M, Hosamirudsari H. Determine the most common clinical symptoms in COVID-19 patients: A systematic review and meta-analysis. J Prev Med Hyg 2020; 61(3): E304-12.
  4. Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al. Comorbidity and its impact on patients with COVID-19. SN Compr Clin Med 2020; 2(8): 1069-76.
  5. Schlosser A, Harris S. Care during COVID-19: Drug use, harm reduction, and intimacy during a global pandemic. Int J Drug Policy 2020; 83: 102896.
  6. Dubey MJ, Ghosh R, Chatterjee S, Biswas P, Chatterjee S, Dubey S. COVID-19 and addiction. Diabetes Metab Syndr Clin Res Rev 2020; 14(5): 817-23.
  7. Volkow ND. Collision of the COVID-19 and addiction epidemics. Ann Intern Med 2020; 173: 61-2.
  8. Testino G. Are patients with alcohol use disorders at increased risk for Covid-19 infection? Alcohol Alcohol 2020; 55: 344-6.
  9. Becker WC, Fiellin DA. When epidemics collide: Coronavirus Disease 2019 (COVID-19) and the opioid crisis. Ann Intern Med 2020; 173: 59-60.
  10. Vardavas CI, Nikitara K. COVID-19 and smoking: A systematic review of the evidence. Tob Induc Dis 2020; 18: 20.
  11. Patanavanich R, Glantz SA. Smoking is associated with COVID-19 progression: A meta-analysis. Nicotine Tob Res Off J Soc Res Nicotine Tob 2020; 22(9): 1653-6.
  12. Olds JL, Kabbani N. Is nicotine exposure linked to cardiopulmonary vulnerability to COVID-19 in the general population? FEBS J 2020; 287(17): 3651-5.
  13. Leung JM, Yang CX, Tam A, Shaipanich T, Hackett T-L, Singhera GK, et al. ACE-2 expression in the small airway epithelia of smokers and COPD patients: Implications for COVID-19. Eur Respir J 2020; 55(5): 2000688.
  14. Smith JC, Sausville EL, Girish V, Yuan M Lou, Vasudevan A, John KM, et al. Cigarette smoke exposure and inflammatory signaling increase the expression of the SARS-CoV-2 receptor ACE2 in the respiratory tract. Dev Cell 2020; 53(5): 514-29.e3.
  15. Brake SJ, Barnsley K, Lu W, McAlinden KD, Eapen MS, Sohal SS. Smoking upregulates angiotensin-converting enzyme-2 receptor: A potential adhesion site for novel coronavirus SARS-CoV-2 (Covid-19).  J Clin Med 2020; 9(3): 841.
  16. Humeniuk R, Ali R, Babor TF, Farrell M, Formigoni ML, Jittiwutikarn J, et al. Validation of the Alcohol, Smoking And Substance Involvement Screening Test (ASSIST). Addiction 2008; 103(6): 1039-47.
  17. Hooshyari Z, Sadralssadat J, Sadralssadat L. [Estimation of validation and reliability of Screening Test of Tobacco, Alcohol and Addictive Drugs in Iran]. Research in addiction 2013; 7: 37-52. (Persian)
  18. Sheikhi F, Yousefian N, Tehranipoor P, Kowsari Z. Estimation of the basic reproduction number of Alpha and Delta variants of COVID-19 pandemic in Iran. PLoS One 2022; 17(5): e0265489.
  19. Oude Munnink BB, Koopmans M. Tracking SARS-CoV-2 variants and resources. Nat Methods 2023; 20(4): 489-90.
  20. Romero Starke K, Reissig D, Petereit-Haack G, Schmauder S, Nienhaus A, Seidler A. The isolated effect of age on the risk of COVID-19 severe outcomes: A systematic review with meta-analysis. BMJ Glob Health 2021; 6(12): e006434.
  21. Kalantari H, Tabrizi AHH, Foroohi F. Determination of COVID-19 prevalence with regards to age range of patients referring to the hospitals located in western Tehran, Iran. Gene Rep 2020; 21: 100910.
