Infectious Disease

Poor medical outcomes in high-risk sleep apnea sufferers, COVID-19

March 09, 2021

2 min read

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Peker does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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Patients with high-risk obstructive sleep apnea and COVID-19 may have an increased risk of delayed recovery, clinical deterioration, and need for supplemental oxygen compared to low-risk patients with OSA, researchers reported.

The multicenter, prospective OSACOVID-19 observational cohort study included 320 patients (mean age 53.2 years; 45.9% women) with confirmed COVID-19 in three hospitals in Istanbul from March to June 2020. The Berlin questionnaire was used to determine whether patients had high risk OSA or low risk OSA. The researchers collected data on modified high-risk OSA scores based on snoring patterns, breathing pauses, and morning / day sleepiness.

The data was provided by Peker Y et al. Ann Am Thorac Soc. 2021; doi: 10.1513 / AnnalsATS.202011-1409OC.

The primary outcome was clinical improvement, which was defined as the decline in two categories on a scale of seven categories ranging from discharge with normal activity to death on days 7, 14, 21, and 28. Secondary outcomes included clinical deterioration, hospitalization, and ancillary oxygen and critical care outcomes.

Based on the Berlin questionnaire, 121 patients (37.8%) were classified as known (n = 3) or high-risk OSA (n = 118), and of these, 70 (21.9%) had modified high-risk OSA.

Two hundred and forty-two patients had to be hospitalized. Clinical improvement within 2 weeks was seen in 75.4% of patients with modified high-risk OSA compared to 88.4% of patients with modified low-risk OSA (P = 0.014).

Modified high-risk OSA was associated with clinical worsening (adjusted HR = 1.55; 95% CI, 1-2.39) and the need for supplemental oxygen (OR = 1.95; 95% CI, 1.06-3 , 59) in the overall cohort, including patients in hospital and not hospitalized.

Modified high-risk OSA (aOR = 0.42; 95% CI, 0.19-0.92) and male sex (OR = 0.39; 95% CI, 0.17-0.86) were predictors of delayed clinical improvement in multivariate regression analyzes. Snoring patterns, particularly louder snoring, predicted delayed clinical improvement, deterioration, the need for hospitalization, and the need for supplemental oxygen and critical care.

“The COVID-19 pandemic is now urging the need for new approaches that go beyond the polysomnographic requirements for the treatment of OSA cases worldwide,” said Dr. med. Yüksel Peker, professor in the Department of Pulmonary Medicine at Koç University Medical Faculty at Koç University Hospital in Istanbul, and colleagues wrote in the annals of the American Thoracic Society. “The further follow-up of the current sample with clinical, laboratory and radiological examinations as well as objective sleep records would provide further insights into the clinical usefulness of the modified Berlin questionnaire as a screening tool during the onset of COVID-19 and in the association between OSA and long-term COVID-19 results. “

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