Sleep Apnea patients are 5X more likely to have a COVID-19 infection requiring hospitalization

Created September 2020

Sleep apnoea is a risk factor for severe COVID-19

medRxiv doi: https://doi.org/10.1101/2020.09.26.20202051. preprint

Satu Strausz, Tuomo Kiiskinen, Martin Broberg, Sanni Ruotsalainen, Jukka Koskela, Adel Bachour, Aarno Palotie, Tuula Palotie, Samuli Ripatti, Hanna M Ollila

Many health problems, such as Sleep Apnea in this case, which are associated with low vitamin D are also risk Factors for COVID-19 --- 1. High Risk category listing contains the following {include} --- 1. Sleep category starts with {include} - - - - - - - - - * The worse the sleep apnea, the lower the vitamin D levels – meta-analysis 2017, 2020 * Sleep Apnea patients – 98 percent had low vitamin D – Feb 2016 * 10 VitaminDWiki page titles contained SLEEP APNEA as of June 2021 --- 1. Diabetes category starts with the following {include} - - - - - - - - - * Most Diabetics helped by Vitamin D (90 percent are deficient) – Nov 2019 * Diabetes helped by 5,000 IU of Vitamin D – RCT Sept 2019 * Type 1 Diabetes is prevented and treated by Vitamin D – review of 16 studies – Sept 2019

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Objective: To investigate if obstructive sleep apnoea (OSA) is an independent risk factor for severe COVID-19. To examine whether the risk for contracting COVID-19 is elevated among OSA patients.

Design and setting: Registry based retrospective case-control study using Finnish nationwide health registries and the FinnGen Study cohort. Participants: Information regarding OSA diagnosis and COVID-19 infection was extracted from the FinnGen study (N=260,405) with a total of 305 patients who had a recorded PCR-validated COVID-19 infection including 26 (8.5%) individuals who were also OSA patients. Severe COVID-19 (N=83, 27.2%) was defined as an infection requiring hospitalization. Among the hospitalized individuals there were 16 (19.3%) with OSA diagnosis. In addition, we also included in our analysis previously reported risk factors for both severe COVID-19 or risk factors and comorbidities for OSA from FinnGen. Main outcome measures: OSA diagnosis, information concerning COVID-19 infection such as hospitalization, were derived from Finnish National Hospital Discharge Registry, Causes of Death Registry and the National Infectious Diseases Registry.

Results: We show that OSA is a risk factor for COVID-19 hospitalization independent from age, sex, body mass index (BMI), hypertension, diabetes, coronary heart disease (CHD), asthma and chronic obstructive pulmonary disease (COPD), (p-unadjusted=1.04x10 -4, OR-adjusted= 5.24 [95%CI 1.33 to 23.43], p-adjusted=0.022). OSA was not associated with the risk of contracting COVID-19 (p=0.49).

Conclusion: While an OSA patients risk of contracting COVID-19 is the same as non-OSA individuals, the OSA patients have a five-fold risk to be hospitalized when affected by COVID-19 than non-OSA individuals. Our findings suggest that, in assessment of patients with suspected or confirmed COVID-19 infection, OSA needs to be recognized as one of the comorbidity risk factors for developing a severe form of the disease.

Tags: Sleep Virus