IntroductionDespite the fact that smoking has been identified as a risk factor for respiratory diseases and lung infections, the relationship between smoking and coronavirus severity remains ambiguous. It is believed that smoking is a risk factor for pulmonary infections. However, the effect of smoking on COVID-19 patients is still controversial.ObjectiveThe aim of the study was to identify and analyze the distinct radiological features in COVID-19 patients with different smoking statuses. Additionally, the study sought to examine the association between smoking and the severity of pulmonary changes.MethodsA retrospective cohort study of 111 patients who were referred to Al-Salt/Hussein Hospital, Al-Salt, Jordan, from January to June 2021, with a confirmed COVID-19 diagnosis and smoking status recorded. Patients' demographics, medical history, age, gender, comorbidity, and length of hospitalization were obtained from their medical records.ResultsStudy groups were similar in median age, prevalence of chosen chronic diseases, and median length of hospital stay. Based on the median scores of the radiological findings in each lung lobe, no statistically significant differences were found between the scores and smoking status (p-values of >0.05; Mann-Whitney test).ConclusionSmoking is an independent risk factor for the severity of COVID-19. Smoking has no noticeable impact on interstitial manifestation in COVID-19 patients.