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新冠病毒-19与阻塞性睡眠呼吸暂停:临床表现及对生活质量的影响

Covid-19 and Obstructive Sleep Apnea: The Theatricals and Quality-of-Life Impact.

作者信息

Sudarsan Shyam Sudhakar, Lohith Kumar Manoj Kumar, Bhumireddy Chalamaiahgari Surekha, Kandaswamy Shoba

机构信息

Department of ENT and Head and Neck Surgery, Saveetha Medical College and Hospital, No. 1, Saveetha Nagar, Thandalam, Chennai, Tamil Nadu 602105 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Apr 19;75(3):1-11. doi: 10.1007/s12070-023-03730-4.

Abstract

COVID-19 caused by SARS-CoV2 has reached pandemic proportions. The fear of Covid-19 has deterred many to abandon efforts for seeking timely medical help. In this setting, Obstructive sleep apnea (OSA)-like covid/non-covid cohorts have presented. Atypical pathologies can present like OSA and take the clinician unawares. With this series of misfits suffering silently, it would be unwise to underestimate its impact on quality-of-life (QOL). To determine the effect on quality-of-life by pathologies mimicking OSA and assess Covid-19 as a cause for delayed presentation. This was a prospective cross-sectional study. 127(N). Recent onset of symptoms of OSA. Study duration March 2020 to September 2021. Pittsburgh Sleep Quality Index (PSQI) screening done. Study criteria defined. Sleep parameters calculated. Primary surgical intervention given. Non-responders were put on CPAP therapy. QOL assessment done with sf-36 and SAQLI. Fear of Covid-19 scale (FCV-19S) quantified to study cause for temporal delay. Correlations computed. Level of Evidence-Level 3. 97 candidates completed study. Demographic and anthropometric details noted. Mean range was 43.85 ± 11.39 years. Male predominance. Overall AHI-19.73 ± 8.72. Moderate impact on QOL by sf-36/SAQLI. 78n Primary surgical candidates fared well. Polysomnography (PSG) and Continuous positive airway pressure (CPAP) titration/trial characteristics for 19n available. Statistically significant improvement in QOL after treatment completion. Correlations were meaningful. Body Mass Index (BMI) as a single factor was not influential on OSA-mimickers. Fear of Covid-19 significantly impacted emergency medical aid acquisition. OSA mimicking atypical airway pathologies may need emergent treatment not only from a surgical point-of-view but also from the QOL of the patient. On the contrary, these also unmask sub-clinical OSA, especially in patients with low/normal BMI. This category of recent onset OSA, if fortunately picked up at the earliest possible presentation, may hopefully not go through the significant QOL impact suffered by chronic OSA candidates.

摘要

由严重急性呼吸综合征冠状病毒 2(SARS-CoV2)引起的 2019 冠状病毒病(COVID-19)已达到大流行程度。对 COVID-19 的恐惧使许多人不敢寻求及时的医疗帮助。在这种情况下,出现了类似阻塞性睡眠呼吸暂停(OSA)的 COVID/非 COVID 队列。非典型病理情况可能表现得像 OSA,让临床医生措手不及。面对这一系列默默忍受痛苦的不匹配情况,低估其对生活质量(QOL)的影响是不明智的。为了确定模仿 OSA 的病理情况对生活质量的影响,并评估 COVID-19 作为延迟就诊原因的情况。这是一项前瞻性横断面研究。127 名(N)。近期出现 OSA 症状。研究持续时间为 2020 年 3 月至 2021 年 9 月。进行匹兹堡睡眠质量指数(PSQI)筛查。定义研究标准。计算睡眠参数。给予主要手术干预。无反应者接受持续气道正压通气(CPAP)治疗。使用简短健康调查量表(sf-36)和睡眠呼吸暂停生活质量指数(SAQLI)进行生活质量评估。对 COVID-19 恐惧量表(FCV-19S)进行量化,以研究时间延迟的原因。计算相关性。证据级别为 3 级。97 名候选者完成研究。记录人口统计学和人体测量学细节。平均年龄范围为 43.85±11.39 岁。男性占主导。总体呼吸暂停低通气指数(AHI)为 19.73±8.72。sf-36/SAQLI 对生活质量有中度影响。78 名(n)主要手术候选者情况良好。19 名(n)可获得多导睡眠图(PSG)和持续气道正压通气(CPAP)滴定/试验特征。治疗完成后生活质量有统计学上的显著改善。相关性有意义。体重指数(BMI)作为单一因素对模仿 OSA 的情况没有影响。对 COVID-19 的恐惧显著影响了紧急医疗救助的获取。模仿非典型气道病理情况的 OSA 不仅从手术角度可能需要紧急治疗,而且从患者生活质量角度也需要。相反,这些情况也会揭示亚临床 OSA,尤其是在体重指数低/正常的患者中。这类近期出现的 OSA,如果幸运地在最早出现时被发现,有望不会经历慢性 OSA 患者所遭受的显著生活质量影响。

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