Quan Stuart F, Weaver Matthew D, Czeisler Mark É, Barger Laura K, Booker Lauren A, Howard Mark E, Jackson Melinda L, McDonald Christine F, Ridgers Anna, Robbins Rebecca, Varma Prerna, Rajaratnam Shantha M W, Czeisler Charles A
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.
Division of Sleep Medicine, Harvard Medical School, Boston, MA.
medRxiv. 2024 Aug 16:2024.08.15.24312067. doi: 10.1101/2024.08.15.24312067.
Cross-sectional studies suggest that obstructive sleep apnea (OSA) is a potential risk factor for incident COVID-19 infection, but longitudinal studies are lacking. In this study, two surveys from a large general population cohort, the COVID-19 Outbreak Public Evaluation (COPE) Initiative, undertaken 147 ± 58 days apart were analyzed to determine whether the pre-existing OSA was a risk factor for the incidence of COVID-19. Of the 24,803 respondents completing the initial survey, 14,950 were negative for COVID-19; data from the follow-up survey were available for 2,325 respondents. Those with incident COVID-19 infection had a slightly higher prevalence of OSA (14.3 vs. 11.5%, p=0.068). Stratification by treatment status revealed that those untreated for their OSA were at greater risk for developing COVID-19 infection (OSA Untreated, 14.2 vs. 7.4%, p≤0.05). In a logistic regression model adjusted for comorbidities, demographic and socioeconomic factors and the interaction between vaccination status and OSA, incident COVID-19 infection was 2.15 times more likely in those with untreated OSA (aOR: 2.15, 95% CI: 1.18-3.92, p≤0.05). Stratification by treatment status revealed only untreated OSA participants were at greater risk for COVID-19 (aOR: 3.21, 95% CI: 1.25-8.23, p≤0.05). The evidence from this study confirms untreated OSA as a risk factor for acquiring COVID-19 infection and highlights the importance of actively treating and managing OSA as a preventative mechanism against COVID-19 disease.
横断面研究表明，阻塞性睡眠呼吸暂停（OSA）是感染新型冠状病毒肺炎（COVID-19）的一个潜在风险因素，但缺乏纵向研究。在本研究中，对来自一个大型普通人群队列（COVID-19疫情公众评估（COPE）倡议）、间隔147±58天进行的两项调查进行了分析，以确定既往存在的OSA是否为COVID-19发病的风险因素。在完成初始调查的24803名受访者中，14950人COVID-19检测呈阴性；2325名受访者有后续调查数据。发生COVID-19感染的患者中OSA患病率略高（14.3%对11.5%，p=0.068）。按治疗状态分层显示，未治疗OSA的患者发生COVID-19感染的风险更高（未治疗OSA，14.2%对7.4%，p≤0.05）。在一个针对合并症、人口统计学和社会经济因素以及疫苗接种状态与OSA之间相互作用进行调整的逻辑回归模型中，未治疗OSA的患者发生COVID-19感染的可能性高2.15倍（调整后比值比：2.15，95%置信区间：1.18-3.92，p≤0.05）。按治疗状态分层显示，只有未治疗OSA的参与者发生COVID-19的风险更高（调整后比值比：3.21，95%置信区间：1.25-8.23，p≤0.05）。本研究的证据证实未治疗的OSA是感染COVID-19的一个风险因素，并强调了积极治疗和管理OSA作为预防COVID-19疾病的一种机制的重要性。
