Assessment of Obstructive Sleep Apnea in Association with Severity of COVID-19: A Prospective Observational Study

Abstract

Introduction OSA has been postulated to be associated with mortality in COVID-19, but studies are lacking thereof. This study was done to estimate the prevalence of OSA in patients with COVID-19 using various screening questionnaires and to assess effect of OSA on outcome of disease. Methodology In this prospective observational study, consecutive patients with RT-PCR confirmed COVID-19 were screened for OSA by different questionnaires (STOPBANG, Berlin Questionnaire, NoSAS, and Epworth Scale). Association between OSA, outcome (mortality) and requirement for respiratory support was assessed. Results In study of 213 patients; screening questionnaires for OSA [STOPBANG, Berlin Questionnaire (BQ), NoSAS] were more likely to be positive in patients who died compared to patients who survived. On binary logistic regression analysis, age ≥ 55 and STOPBANG score ≥ 5 were found to have small positive but independent effect on mortality even after adjusting for other variables. Proportion of patients who were classified as high risk for OSA by various OSA screening tools significantly increased with increasing respiratory support ( p < 0.001 for STOPBANG, BQ, ESS and p = 0.004 for NoSAS). Conclusion This is one of the first prospective studies of sequentially hospitalized patients with confirmed COVID-19 status who were screened for possible OSA could be an independent risk factor for poor outcome in patients with COVID-19.

Sleep EEG Signatures in COVID-19 Survivors

“…Increased REM density has been associated with depression [ 11 , 24 ]. It may be a physiological marker for severity or poor prognosis in other psychiatric disorders, including relapse in recovering alcoholics, suicidality in schizophrenia, and poor response to PSD or interpersonal psychotherapy in depression.…”

The Endocannabinoid System as Prognostic Biomarker of the Obstructive Sleep Apnea Morbidity in COVID-19-Recovered Individuals

“…Even though many authors have already proposed that COVID-19 might induce sleep disturbances, limited studies have identified in post-infected individuals. In this regard, recent publications have suggested the likely existence of sleep disorders in post-COVID-19-infected subjects leading to highlight the importance of proper medical counselling [ 67 – 69 ]. In sum, although my considerations might be too speculative, the described body of evidence allows me to propose the study of the components of the endocannabinoid system as diagnostic tool of OSA morbidity in recovered subjects from COVID-19.…”

Significant association of obstructive sleep apnoea with increased risk for fatal COVID-19: A quantitative meta-analysis based on adjusted effect estimates

“…In this paper, the authors descriptively reviewed the potential relationship between obstructive sleep apnoea (OSA) and the risk for mortality among patients with coronavirus disease 2019 (COVID-19), but failed to quantitatively address this association. To our knowledge, some original studies reported that OSA was significantly linked to an elevated risk for fatal COVID-19 ( 2 , 3 , 4 ), while some others observed non-significant relationship between OSA and fatal COVID-19 ( 5 , 6 , 7 ). Therefore, there is an urgent need to evaluate the association of OSA with fatal COVID-19 by performing a quantitative meta-analysis.…”