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Another factor was the different strains of COVID-19, some with severe symptoms and others showing mild symptoms: Smoking decreases immunity, so the symptoms will increase and for the lungs too because if COVID-19 caused infection in the lungs, this is also a harder problem

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doi: 10.3389/fpubh.2025.1689766 Received 20 August 2025 Revised 05 November 2025 Accepted 17 November 2025 Published 18 December 2025 Volume 13 - 2025 Edited by Jamie Hartmann-Boyce, University of Massachusetts Amherst, United States Reviewed by Faiz Albar Nasution, University of North Sumatra, Indonesia Ricardo De Moraes E