Affiliation:
1. University of Pennsylvania
2. Geneva University Hospitals and University of Geneva
3. La Tour Hospital
4. Geneva University Hospitals
5. Lausanne University Hospital and University of Lausanne
6. Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes
Abstract
Abstract
Background
This study evaluates the impact of comorbid obstructive sleep apnea (OSA) on coronavirus disease 2019 (COVID-19) acute encephalopathy (AE).
Methods
Between 3/1/2020 and 11/1/2021, 97 consecutive patients were evaluated at the Geneva University Hospitals with a neurological diagnosis of COVID-19 AE. They were divided in two groups depending on the presence or absence of high risk for OSA based on the modified NOSAS score (mNOSAS, respectively ≥8 and <8). We compared patients’ characteristics (clinical, biological, brain MRI, EEG, pulmonary CT). The severity of COVID-19 AE relied on the RASS and CAM scores.
Results
Most COVID-19 AE patients presented with a high mNOSAS, suggesting an underlying OSA (>80%). Patients with a high mNOSAS had a more severe form of COVID-19 AE (84.8% versus 27.8%), longer mean duration of COVID-19 AE (27.9 versus 16.9 days), higher mRS at discharge (≥3 in 58.2% versus 16.7%), and increased prevalence of brain vessels enhancement (98.1% versus 20.0%). Underlying OSA was associated with a 14 fold increased risk of developing a severe COVID-19 AE (OR=14.52).
Discussion
These observations suggest an association between comorbid OSA and COVID-19 AE severity. Comorbid OSA could be a predisposing factor leading to severe COVID-19 AE and consecutive long-term sequalae.
Publisher
Research Square Platform LLC