Sleep Apnea is Associated with Long COVID Symptoms

According to a research published in the journal Sleep, adults with obstructive sleep apnea (OSA) were more likely to exhibit symptoms of extended COVID than adults without apnea. The findings are based on the National Institutes of Health’s RECOVER (Researching COVID to Enhance Recovery) Initiative.

5% of adults have sleep apnea.

Researchers examined the electronic health records of 2.2 million Americans, both children, and adults, who tested positive for COVID-19 between March 2020 and February 2022. They examined electronic health record codes from three networks to identify patients with preexisting OSA: the National COVID Cohort Collaborative (N3C); the adult-only National Patient-Centered Clinical Research Network (PCORnet); and PCORnet’s pediatric population, which is anchored in PEDSnet, a pediatric learning health system within PCORnet.

OSA was found in 5% of the adults and fewer than 2% of the children in the research.

Following that, the researchers utilized machine learning to measure follow-up symptoms and doctor visits to predict which persons were more likely to have lengthy COVID. Long COVID was suspected in about 5% of adults in the N3C trial with OSA, 17% of adults in PCORnet, and less than 5% of children in PEDSnet, however only those patients in the N3C study were examined at long COVID clinics.

In PCORnet, persistent long-COVID symptoms were observed more than 30 days after initial disease diagnosis, and certain symptoms and conditions, including myocarditis, indicated long COVID in PEDSnet.

If a patient died within 30 days after a positive COVID-19 test, they were excluded.

Long COVID is associated with a 75% increased risk.
The chances ratio for someone with OSA to have lengthy COVID ranged from 1.41 to 3.93. After controlling for other risk variables for extended COVID, such as obesity and age, the odds ratios decreased but remained significant. The biggest effect was reported in the N3C research, where OSA patients were 75% more likely to have lengthy COVID.

The increased odds of having lengthy COVID in PCORnet were 12% if the patient additionally had proven OSA.

“The association was attenuated yet still elevated after successively adjusting for demographic factors, hospitalization, obesity, and comorbidities,” the authors said.

In the N3C research, women had an 89% increased risk of having lengthy COVID if they had OSA, compared to a 59% increased risk for men.

However, when correcting for obesity, the unadjusted risk of OSA and long COVID vanished in children, with no significant difference in the odds of probable long COVID when comparing children with and without OSA (PEDSnet: 1.05; 95% CI, 0.89, 1.24).

Long COVID, apnea, and obesity

The authors said their study shows that the observed risk people with OSA have for developing long COVID “may in part be due to confounding from underlying associations between obesity, or other comorbidities.”

In a press release on the study from the National Heart, Lung, and Blood Institute (NHLBI), senior author Lorna E. Thorpe, PhD, MPH, of New York University’s Grossman School of Medicine said, “Part of the challenge is that many of the risk factors for sleep apnea are also risk factors for COVID-19 outcomes.”

Several critical pieces of data were lacking from the research, according to the authors, including immunization status, race and ethnicity, and an assessment of whether long-COVID symptoms were most typically reported in OSA patients.

“People with obstructive sleep apnea should also keep up with their vaccinations to minimize the risk of infection.”

Nonetheless, they said these findings suggest that patients with OSA be monitored for post-infection symptoms.

“We still have a lot to learn about the long-term effects of this virus, but this study could inform clinical care by identifying patients who may benefit from closer monitoring,” said Marishka K. Brown, PhD, director of the National Center on Sleep Disorders Research at the NHLBI. She was not involved in the study.

“People with obstructive sleep apnea should also keep up with their vaccinations to minimize the risk of infection,” added Thorpe.

Source Link