Comparing clinical symptoms and short-term side effects of surgery between smokers and non-smokers in COVID-19 patients with orthopedic trauma

 The pneumonia outbreak caused by COVID-19 was reported in December 2019 in Wuhan, China. In Iran, the first case of this outbreak was reported on February 20, 2017, in Qom. Primary manifestations of this disease range from asymptomatic cases to moderate infection of the upper respiratory tract and fatal pneumonia. In addition, we are aware that smoking suppresses the immune system and intensifies inflammatory responses in the lungs. On the other hand, the negative effects of smoking on orthopedic trauma surgeries are not subtle and neglectable. 

 In the present study, data of 31 orthopedic trauma patients with COVID-19 was collected by means of a questionnaire. Studied patients were classified into two groups of smokers and non-smokers: 17 had a history of smoking and 14 had no previous history of smoking. 

 The mean age of the 31 studied patients was 48.41 years, with a minimum of 17 and a maximum of 96 years. The mean age was 43.35 (with the standard deviation of 20.59) years in smokers and 54.57 (with the standard deviation of 22.69) years in non-smokers. Mean age was 56.6 (with the standard deviation of 19.33) years in patients with cough and 40.75 (with the standard deviation of 22.02) years in patients who did not cough. Evaluating need for ICU admission and oxygen therapy showed that 35.3% (6 cases) of smokers and 14.3% (2 cases) of non-smokers needed ICU and 70.6% (12 cases) of smokers and 64.3% (9 cases) of non-smokers needed oxygen therapy. We also found that the mean duration of hospitalization after the surgery was 3.5 (with the standard deviation of 3.37) days in non-smokers and 8.58 (with standard deviation 13/13) days in smokers. 

 According to the results of this article, trauma patients who coughed had a significantly higher average age, but other clinical symptoms were not significantly related to the age of the patients. Although no significant relationship was observed between smoking and orthopedic trauma, the need for ICU and oxygen after surgery as well as time interval between corona diagnosis and surgery were higher in the smoking group in comparison to the non-smoking group. It seems that smoker COVID-19 patients with orthopedic trauma need more attention during hospitalization and surgery as well as after surgery in order to reduce short-term complications and in similar conditions, they may be more likely than non-smokers to have a longer duration of hospitalization. However, more studies with larger sample size and longer follow-up time are required to further evaluate the detrimental effects of smoking.