Patients with COVID-19 who have obstructive sleep apnea (OSA) have higher mortality and hospital lengths of stay than COVID-19 patients without OSA. Additionally, rates of OSA were found to be similar in patients presenting to the emergency department with and without COVID-19, according to findings published in the journal Sleep and Breathing.    

The current study was conducted at the 2 sites in The Netherlands. The researchers sought to compare the prevalence of OSA in patients with and without SARS-CoV-2 infection who were admitted to the same hospital during the same period of time. They also evaluated the effect of OSA on clinical outcomes associated with COVID-19 infection. The study was conducted during the peak of the first wave of the COVID-19 pandemic in The Netherlands — between March 1, 2020, and May 16, 2020. During this time, all individuals presenting to the ED with any sign of COVID-19 were routinely tested by nasopharyngeal swab for the presence of SARS-CoV-2 infection.

A total of 1884 patients presenting to the ED were enrolled in the study; 723 were diagnosed with COVID-19 and 1161 presented with respiratory symptoms but tested negative for COVID-19. The prevalence of OSA did not differ between the 2 groups (6.8% in the COVID-positive arm vs 5.7% in the COVID-negative arm; P =.230). In the COVID-positive arm, however, the mortality rate was higher among those who also had OSA vs those without OSA (34.7% vs 21.2%, respectively; P =.028). Notably, the increased risk for mortality among patients with comorbid COVID-19 and OSA was independent of body mass index, age, male gender, cardiovascular disease, diabetes, and obstructive lung disease.


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Besides having higher rates of mortality, the percentage of patients admitted to the intensive care unit was higher in the COVID-positive OSA group vs the COVID-positive non-OSA group (24.5% vs 13.9%, respectively; P =.044). Similarly, the COVID-positive OSA group also experienced longer hospital lengths of stay (12.6±15.7 days vs 9.6±9.9 days, respectively; P =.049).

The findings from this study demonstrate that OSA should be included in COVID-19 risk factor analyses, said investigators. Clinicians need to be aware of the relationship between OSA and COVID-19 outcomes, they noted, adding that the mechanism underlying this relationship warrants additional exploration.

Disclosure: None of the study authors has declared affiliations with biotech, pharmaceutical, and/or device companies.

Reference                                                                                                                                    

Voncken SFJ, Feron TMH, Laven SAJS, et al. Impact of obstructive sleep apnea on clinical outcomes in patients hospitalized with COVID-19. Sleep Breath. Published online September 24, 2021. doi:10.1007/s11325-021-02476-z

This article originally appeared on Pulmonology Advisor