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

Hu, Mengke; Han, Xueya; Ren, Jiahao; Wang, Yadong; Yang, Haiyan

doi:10.1016/j.smrv.2022.101624

Cited by 17 publications

(13 citation statements)

References 20 publications

(28 reference statements)

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“…Passend dazu zeigt eine zum Zeitpunkt dieses Reviews als Preprint vorliegende Studie an über 500.000 Menschen zweier bevölkerungsbasierter Kohorten (UK Biobank und FinnGen), dass eine vorbestehende Insomnie einen kausalen Risikofaktor für eine Erkrankung an einem respiratorischen Infekt einschließlich COVID-19 und einen schweren COVID-19-Verlauf darstellt [ 32 ]. Auch eine chronische Schlafstörung in Form eines Schlafapnoesyndroms stellt gemäß einer quantitativen Metaanalyse einen unabhängigen Risikofaktor für einen fatalen Ausgang einer COVID-19-Infektion dar [ 33 ]. Der Zusammenhang zwischen Schlafqualität und COVID-19-Outcome ist zudem Gegenstand eines systematischen Reviews [ 34 ].…”

Section: Schlafstörungenunclassified

Kognitive Störungen und Schlafstörungen bei Long-COVID

2022

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Hintergrund In den letzten 2 Jahren der COVID-19(„coronavirus disease 2019“)-Pandemie ist das Wissen um Langzeitfolgen der Erkrankung, das sog. „Long-COVID“, rapide gewachsen. Es bleiben jedoch noch viele Fragen offen, v. a. was die Ursachen überdauernder Beschwerden und ihre Prognose betrifft. Kognitive Störungen und Schlafstörungen gehören zu den häufig beklagten Beschwerden. Beide gehen mit starkem Leidensdruck und deutlicher Alltagsbeeinträchtigung einher. Ziel der Arbeit Wie ist die Datenlage zum Auftreten kognitiver Störungen und Schlafstörungen bei Long-COVID? Welches sind Einflussfaktoren und was ist bekannt zum Verlauf und zu möglichen zugrunde liegenden Mechanismen? Welche Therapieoptionen gibt es? Material und Methode In einem narrativen Review werden die wichtigsten Befunde zu kognitiven Störungen und Schlafstörungen bei Long-COVID dargestellt. Es wird ein Überblick gegeben über die Kohortenstudien mit Daten zu Prävalenz und Einflussfaktoren beider Symptomkomplexe. Es werden derzeitige Kenntnisse und Hypothesen zu pathophysiologischen Mechanismen dargestellt und ein Ausblick auf Behandlungsansätze gegeben. Ergebnisse Etwa ein Fünftel der Betroffenen berichtet mehr als 3 Monate nach einer SARS-CoV-2(„severe acute respiratory syndrome coronavirus 2“)-Infektion über kognitive Einschränkungen, etwa ein Drittel über Schlafstörungen, wobei es neben insomnischen auch zu hypersomnische Beschwerden kommt. Kognitive Störungen und Schlafstörungen treten bei Betroffenen aller Schweregrade auf. Es gibt Hinweise auf eine Besserung kognitiver Defizite im Verlauf, allerdings sind weitere Längsschnittstudien notwendig. Diskussion Neben der Prognose sind die zugrunde liegenden Krankheitsmechanismen noch unzureichend verstanden. Zudem besteht großer Forschungsbedarf zur Wirksamkeit und zu spezifischen Wirkfaktoren therapeutischer Interventionen .

