Yesterday in PLOS One, Israeli researchers report that a high risk of obstructive sleep apnea is associated with severe COVID-19 and longer hospitalization.
The study was based on medical records and outcomes seen among 119 COVID-19 patients who were given questionnaires about sleep quality in the 6 to 8 weeks following hospitalization for the novel coronavirus.
Among the 119 patients, 37 (31.1%) had a documented risk of obstructive sleep apnea (OSA). All patients were seen at the Shaare Zedek Medical Center in Jerusalem from June to November 2020.
Quadruple the risk for severe COVID
Patients with OSA were more likely to be male or older or have a higher body mass index (BMI), higher rate of high blood pressure, and more frequent snoring than patients with low OSA risk. The percentage of patients with severe COVID-19 disease at risk for OSA was significantly higher than that of patients with mild disease (50% vs 22.9%).
After adjusting for BMI, age, high blood pressure, and chronic disease, the odds ratio for severe COVID-19 and OSA was 4.3 (95% confidence interval, 1.2 to 16.0).
Some COVID-19 patients who have not been diagnosed with OSA [obstructive sleep apnea] could still be at high risk for OSA.
"The suggested mechanisms by which OSA increases the risk of poor outcomes from COVID-19 include exacerbation or endothelial dysfunction, inflammation, oxidative stress, microaspiration, and lung injury," the authors said. "We recommend that clinicians be aware that some COVID-19 patients who have not been diagnosed with OSA could still be at high risk for OSA, thus making them prone to severe COVID-19."