Sleep Apnea is a Risk Factor for Severe COVID-19

Sleep Apnea is a Risk Factor for Severe COVID-19

A group of Finish and American research study results show that COVID-19 outcome is mediated primarily through respiratory distress. Risk factors for severe COVID-19 have been identified as older age, male sex, obesity, diabetes, cardiovascular disease and poor lung function.6 In addition, other respiratory diseases have been listed as potential contributors for COVID-19 severity. Indeed, there are studies suggesting that obstructive sleep apnoea (OSA) may be a risk factor for severe COVID-19.

Background 

Obstructive sleep apnoea (OSA) is associated with higher body mass index (BMI), diabetes, older age and male gender, which are all risk factors for severe COVID-19.

We aimed to study if OSA is an independent risk factor for COVID-19 infection or for severe COVID-19.

Methods 

OSA diagnosis and COVID-19 infection were extracted from the hospital discharge, causes of death and infectious diseases registries in individuals who participated in the FinnGen study (n=260 405). Severe COVID-19 was defined as COVID-19 requiring hospitalisation. Multivariate logistic regression model was used to examine association. Comorbidities for either COVID-19 or OSA were selected as covariates. We performed a meta-analysis with previous studies.

Results 

We identified 445 individuals with COVID-19, and 38 (8.5%) of them with OSA of whom 19 out of 91 (20.9%) were hospitalised. OSA associated with COVID-19 hospitalisation independent from age, sex, BMI and comorbidities (p-unadjusted=5.13×10−5, OR-adjusted=2.93 (95% CI 1.02 to 8.39), p-adjusted=0.045). OSA was not associated with the risk of contracting COVID-19 (p=0.25). A meta-analysis of OSA and severe COVID-19 showed association across 15 835 COVID-19 positive controls, and n=1294 patients with OSA with severe COVID-19 (OR=2.37 (95% 1.14 to 4.95), p=0.021).

Conclusion 

Risk for contracting COVID-19 was the same for patients with OSA and those without OSA. In contrast, among COVID-19 positive patients, OSA was associated with higher risk for hospitalisation. Our findings are in line with earlier works and suggest OSA as an independent risk factor for severe COVID-19.

Lead Investigator/Researcher

  1. Satu Strausz
  2. Tuomo Kiiskinen
  3. Martin Broberg
  4. Sanni Ruotsalainen
  5. Jukka Koskela
  6. Adel Bachour
  7. FinnGen
  8. Aarno Palotie
  9. Tuula Palotie
  10. Samuli Ripatti
  11. Hanna M. Ollila

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