The association between high risk of sleep apnea, comorbidities, and risk of COVID-19: a population-based international harmonized study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • for the International COVID Sleep Study (ICOSS) group - (Author)
  • University of Toronto
  • Charité – Universitätsmedizin Berlin
  • Peking University
  • University of Bergen
  • Haukeland universitets­sjukehus
  • Université Laval
  • Medical University of Vienna
  • University of Oxford
  • Uppsala University
  • Northwestern University
  • University of Turku
  • Chinese University of Hong Kong
  • Mississippi State University
  • Baylor College of Medicine
  • University of Montpellier
  • University of Rome La Sapienza
  • IRCCS Fondazione Santa Lucia - Roma
  • Institute of Neurological Sciences of Bologna
  • University of Modena and Reggio Emilia
  • University of Helsinki
  • National Center of Neurology and Psychiatry Kodaira
  • Tokyo Women's Medical University
  • Hopital Hotel-Dieu AP-HP
  • Université Paris Cité
  • Medical University of Gdańsk
  • Onofre Lopes University Hospital
  • Federal University of Rio Grande do Norte
  • Tokyo Medical University
  • Neuropsychiatric Research Institute, Tokyo

Abstract

Purpose: Obstructive sleep apnea (OSA) may increase the risk of severe COVID-19; however, the level of potential modulation has not yet been established. The objective of the study was to determine the association between high risk of OSA, comorbidities, and increased risk for COVID-19, hospitalization, and intensive care unit (ICU) treatment. Methods: We conducted a cross-sectional population-based web survey in adults in 14 countries/regions. The survey included sociodemographic variables and comorbidities. Participants were asked questions about COVID-19, hospitalization, and ICU treatment. Standardized questionnaire (STOP questionnaire for high risk of OSA) was included. Multivariable logistic regression was conducted adjusting for various factors. Results: Out of 26,539 respondents, 20,598 (35.4% male) completed the survey. Mean age and BMI of participants were 41.5 ± 16.0 years and 24.0 ± 5.0 kg/m2, respectively. The prevalence of physician-diagnosed OSA was 4.1% and high risk of OSA was 9.5%. We found that high risk of OSA (adjusted odds ratio (aOR) 1.72, 95% confidence interval (CI): 1.20, 2.47) and diabetes (aOR 2.07, 95% CI: 1.23, 3.48) were associated with reporting of a COVID-19 diagnosis. High risk for OSA (aOR 2.11, 95% CI: 1.10–4.01), being male (aOR: 2.82, 95% CI: 1.55–5.12), having diabetes (aOR: 3.93, 95% CI: 1.70–9.12), and having depression (aOR: 2.33, 95% CI: 1.15–4.77) were associated with increased risk of hospitalization or ICU treatment. Conclusions: Participants at high risk of OSA had increased odds of having COVID-19 and were two times more likely to be hospitalized or treated in ICU.

Details

Original languageEnglish
Pages (from-to)849-860
Number of pages12
JournalSleep and Breathing
Volume25
Issue number2
Publication statusPublished - Jun 2021
Peer-reviewedYes
Externally publishedYes

External IDs

Scopus 85105374593
PubMed 33907966

Keywords

Sustainable Development Goals

Keywords

  • COVID-19, Depression, Diabetes, Obstructive sleep apnea, STOP questionnaire