Harvard School of Dental Medicine, Boston, MA, United States.
Ministry of Health, Kuwait City, Kuwait.
Front Public Health. 2024 Feb 21;12:1348441. doi: 10.3389/fpubh.2024.1348441. eCollection 2024.
Obstructive sleep apnea (OSA) can adversely affect the immune response through clinical factors such as hypoxia, inflammation, and sleep disturbance. Since SARS-CoV-2 heavily relies on local and systemic host immune responses, this study aims to examine the links between the severity of OSA risk, cytokine levels, and the severity of symptoms associated with SARS-CoV-2 infection.
Saliva and blood samples from 50 COVID-19 patients and 30 non-infected hospital staff members were collected. Using Luminex multiplex analysis, 65 blood and salivary cytokines were examined from the collected samples. Ordinal logistic regression analysis was utilized to examine the association between the self-reported risk of OSA, assessed through the STOP-Bang questionnaire, and the likelihood of experiencing severe symptoms of COVID-19. Mann-Whitney test was then performed to compare the cytokine levels between individuals with moderate to severe risk of OSA to those with a mild risk of OSA.
Ordinal logistic regression analysis revealed that individuals with a moderate to severe risk of OSA were 7.60 times more likely to experience more severe symptoms of COVID-19 compared to those with a mild risk of OSA (OR = 7.60, 95%CI: 3.03, 19.06, < 0.001). Moreover, among COVID-19-positive patients with a moderate to severe risk of OSA, there was a statistically significant negative correlation with serum IL-6 ( < 0.05), Eotaxin (CCL11) ( = 0.04), and salivary MIP-3α/CCL20 ( = 0.04). In contrast, individuals without COVID-19 who had a moderate to severe risk of OSA exhibited a significant positive correlation with serum IL-6 ( = 0.04).
Individuals with moderate to severe risk of OSA were more likely to experience severe COVID-19 symptoms than those with mild risk for OSA. Additional analysis from the present studies revealed distinct patterns of oral and systemic immune responses between individuals with mild and moderate to severe risk of OSA. Findings from the present study underscores the importance of early detection and management of OSA to improve clinical outcomes, particularly when faced with the subsequent superimposed infection such as COVID-19.
阻塞性睡眠呼吸暂停（OSA）可通过临床因素（如缺氧、炎症和睡眠障碍）对免疫反应产生不利影响。由于 SARS-CoV-2 严重依赖于局部和全身宿主免疫反应，本研究旨在探讨 OSA 风险严重程度、细胞因子水平与 SARS-CoV-2 感染相关症状严重程度之间的联系。
收集 50 例 COVID-19 患者和 30 名未感染医院工作人员的唾液和血液样本。使用 Luminex 多重分析检测收集样本中的 65 种血液和唾液细胞因子。采用有序逻辑回归分析，评估通过 STOP-Bang 问卷报告的 OSA 风险与 COVID-19 严重症状发生的可能性之间的关系。然后进行 Mann-Whitney 检验，比较中重度 OSA 风险个体与轻度 OSA 风险个体之间的细胞因子水平。
有序逻辑回归分析显示，与轻度 OSA 风险个体相比，中重度 OSA 风险个体发生 COVID-19 更严重症状的可能性高 7.60 倍（OR=7.60，95%CI：3.03，19.06，<0.001）。此外，在中重度 OSA 风险的 COVID-19 阳性患者中，血清 IL-6（ < 0.05）、Eotaxin（CCL11）（ = 0.04）和唾液 MIP-3α/CCL20（ = 0.04）呈统计学显著负相关。相比之下，中重度 OSA 风险但无 COVID-19 的个体中，血清 IL-6（ = 0.04）呈显著正相关。
与轻度 OSA 风险个体相比，中重度 OSA 风险个体发生 COVID-19 严重症状的可能性更高。本研究的进一步分析揭示了轻度和中重度 OSA 风险个体之间口腔和全身免疫反应的不同模式。本研究的结果强调了早期检测和管理 OSA 的重要性，以改善临床结果，尤其是在面临 COVID-19 等后续叠加感染时。