  22. Pinna G. Sex and COVID-19: A protective role for reproductive steroids. Trends Endocrinol Metab 2021; 32(1): 3-6.
  23. Hopkinson NS, Rossi N, El-Sayed-Moustafa J, Laverty AA, Quint JK, Freidin M, et al. Current smoking and COVID-19 risk: Results from a population symptom app in over 2.4 million people. Thorax 2021; 76(7): 714-22.
  24. Usman MS, Siddiqi TJ, Khan MS, Patel UK, Shahid I, Ahmed J, et al. Is there a smoker’s paradox in COVID-19? BMJ Evid Based Med 2021; 26(6): 279-84.
  25. Farsalinos K, Barbouni A, Niaura R. Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option? Intern Emerg Med 2020; 15(5): 845-52.
  26. World Health Organization. Global Adult Tobacco Survey (GATS). Fact sheet China 2010. Available from: https://cdn.who.int/media/docs/default-source/ncds/ncd-surveillance/data-reporting/china/gats/en-tfi-china-gats factsheet-2010.pdf?sfvrsn=df210d51_3&download=true
  27. Farsalinos K, Barbouni A, Poulas K, Polosa R, Caponnetto P, Niaura R. Current smoking, former smoking, and adverse outcome among hospitalized COVID-19 patients: A systematic review and meta-analysis. Ther Adv Chronic Dis 2020; 11: 2040622320935765.
  28. Miyara M, Tubach F, Pourcher V, Morelot-Panzini C, Pernet J, Lebbah S, et al. Low incidence of daily active tobacco smoking in patients with symptomatic COVID-19. Qeios 2020; ID: WPP19W.3.
  29. Wang H, Yu M, Ochani M, Amella CA, Tanovic M, Susarla S, et al. Nicotinic acetylcholine receptor alpha7 subunit is an essential regulator of inflammation. Nature 2003; 421(6921): 384-8.
  30. Akerström S, Mousavi-Jazi M, Klingström J, Leijon M, Lundkvist A, Mirazimi A. Nitric oxide inhibits the replication cycle of severe acute respiratory syndrome coronavirus. J Virol 2005; 79(3): 1966-9.
  31. Mahdavi A, Aliramezany M. Addiction and Covid-19 Disease: Risks and misconceptions. Addict Health 2021; 13(1): 66-7.
  32. Saeedi M, Omrani-Nava V, Maleki I, Hedayatizadeh-Omran AA, Moosazadeh M, et al. Opium Addiction and COVID-19: Truth or false beliefs. Iran J Psychiatry Behav Sci 2020; 14(2): e103509.
  33. Wang QQ, Kaelber DC, Xu R, Volkow ND. COVID-19 risk and outcomes in patients with substance use disorders: Analyses from electronic health records in the United States. Mol Psychiatry 2021; 26(1): 30-9.
  34. Hudzik B, Nowak J, Zubelewicz-Szkodzinska B. Consideration of immunomodulatory actions of morphine in COVID-19 - Short report. Eur Rev Med Pharmacol Sci 2020; 24(24): 13062-4.
  35. Roshanravan N, Ghaffari S, Hedayati M. Angiotensin converting enzyme-2 as therapeutic target in COVID-19. Diabetes Metab Syndr Clin Res Rev 2020; 14(4): 637-9.
  36. Jamali Z, Emamian MH, Hashemi H, Fotouhi A. The association of opioid use disorder and COVID-19, a longitudinal study. Int J Prev Med 2022; 13: 157.
  37. Health Protection Surveillance Centre. Epidemiology of COVID-19 in Ireland daily reports 2020. Available from: https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/casesinireland/archive/dailyepidemiologyofcovid-19inirelandreports2020/
  38. Riahi T, Sadeghzadeh-Bazargan A, Shokri S, Ahmadvand D, Hassanlouei B, Baghestani A, et al. The effect of opium on severity of COVID-19 infection: An original study from Iran. Med J Islam Repub Iran 2021; 35: 115.
  39. Ford R, Bammer G, Becker N. The determinants of nurses’ therapeutic attitude to patients who use illicit drugs and implications for workforce development. J Clin Nurs 2008; 17(18): 2452-62.
Fundamentals of Mental Health
Volume 25, Issue 4
July and August 2023
Pages 263-269