Association of clinically significant obstructive sleep apnoea with risks of contracting COVID-19 and serious COVID-19 complications: a retrospective population-based study of health administrative data

Cross-sectional studies suggest that obstructive sleep apnea (OSA) is a potential risk factor for incident COVID-19 infection, but longitudinal studies are lacking. In this study, two surveys from a large general population cohort, the COVID-19 Outbreak Public Evaluation (COPE) Initiative, undertaken 147 +/- 58 days apart were analyzed to determine whether the pre-existing OSA was a risk factor for the incidence of COVID-19. Of the 24,803 respondents completing the initial survey, 14,950 were negative for COVID-19; data from the follow-up survey were available for 2,325 respondents. Those with incident COVID-19 infection had a slightly higher prevalence of OSA (14.3 vs. 11.5%, p=0.068). Stratification by treatment status revealed that those untreated for their OSA were at greater risk for developing COVID-19 infection (OSA Untreated, 14.2 vs. 7.4%, p<0.05). In a logistic regression model adjusted for comorbidities, demographic and socioeconomic factors and the interaction between vaccination status and OSA, incident COVID-19 infection was 2.15 times more likely in those with untreated OSA (aOR: 2.15, 95% CI: 1.18-3.92, p<0.05). Stratification by treatment status revealed only untreated OSA participants were at greater risk for COVID-19 (aOR: 3.21, 95% CI: 1.25-8.23, p<;0.05). The evidence from this study confirms untreated OSA as a risk factor for acquiring COVID-19 infection and highlights the importance of actively treating and managing OSA as a preventative mechanism against COVID-19 disease.

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Association between obstructive sleep apnea (OSA) and COVID‐19 severity

Nassi‐Liberman,

Oberman,

Strahl

et al. 2024

Journal of Sleep Research

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SummaryObstructive sleep apnea and sleep‐related hypoxia have been associated with higher rates of hospitalization and mortality among patients with Coronavirus disease 2019 (COVID‐19). We further explored the association between obstructive sleep apnea, COVID‐19 severity and related mortality. In addition, we examined the effects of clinical and demographic parameters on COVID‐19. In this retrospective study, we included adult patients who were diagnosed with COVID‐19 prior to the Omicron variant identification. We compared the severity of COVID‐19 and mortality with the diagnosis of obstructive sleep apnea. The study population included 44,275 patients who tested positive for COVID‐19. Of these, 97% had mild or asymptomatic disease, 1.2% had moderate disease, and 1.8% had severe disease. Obstructive sleep apnea was diagnosed in 980 (2.2%) patients. In a multivariate analysis, obstructive sleep apnea diagnosis increased the risk of severe COVID‐19 by 1.6 (95% confidence interval: 1.1–2.4) compared with mild disease. However, no increase in mortality was associated with obstructive sleep apnea. Interestingly, patients with moderate and high socioeconomic status had a 1.6 times higher risk for severe COVID‐19 than patients from the low socioeconomic status group (95% confidence interval: 1.2–2.1 and 95% confidence interval: 1.1–2.3, respectively). The risk of dying due to COVID‐19 was 1.6 (95% confidence interval: 1.1–2.5) and 3.1 (95% confidence interval: 1.8–5.3) times higher in patients with medium and high socioeconomic status, respectively, compared with patients with low socioeconomic status. Diagnosis of obstructive sleep apnea was found to be an independent risk factor for severe COVID‐19. The higher the socioeconomic status, the higher the risk of severe COVID‐19 morbidity and mortality.

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Association of clinically significant obstructive sleep apnoea with risks of contracting COVID-19 and serious COVID-19 complications: a retrospective population-based study of health administrative data

Cited by 7 publications

References 45 publications

Difficulties and countermeasures in the field of sleep medicine during the pandemic

Difficulties and countermeasures in the field of sleep medicine during the pandemic

Obstructive Sleep Apnea is a Risk Factor for Incident COVID-19 Infection

Association between obstructive sleep apnea (OSA) and COVID‐19 severity

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