Obstructive sleep apnea is an independent risk factor for severe COVID-19: a population-based study

Sleep

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Rögnvaldsson, Kristján Godsk¹  Eyþórsson, Elías Sæbjörn²  Emilsson, Össur Ingi¹  Eysteinsdóttir, Björg⁴  Pálsson, Runólfur¹  Gottfreðsson, Magnús¹  Guðmundsson, Gunnar¹  Steingrímsson, Vilhjálmur¹ 

[1] Faculty of Medicine, University of Iceland;Internal Medicine and Emergency Services, Landspitali – The National University Hospital of Iceland;Division of Respiratory, Allergy and Sleep Research, Uppsala University;Division of Respiratory Medicine and Sleep, Landspitali – National University Hospital of Iceland;Division of Infectious Diseases, Landspitali – National University Hospital of Iceland

关键词: COVID-19;    comorbidities;    hospitalization;    obstructive sleep apnea;    positive airway pressure treatment;   

DOI  :  10.1093/sleep/zsab272

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Study Objectives Obstructive sleep apnea (OSA) has been proposed as a risk factor for severe COVID-19. Confounding is an important consideration as OSA is associated with several known risk factors for severe COVID-19. Our aim was to assess the association of OSA with hospitalization due to COVID-19 using a population-based cohort with detailed information on OSA and comorbidities.Methods Included were all community-dwelling Icelandic citizens 18 years of age and older diagnosed with SARS-CoV-2 infection in 2020. Data on demographics, comorbidities, and outcomes of COVID-19 was obtained from centralized national registries. Diagnosis of OSA was retrieved from the centralized Sleep Department Registry at Landspitali – The National University Hospital. Severe COVID-19 was defined as the composite outcome of hospitalization and death. The associations between OSA and the outcome were expressed as odds ratios (OR) with 95% confidence intervals (95% CI), calculated using logistic regression models and inverse probability weighting.Results A total of 4,756 individuals diagnosed with SARS-CoV-2 infection in Iceland were included in the study (1.3% of the Icelandic population), of whom 185 had a diagnosis of OSA. In total, 238 were hospitalized or died, 38 of whom had OSA. Adjusted for age, sex, and BMI, OSA was associated with poor outcome (OR 2.2, 95% CI 1.4–3.5). This association was slightly attenuated (OR 2.0, 95% CI 2.0, 1.2–3.2) when adjusted for demographic characteristics and various comorbidities.Conclusions OSA was associated with twofold increase in risk of severe COVID-19, and the association was not explained by obesity or other comorbidities.

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