Associations of sleep and circadian phenotypes with COVID-19 susceptibility and hospitalization: an observational cohort study based on the UK Biobank and a two-sample Mendelian randomization study

Sleep

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Liu, Zheran¹  Luo, Yaxin²  Su, Yonglin³  Wei, Zhigong¹  Li, Ruidan¹  He, Ling¹  Yang, Lianlian¹  Pei, Yiyan¹  Ren, Jianjun⁴  Peng, Xingchen¹  Hu, Xiaolin⁵ 

[1] Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University;Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University;West China Hospital, Sichuan University;Department of Otolaryngology-Head and Neck Surgery, West China Biomedical Big Data Center, West China Hospital, West China Medical School, Sichuan University;West China School of Nursing, West China Hospital, Sichuan University

关键词: Mendelian randomization;    cohort study;    COVID-19;    sleep;   

DOI  :  10.1093/sleep/zsac003

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Study Objectives Sleep and circadian phenotypes are associated with several diseases. The present study aimed to investigate whether sleep and circadian phenotypes were causally linked with coronavirus disease 2019 (COVID-19)-related outcomes.Methods Habitual sleep duration, insomnia, excessive daytime sleepiness, daytime napping, and chronotype were selected as exposures. Key outcomes included positivity and hospitalization for COVID-19. In the observation cohort study, multivariable risk ratios (RRs) and their 95% confidence intervals (CIs) were calculated. Two-sample Mendelian randomization (MR) analyses were conducted to estimate the causal effects of the significant findings in the observation analyses. Odds ratios (ORs) and the corresponding 95% CIs were calculated and compared using the inverse variance weighting, weighted median, and MR-Egger methods.Results In the UK Biobank cohort study, both often excessive daytime sleepiness and sometimes daytime napping were associated with hospitalized COVID-19 (excessive daytime sleepiness [often vs. never]: RR = 1.24, 95% CI = 1.02−1.5; daytime napping [sometimes vs. never]: RR = 1.12, 95% CI = 1.02−1.22). In addition, sometimes daytime napping was also associated with an increased risk of COVID-19 susceptibility (sometimes vs. never: RR = 1.04, 95% CI = 1.01−1.28). In the MR analyses, excessive daytime sleepiness was found to increase the risk of hospitalized COVID-19 (MR IVW method: OR = 4.53, 95% CI = 1.04−19.82), whereas little evidence supported a causal link between daytime napping and COVID-19 outcomes.Conclusions Observational and genetic evidence supports a potential causal link between excessive daytime sleepiness and an increased risk of COVID-19 hospitalization, suggesting that interventions targeting excessive daytime sleepiness symptoms might decrease severe COVID-19 rate.

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