既往存在的睡眠障碍与新型冠状病毒肺炎风险：一项荟萃分析
Pre-existing sleep disturbances and risk of COVID-19: a meta-analysis.
作者信息
Zhou Jiawei, Li Xia, Zhang Ting, Liu Ziyan, Li Peng, Yu Na, Wang Wei
机构信息
Department of Respiratory and Critical Care Medicine, The First Hospital of China Medical University, Shenyang, China.
出版信息
EClinicalMedicine. 2024 Jul 5;74:102719. doi: 10.1016/j.eclinm.2024.102719. eCollection 2024 Aug.
BACKGROUND
Sleep disturbances are widespread but usually overlooked health risk factors for coronavirus disease 2019 (COVID-19). We aimed to investigate the influence of pre-existing sleep disturbances on the susceptibility, severity, and long-term effects of COVID-19.
METHODS
We searched PubMed, Web of Science, and Embase for relevant articles from inception to October 27, 2023 and updated at May 8, 2024. Sleep disturbances included obstructive sleep apnea (OSA), insomnia, abnormal sleep duration, night-shift work, and any other sleep disturbances. Outcomes were COVID-19 susceptibility, hospitalization, mortality, and long COVID. The effect sizes were pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). This study is registered with PROSPERO (CRD42024503518).
FINDINGS
A total of 48 observational studies (n = 8,664,026) were included. Pre-existing sleep disturbances increased the risk of COVID-19 susceptibility (OR = 1.12, 95% CI 1.07-1.18), hospitalization (OR = 1.25, 95% CI 1.15-1.36), mortality (OR = 1.45, 95% CI 1.19-1.78), and long COVID (OR = 1.36 95% CI 1.17-1.57). Subgroup analysis showed that younger individuals with sleep disturbances were associated with higher susceptibility and hospitalization and a lower risk of mortality than older individuals. Males with sleep disturbances were associated with higher mortality. For specific sleep disturbances, the susceptibility and hospitalization of COVID-19 were associated with OSA, abnormal sleep duration, and night-shift work; mortality of COVID-19 was linked to OSA; risk of long COVID was related to OSA, abnormal sleep duration and insomnia.
INTERPRETATION
Pre-existing sleep disturbances, especially OSA, increased the risk of COVID-19 susceptibility, hospitalization, mortality, and long COVID. Age and sex played important roles in the effect of sleep disturbances on COVID-19.
FUNDING
The National Natural Science Foundation of China and the Key Laboratory of Respiratory Diseases of Liaoning Province.
背景
睡眠障碍是广泛存在但通常被忽视的2019冠状病毒病（COVID-19）健康风险因素。我们旨在研究既往存在的睡眠障碍对COVID-19易感性、严重程度和长期影响。
方法
我们检索了PubMed、Web of Science和Embase，查找从创刊至2023年10月27日并于2024年5月8日更新的相关文章。睡眠障碍包括阻塞性睡眠呼吸暂停（OSA）、失眠、睡眠时间异常、夜班工作以及任何其他睡眠障碍。结局指标为COVID-19易感性、住院、死亡率和长期新冠症状。效应量合并为比值比（OR）和95%置信区间（95%CI）。本研究已在PROSPERO注册（CRD42024503518）。
结果
共纳入48项观察性研究（n = 8,664,026）。既往存在的睡眠障碍增加了COVID-19易感性（OR = 1.12，95%CI 1.07 - 1.18）、住院（OR = 1.25，95%CI 1.15 - 1.36）、死亡率（OR = 1.45，95%CI 1.19 - 1.78）和长期新冠症状（OR = 1.36，95%CI 1.17 - 1.57）的风险。亚组分析显示，有睡眠障碍的年轻人与较高的易感性和住院率相关，且死亡率风险低于老年人。有睡眠障碍的男性死亡率较高。对于特定的睡眠障碍，COVID-19的易感性和住院与OSA、睡眠时间异常和夜班工作有关；COVID-19的死亡率与OSA有关；长期新冠症状的风险与OSA、睡眠时间异常和失眠有关。
解读
既往存在的睡眠障碍，尤其是OSA，增加了COVID-19易感性、住院、死亡率和长期新冠症状的风险。年龄和性别在睡眠障碍对COVID-19的影响中起重要作用。
资助
中国国家自然科学基金和辽宁省呼吸疾病重点实验室。
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