Du Wei, Xu Hong, Chang Yunqi, Feng Biying, Wang Qiong, Li Weifeng
Department of Respiratory Medicine, General Hospital of Southern Theater Command, Guangzhou, China.
Department of Disease Control and Prevention, General Hospital of Southern Theater Command, Guangzhou, China.
Front Med (Lausanne). 2025 Mar 20;12:1472176. doi: 10.3389/fmed.2025.1472176. eCollection 2025.
Obstructive sleep apnea (OSA) is associated with health complications, but its impact on COVID-19 outcomes is not known. This study investigated the association between OSA and outcomes of hospitalized COVID-19 patients.
The Nationwide Inpatient Sample 2020 was searched for adults hospitalized for COVID-19. The outcomes of interest were in-hospital mortality, non-routine discharge, prolonged length of stay (LOS), and complications. Patients with OSA were matched to those without OSA in a 1:4 ratio using propensity score matching (PSM) according to age, sex, and major comorbidities.
After PSM, there were 54,900 adult COVID-19 patients consisting of 10,980 with OSA and 43,920 without OSA. The mean age was 63.2 years and 62.8% were male. Patients with OSA had higher odds of respiratory failure (adjusted OR [aOR] = 1.20, 95% confidence interval [CI]: 1.14-1.25), heart failure (aOR = 1.71, 95% CI: 1.60-1.82), and arrhythmias (aOR = 1.18, 95% CI: 1.08-1.30). Conversely, OSA was associated with lower odds of cerebrovascular accidents (CVAs) (aOR = 0.71, 95% CI: 0.62-0.81, < 0.001), and a reduced likelihood of in-hospital mortality among patients ≥70 years old (aOR = 0.82, 95% CI: 0.75-0.89, < 0.001) and males (aOR = 0.79, 95% CI: 0.72-0.88, < 0.001), but not females.
OSA is associated with higher risks of respiratory failure, heart failure, and arrhythmias in patients hospitalized for COVID-19. However, patients with OSA who are ≥70 years old and those who are male are less likely to have CVAs and in-hospital mortality. These findings underscore the complex relationship between OSA and COVID-19. As the study focused on hospitalized patients, the findings may not apply to mild or asymptomatic COVID-19 cases. Future research should include community-based cohorts and prospective studies to better understand this association.
阻塞性睡眠呼吸暂停（OSA）与健康并发症相关，但其对新冠病毒病（COVID-19）结局的影响尚不清楚。本研究调查了OSA与COVID-19住院患者结局之间的关联。
在2020年全国住院患者样本中搜索因COVID-19住院的成年人。感兴趣的结局包括院内死亡率、非常规出院、住院时间延长（LOS）和并发症。使用倾向评分匹配（PSM），根据年龄、性别和主要合并症，将OSA患者与无OSA患者按1:4的比例进行匹配。
PSM后，有54900例成年COVID-19患者，其中10980例有OSA，43920例无OSA。平均年龄为63.2岁，男性占62.8%。OSA患者发生呼吸衰竭的几率更高（调整后的比值比[aOR]=1.20，95%置信区间[CI]：1.14-1.25）、心力衰竭（aOR=1.71，95%CI：1.60-1.82）和心律失常（aOR=1.18，95%CI：1.08-1.30）。相反，OSA与脑血管意外（CVA）几率较低相关（aOR=0.71，95%CI：0.62-0.81，P<0.001），并且在≥70岁的患者（aOR=0.82，95%CI：0.75-0.89，P<0.001）和男性患者（aOR=0.79，95%CI：0.72-0.88，P<0.001）中院内死亡的可能性降低，但女性患者并非如此。
OSA与COVID-19住院患者呼吸衰竭、心力衰竭和心律失常的较高风险相关。然而，≥70岁的OSA患者和男性患者发生CVA和院内死亡的可能性较小。这些发现强调了OSA与COVID-19之间的复杂关系。由于该研究聚焦于住院患者，这些发现可能不适用于轻度或无症状的COVID-19病例。未来的研究应纳入基于社区的队列和前瞻性研究，以更好地理解这种关联。