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Section: Schlafstörungenunclassified

Kognitive Störungen und Schlafstörungen bei Long-COVID

2022

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“…One limitation is that the risk estimates could only be computed in univariate analysis. These data are further supported by the meta-analysis of HU et al [11] including data from 13 studies and 31 933 COVID-19 patients. The mean adjusted effect estimate (EE) for COVID-19-related mortality in OSA patients was 1.56 (95% CI 1.2-2.0) for the entire analysis population.…”

Section: The Relationship Between Sars-cov-2 Infections and Sleep Dis...mentioning

confidence: 53%

“…The overlap of risk factors for severe COVID-19 and OSA, namely Initially, data on the influence of OSA on COVID-19 outcomes were contradictory when confounders like obesity were added in the analysis models [8]. However, recent large studies and meta-analyses suggest that OSA is a mild-to-moderate risk factor for adverse outcomes in COVID-19, including increased rates of hospitalisation and need for intensive care, as well as mortality [3,[11][12][13]. One of the most comprehensive analyses, to date, on factors predicting adverse COVID-19 outcomes was published by BELLOU et al [3].…”

Section: The Relationship Between Sars-cov-2 Infections and Sleep Dis...mentioning

confidence: 99%

Lessons for sleep medicine learned from the COVID-19 pandemic

Grote

2022

Breathe

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During the coronavirus disease 2019 (COVID-19) pandemic, sleep medicine services were dramatically reduced worldwide. Implementation of mitigation strategies was suggested by expert organisations and helped to restart sleep medicine services. Distance communication and monitoring during diagnosis, treatment initiation, and treatment follow-up have been used widely, in particular for patients with sleep apnoea. Follow-up studies demonstrate both advantages and potential disadvantages with the use of these new technologies.Emerging epidemiological evidence suggests that obstructive sleep apnoea may be an independent risk factor for adverse outcome in COVID-19, including an increased risk for hospitalisation and elevated mortality. Experimental studies explaining the underlying mechanisms behind these findings are warranted.

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“…Coincidently, at the time of this publication, over a dozen studies have associated OSA with risk of COVID-19 [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ], and many studies have associated COVID-19 with hypertension [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ] and with preexisting and comorbid anxiety [ 49 , 50 , 51 , 52 , 53 , 54 , 55 ], although some findings of psychiatric disorders in COVID-19 are inconsistent [ 56 ]. Nevertheless, these relationships suggest that a common pathophysiological mechanism may mediate hypertension, anxiety, and OSA with increased risk for CVD and COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Hypertension, Anxiety and Obstructive Sleep Apnea in Cardiovascular Disease and COVID-19: Mediation by Dietary Salt

Brown

2022

Diseases

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This perspective paper used a grounded theory method to synthesize evidence proposing that sodium toxicity from excessive dietary salt intake is a potential common pathophysiological mechanism that mediates the association of hypertension, obstructive sleep apnea, and anxiety with cardiovascular disease and COVID-19. Increased anxiety in these conditions may be linked to a high-salt diet through stimulation of the sympathetic nervous system, which increases blood pressure while releasing catecholamines, causing a “fight or flight” response. A rostral shift of fluid overload from the lower to the upper body occurs in obstructive sleep apnea associated with COVID-19 and cardiovascular disease, and may be related to sodium and fluid retention triggered by hypertonic dehydration. Chronic activation of the renin-angiotensin-aldosterone system responds to salt-induced dehydration by increasing reabsorption of sodium and fluid, potentially exacerbating fluid overload. Anxiety may also be related to angiotensin II that stimulates the sympathetic nervous system to release catecholamines. More research is needed to investigate these proposed interrelated mechanisms mediated by dietary salt. Furthermore, dietary interventions should use a whole-food plant-based diet that eliminates foods processed with salt to test the effect of very low sodium intake levels on hypertension, anxiety, and obstructive sleep apnea in cardiovascular disease and COVID-19.

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

Cited by 17 publications

References 20 publications

Kognitive Störungen und Schlafstörungen bei Long-COVID

Kognitive Störungen und Schlafstörungen bei Long-COVID

Lessons for sleep medicine learned from the COVID-19 pandemic

Hypertension, Anxiety and Obstructive Sleep Apnea in Cardiovascular Disease and COVID-19: Mediation by Dietary Salt

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