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.
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.
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.
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).
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.
- Satu Strausz
- Tuomo Kiiskinen
- Martin Broberg
- Sanni Ruotsalainen
- Jukka Koskela
- Adel Bachour
- Aarno Palotie
- Tuula Palotie
- Samuli Ripatti
- Hanna M. Ollila