Sleep apnoea is a risk factor for severe COVID-19

Author:

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

Abstract

BackgroundObstructive 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.MethodsOSA 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.ResultsWe 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).ConclusionRisk 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.

Funder

AstraZeneca UK Ltd

Merck Sharp & Dohme Corp

Genentech Inc

Academy of Finland

Signe and Ane Gyllenberg foundation

Yrjö Jahnsson foundation

Celgene Corporation

Sigrid Juselius Foundation

Maze Therapeutics Inc

Pfizer Inc

Sydäntutkimussäätiö

Sanofi US Services Inc

GlaxoSmithKline

HUCH research grant

Instrumentarium science foundation

Oskar Öfflund foundation

Biogen MA Inc

University of Helsinki HiLIFE Fellow and Grand Challenge grants

Academy of Finland Center of Excellence in Complex Disease Genetics

Celgene International II Sàrl

AbbVie Inc

Business Finland

Janssen Biotech Inc

Academy of Finland Covid-19 research funding

Juho Vainio Foundation

Publisher

BMJ

Subject

Pulmonary and Respiratory Medicine

Reference20 articles.

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2. Estimating the burden of SARS-CoV-2 in France

3. Finnish Institute for Health and Welfare . Infectious diseases and vaccinations. Available: https://thl.fi/en/web/infectious-diseases-and-vaccinations/what-s-new/coronavirus-covid-19-latest-updates/situation-update-on-coronavirus

4. Acute respiratory failure in COVID-19: is it “typical” ARDS?

5. COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted?;Fan;Lancet Respir Med,2020

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