Introduction: Smoking and its involvement in acute community-acquired pneumonia have been a controversial topic until now. Our objective was to evaluate the impact of smoking on this disease in terms of clinical severity, complications and mortality.

Methods:A single-center retrospective comparative study conducted at the Ibn Nafis Department, from 2019 to February 2022,including 100 patients hospitalized for acute community-acquired pneumonia.

Results:The mean age of smoking patients was 56±19 years and 59±18 years for non-smokers. A sex ratio was 1.59 for smokers and 1.7 for non-smokers. Smoking was noted in 70 patients with a median consumption of 25 pack-years. The median PSI score was 60.55 (57-134) and 66.7 (58-132) in smokers and non-smokers respectively(p=0.152).Pneumonia infection was confirmed in 7 smokers and 3 non-smoking patients, with a significant difference (p=0.04). No statistically significant correlation was found between smoking and acute community-acquired pneumonia in terms of severity on admission (desaturation, radiological lesions). Complications occurred in 14 patients (14%), dominated by persistent fever and severe sepsis, especially in patients who smoked (6% versus 2%; p=0.02); (2% versus 0; p=0.03).Transfer to the intensive care unit was more frequent in patients who smoked (10.4% vs 7.7%; p=0.02). The use of NIV was more pronounced in the smoking population with a significant result (11.6% vs 0; p=0.02). No statistically significant correlation with mortality and severity at hospital discharge.

Conclusion:Our study confirmed the positive association between smoking and the occurrence of complications during hospitalization for acute community acquired pneumonia.