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Sleep apnoea is a risk factor for severe COVID-19

By Satu Strausz, Tuomo T. J. Kiiskinen, Martin Broberg, Sanni E Ruotsalainen, Jukka T Koskela, Adel Bachour, Finn Gen, Aarno Palotie, Tuula Palotie, Samuli Ripatti, Hanna M Ollila

Posted 28 Sep 2020
medRxiv DOI: 10.1101/2020.09.26.20202051

ObjectiveTo investigate if obstructive sleep apnoea (OSA) is an independent risk factor for severe COVID-19. To examine whether the risk for contracting COVID-19 is elevated among OSA patients. Design and settingRegistry based retrospective case-control study using Finnish nationwide health registries and the FinnGen Study cohort. ParticipantsInformation regarding OSA diagnosis and COVID-19 infection was extracted from the FinnGen study (N=260,405) with a total of 305 patients who had a recorded PCR- validated COVID-19 infection including 26 (8.5%) individuals who were also OSA patients. Severe COVID-19 (N=83; 27.2%) was defined as an infection requiring hospitalization. Among the hospitalized individuals there were 16 (19.3%) with OSA diagnosis. In addition, we also included in our analysis previously reported risk factors for both severe COVID-19 or risk factors and comorbidities for OSA from FinnGen. Main outcome measuresOSA diagnosis, information concerning COVID-19 infection such as hospitalization, were derived from Finnish National Hospital Discharge Registry, Causes of Death Registry and the National Infectious Diseases Registry. ResultsWe show that OSA is a risk factor for COVID-19 hospitalization independent from age, sex, body mass index (BMI), hypertension, diabetes, coronary heart disease (CHD), asthma and chronic obstructive pulmonary disease (COPD), (p-unadjusted=1.04x10-4, OR- adjusted=5.14 [95%CI 1.31 to 22.91], p-adjusted=0.023). OSA was not associated with the risk of contracting COVID-19 (p=0.49). ConclusionWhile an OSA patients risk of contracting COVID-19 is the same as non-OSA individuals, the OSA patients have a five-fold risk to be hospitalized when affected by COVID-19 than non-OSA individuals. Our findings suggest OSA as one of the risk factors for severe COVID-19. While these associations are statistically significant, they would benefit from replication in an independent cohort.

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