Open Access Maced J Med Sci. 2021 Mar 04; 9(T4):111-117. 111 Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2021 Mar 04; 9(T4):111-117. https://doi.org/10.3889/oamjms.2021.5757 eISSN: 1857-9655 Category: T4 - Thematic Issue “Contribution of Nurses on Sustainable Development Goals (SDGs)” Section: Public Health Disease Control Tobacco Use and the Risk of Sufering from COVID-19 Dianita Sugiyo 1,2 *, Ralalicia Limato 3,4 , Saskia Dyah Handari 5,6 1 Department of Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Indonesia; 2 Muhammadiyah Steps, Universitas Muhammadiyah Yogyakarta, Indonesia; 3 Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia; 4 Centre for Tropical Medicine and Global Health, Nufeld Department of Medicine, University of Oxford, Oxford, UK; 5 Department of Cardiology, Medical School, Ciputra University, Surabaya, Indonesia; 6 Department of Cardiology, Siloam Hospital, Surabaya, Indonesia Abstract BACKGROUND: Coronavirus disease (COVID-19) has become a global pandemic and is confrmed worldwide to cause a high mortality rates; as of the April 23, 2020, over 189,000 deaths have occurred in 2,700,800 COVID-19 cases. However, it appears that little consideration has been given to smokers and the users of tobacco-related products relative to the impact of the virus on that particular cohort of patients. AIM: The aim of the study was to commence a narrative review of research and academic articles of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence related to cigarette smoking and the consumption of tobacco-related products. METHODS: The study involved evidence-based publication searches on ProQuest and EBSCOhost databases informed by a number of keywords. The additional data were obtained from relevant journals searched manually, as well as following up references or primary articles. The search was conducted from April 23 to 24, 2020, adopting the use of several terms, such as “tobacco use” AND “COVID”, “tobacco use” AND “SARS-CoV-2”, “smokers” AND “COVID”, “cigarette” AND “SARS-CoV-2”, and “tobacco use” AND COVID-19 AND sars-cov-2. RESULTS: Several studies (n = 8) confrmed that conventional smoking and electronic cigarette use correlated with the decline of the human immune system and the feasibility of infection. The second group of evidence (n = 9) explored higher Angiotensin-converting enzyme 2 among smokers, as the binding sites of SARS-COV-2. CONCLUSION: Tobacco use among smokers and former smokers is signifcantly correlated to the decline in the status of the human immune system and worsen the disease prognosis. In addition, smoking status is associated with a greater likelihood of smokers being infected with SARS-COV-2; a condition that can further develop into coronavirus disease. Edited by: Sasho Stoleski Citation: Sugiyo D, Limato R, Handari SD. Tobacco Use and the Risk of Sufering from COVID-19. Open Access Maced J Med Sci. 2021 Mar 04; 9(T4):111-117. https://doi.org/10.3889/oamjms.2021.5757 Key words: Angiotensin-converting enzyme 2 receptor; Cigarette; COVID-19; Respiratory virus epidemics; Smoking *Correspondence: Dianita Sugiyo, School of Nursing, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Indonesia. E-mail: dianita.sugiyo@umy.ac.id Received: 20-Jan-2021 Revised: 19-Feb-2021 Accepted: 22-Feb-2021 Copyright: © 2021 Dianita Sugiyo, Ralalicia Limato, Saskia Dyah Handari Funding: This research did not receive any fnancial support. Competing Interest: The authors have declared that no competing interest exists Open Access: This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 International License (CC BY-NC 4.0) Introduction At present, global attention has been directed toward the disease of coronavirus (COVID-19), a respiratory infection lead by coronavirus 2 (severe acute respiratory syndrome coronavirus 2 [SARS- CoV-2]) [1] and resulting a respiratory syndrome in severe and acute condition. This illness case was detected frst at the end of 2019, specifcally December, in district of Wuhan, China; after which the virus spread rapidly over 27 countries [2]. By identifying the global impact, on January 30, 2020, the World Health Organization (WHO) stated that the outbreak of the disease was resulting from coronavirus was a global health emergency [3], [4]. It is reported that the disease caused the high mortality rate. This respiratory infection caused death above 2858 cases, and infected patients more than 83,652 cases globally. This COVID-19 led to the worst mortality rate in Wuhan [3]. The respiratory infections, such as mild- to-severe cold, were predominantly transferred by coronavirus as pathogens among humans and animals. These pathogens have been known to cause global respiratory diseases, labeled as “SARS” (SARS-CoV) and specifcally in the Middle East as Middle East respiratory syndrome-CoV [3], [5]. Compared to the two previous widespread respiratory diseases cited above, the early stage atypical symptoms of some COVID-19 patients lead this disease to be proven more deadly [3] than the two preceding it. Given the fact that no COVID-19 treatment, with specifc antiviral medication or vaccine has been efectively validated, the most valuable thing would be a therapy to support a delay in the symptoms which, in turn, could protect an individual’s vital organs [3]. The respiratory droplets produced when people are sneezing, coughing, and exhaling are possibly transmitted through direct interaction among such people [1]. The high fatalities among smokers in China, as the epicenter of pandemic outbreak, were likely due to the high smoking rates among males in the country; around 50% of the total population [6]. On the other hand, although all the adverse health impact are enhanced by tobacco use, both smoke