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Cohorts were matched for current age, age at index event, sex, race, ethnicity, and multiple comorbidities including chronic obstructive pulmonary disease, asthma, diabetic gastroparesis, chronic bronchitis, gastroesophageal reflux disease, chronic rhinitis, postnasal drip, heart failure, tobacco use, overweight status, obesity status, metformin use, insulin use, and angiotensin-converting enzyme inhibitor use

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One explanation is that while antioxidants can initially protect cells, prolonged exposure might deplete intracellular antioxidant reserves and make cells more susceptible to damage