WHAT IS THE RISK OF DEVELOPING A SEVERE FORM OF COVID-19 INFECTION AMONG ADULTS WHO CURRENTLY SMOKE COMPARED TO EX-SMOKERS? A protocol for systematic review and meta-analysis

IntroductionSmoking is one of the lifestyle choices associated with an increased risk of chronic health conditions and poorer COVID-19 outcomes. Because it is known that the lungs recover after quitting smoking, a direct comparison of the severity of COVID-19 infection in current and former smokers needs to be investigated. Methods and analysisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) 2015 Checklist was used. Non-randomized studies will be searched in PubMed, Cochrane CENTRAL library, Embase, and Epistemonikos from December 2019 to the present. Hand-searching of grey literature, key journals, and reference lists will be conducted This review will include studies of current and former smokers, with the main outcome being ICU admission, assisted respiration, or death. Two independent reviewers will select primary studies and abstract data from them. The Newcastle-Ottawa checklist will be used to assess the risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework will be used to assess the quality of cumulative evidence. RevMan 5.4 will be used for data analysis. The I2 statistic will be used to evaluate heterogeneity. For similar studies, the fixed-effect method of a meta-analysis will be used; otherwise, a random-effect model will be used. The qualitative synthesis will be used for studies that are ineligible for the quantitative approach. Ethical consideration and disseminationBecause published data will be reviewed, no ethical approval is required. Our findings will be presented at national and/or international conferences, and they will be published in a peer-reviewed journal. PROSPERO registration number CRD42022368552 ARTICLE SUMMARY Strengths and limitations of this studyO_LIThis is a focused research question comparing the current and ex-smokers risk of contracting the severe form of COVID-19. C_LIO_LIThis systematic review and meta-analysis will provide evidence of the dangers of smoking during the COVID-19 pandemic. C_LIO_LIThe PRISMA-P reporting guidelines were strictly followed while writing this protocol. C_LIO_LIStudy selection will be carried out by two independent reviewers and a third person will intervene if a disagreement arises. C_LIO_LIA potential limitation is that an observational study design will be used in this systematic review. C_LI