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Obstetrician Patji Alnæs-Katjavivi criticizes the National Institute of Public Health assessments on smoking and COVID-19. Now, Chief Physician Kirsten Gravningen of the National Institute of Public Health informs Dagbladet that they are working on a new quick overview of risk factors related to covid-19.
– The latest updated rapid overview of knowledge about covid-19 and risk factors for serious diseases is from May 20, 2020. We are now working on a new rapid research summary where we review peer-reviewed studies that examine the importance of risk factors, including smoking, Gravningen tells Dagbladet.
Review
FHI’s response came as a result of Dagbladet confronting them with criticism of the existing quick overview. It concludes that there is no clear link between smoking and the risk of severe illness and death from COVID-19.
– I am fundamentally critical of the knowledge base of the National Institute of Public Health and their interpretation of the research articles they have selected, obstetrician Patji Alnæs-Katjavivi tells Dagbladet.
In the quick overview, FHI bases its knowledge base on COVID-19 and smoking on three studies. At the time the survey was designed, two of the studies were incomplete. However, at a later date, the relevant studies have been reviewed and published in the journals BMJ and Nature, without the National Institute of Public Health having updated its rapid review.
The studies
Alnæs-Katjavivi explains that when an article was published, the categories for smoking had changed. The article addresses the link between smoking and the risk of severe COVID-19 disease. Alnæs-Katjavivi says that one finds the most significant findings in the large group, where the smoking status is listed as unknown.
However, the second study changed its conclusion since the National Institute of Public Health published the quick overview, according to Alnæs-Katjavivi.
– The incomplete version of the second article shows that smokers have a lower mortality with covid-19 disease than people who have never smoked. While the published version shows that previous smokers with covid-19 have a higher mortality compared to people who have never smoked, and rather that current smokers also have a slightly higher mortality with covid-19 disease compared with people who have never smoked.
Alnæs-Katjavivi says the third study from the Quick Overview has always shown a clearly higher risk of death among smokers who have been diagnosed with COVID-19.
– I would like to ask the Norwegian Institute of Public Health to analyze their own quick overview and assess whether the database is still good enough to be used.
Ask FHI to turn to smokers
NTNU Study
In October, Dagbladet reported on a new study conducted by NTNU researchers in collaboration with British researchers. That study shows that there is a clear link between smoking and an increased risk of severe COVID-19 disease. This is contrary to the current FHI conclusion on the quick overview.
At the time, the secretary general of the Norwegian Cancer Society, Ingrid Stenstadvold Ross, told Dagbladet that they hoped that smoking would be included in the list of FHI risk factors for severe covid-19 disease. Stenstadvold Ross now tells Dagbladet that he supports Alnæs-Katjavivi’s criticism of FHI’s quick overview.
– We share the concern of obstetrician Patji Alnæs-Katjavivi. The researchers behind the study at NTNU believe that smokers should be included in the general description of those most at risk, but the National Institute of Public Health has not followed up. It’s disappointing, he tells Dagbladet.
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FHI responds
FHI’s chief physician, Gravningen, informs Dagbladet that they are familiar with the study at NTNU.
– We are familiar with the study mentioned by NTNU professor Erik Solligård in the media. They analyze the genetic data of the participants using the Mendelian randomization method. It is an interesting study; However, FHI will not change the advice based on a single study, the FHI superior states and continues:
– Smoking increases the risk of cardiovascular disease, cancer and chronic lung disease that are risk factors for the severe course of covid-19. In analyzes adjusting for both smoking and diseases caused by smoking, there have been conflicting findings about smoking as an independent risk factor. Therefore, several studies are needed to clarify that smoking is an independent risk factor, and we are closely monitoring new research in this field.
