Obstructive Sleep Apnea and Risk of COVID-19 Infection, Hospitalization and Respiratory Failure

Abstract

Purpose To study the relationship between OSA and risk of COVID-19 infection and disease severity, identified by the need for hospitalization and progression to respiratory failure. Methods We queried the electronic medical record system for an integrated health system of 10 hospitals in the Chicago metropolitan area to identify cases of COVID-19. Comorbidities and outcomes were ascertained by ICD-10-CM coding and medical record data. We evaluated the risk for COVID-19 diagnosis, hospitalization, and respiratory failure associated with OSA by univariate tests and logistic regression, adjusting for diabetes, hypertension, and BMI to account for potential confounding in the association between OSA, COVID-19 hospitalization, and progression to respiratory failure. Results We identified 9405 COVID-19 infections, among which 3185 (34%) were hospitalized and 1779 (19%) were diagnosed with respiratory failure. OSA was more prevalent among patients requiring hospitalization than those who did not (15.3% versus 3.4%, p < 0.0001; OR 5.20, 95% CI (4.43, 6.12)), and among those who progressed to respiratory failure (19.4% versus 4.5%, p < 0.0001; OR 5.16, 95% CI (4.41, 6.03)). After adjustment for diabetes, hypertension, and BMI, OSA was associated with increased risk for hospitalization (OR 1.65; 95% CI (1.36, 2.02)) and respiratory failure (OR 1.98; 95% CI (1.65, 2.37)). Conclusions Patients with OSA experienced approximately 8-fold greater risk for COVID-19 infection compared to a similar age population receiving care in a large, racially, and socioeconomically diverse healthcare system. Among patients with COVID-19 infection, OSA was associated with increased risk of hospitalization and approximately double the risk of developing respiratory failure.

Obstructive sleep apnea and risk of COVID-19 infection, hospitalization and respiratory failure

“…Maas et al conducted a retrospective study to estimate the risk for coronavirus disease 2019 (COVID-19) infection in patients with obstructive sleep apnea (OSA) and to study the relationship between OSA and COVID-19 disease severity [1]. The researchers concluded that patients with OSA experienced an 8fold greater risk for COVID-19 in comparison to a control group derived from a large patient registry including data from 10 different hospitals.…”

Obstructive sleep apnea (OSA) and outcomes from coronavirus disease 2019 (COVID-19) pneumonia: a systematic review and meta-analysis

“…Unfortunately, until now, the evidence regarding the link between OSA and COVID-19 is still conflicting. Several observational studies showed that the presence of OSA was associated with poor COVID-19 outcomes [ 15 , 16 , 17 ] , but several others showed that OSA did not alter the outcomes of COVID-19 18 , 19 . This article aims to explore and give clear evidence regarding the potential association between OSA and poor outcomes of COVID-19.…”

COVID-Somnia: How the Pandemic Affects Sleep/Wake Regulation and How to Deal with it?

“…Sleep plays an importnat role in regulation of cellular as well as humoral immunity and sleep deprivation can reduce immune response [ 10 ]. Subjects with obstructive sleep apnea have been found to have an increased risk of contracting SARS-CoV-2 infection, getting hospitalized, and developing respiratory failure [ 14 ]. Thus, an adequate amount of optimal quality sleep appears an important factor to counteract infection.…”

“…At a larger level, sleep medicine services have been impacted globally during the COVID-19 pandemic [ 14 – 16 ]. Considering the important association between sleep and SARS-CoV-2 infection, several societies have proposed guidelines to mitigate sleep disorders and using telemedicine facilities to manage patients during the pandemic.…”