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Open Access 07-07-2023 | COVID-19 | Sleep Breathing Physiology and Disorders • Original Article

Association between undiagnosed obstructive sleep apnea and severe course of COVID-19: a prospective observational study

Authors: Natalia Celejewska-Wójcik, Kamil Polok, Karolina Górka, Tomasz Stachura, Aleksander Kania, Paweł Nastałek, Sabina Lichołai, Weronika Zastrzeżyńska, Marek Przybyszowski, Krzysztof Sładek

Published in: Sleep and Breathing | Issue 1/2024

Abstract

Purpose

Obstructive sleep apnea (OSA) is associated with many long-term health consequences. We hypothesized that previously unrecognized and untreated OSA may be associated with more severe respiratory failure in hospitalized patients with COVID-19.

Methods

Patients hospitalized in the Pulmonology Department with confirmed COVID-19, University Hospital in Kraków, Poland, between September 2020 and April 2021 were enrolled. OSA screening questionnaires including Epworth Sleepiness Scale (ESS), STOP-BANG, Berlin questionaire (BQ), OSA-50, and No-SAS were completed. Polygraphy was performed after > 24 h without requirement for supplemental oxygen.

Results

Of 125 patients with median age of 61.0 years, 71% of whom were male. OSA was diagnosed in 103 patients (82%) and was categorized as mild, moderate, and severe in 41 (33%), 30 (24%), and 32 (26%), respectively. Advanced respiratory support was introduced in 85 patients (68%), and 8 (7%) patients eventually required intubation. Multivariable analysis revealed that increased risk of requirement for advanced respiratory support was associated with higher respiratory event index (OR 1.03, 95%CI 1.00 to 1.07), oxygen desaturation index (OR 1.05, 95%CI 1.02 to 1.10), and hypoxic burden (1.02 95% CI 1.00 to 1.03) and lower minimal SpO₂ (OR 0.89, 95%CI 0.81 to 0.98), but not with results of OSA screening tools like BQ score (OR 0.66, 95%CI 0.38 to 1.16), STOP-BANG score (OR 0.73, 95%CI 0.51 to 1.01), NoSAS score (OR 1.01, 95%CI 0.87 to 1.18), or OSA50 score (OR 0.84, 95%CI 0.70 to 1.01).

Conclusion

Previously undiagnosed OSA was common among hospitalized patients who survived the acute phase of COVID-19. The degree of OSA was associated with the severity of respiratory failure.

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Title: Association between undiagnosed obstructive sleep apnea and severe course of COVID-19: a prospective observational study
Authors: Natalia Celejewska-Wójcik
Kamil Polok
Karolina Górka
Tomasz Stachura
Aleksander Kania
Paweł Nastałek
Sabina Lichołai
Weronika Zastrzeżyńska
Marek Przybyszowski
Krzysztof Sładek
Publication date: 07-07-2023
Publisher: Springer International Publishing
Keywords: COVID-19
Sleep Apnea
Non-Invasive Ventilation
Sleep-Related Breathing Disorder
Published in: Sleep and Breathing / Issue 1/2024
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-023-02855-8

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