Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Associations Between Obstructive Sleep Apnea (OSA) and COVID-19 Infection and Hospitalization Among U.S. Adults

Stuart F. Quan
* ORCID logo ,
Matthew Weaver
,
Mark Czeisler
,
Laura Barger
,
Lauren Booker
,
Mark Howard
,
Melinda Jackson
ORCID logo ,
Rashon Lane
,
Christine McDonald
,
Anna Ridgers
,
Rebecca Robbins
,
Prerna Varma
,
Shantha Rajaratnam
,
Charles Czeisler
Version 1 : Received: 26 September 2022 / Approved: 26 September 2022 / Online: 26 September 2022 (08:02:12 CEST)

A peer-reviewed article of this Preprint also exists.

Quan SF, Weaver MD, Czeisler MÉ, et al. Associations between obstructive sleep apnea and COVID-19 infection and hospitalization among U.S. adults. J Clin Sleep Med. 2023;19(7):1303–1311. Quan SF, Weaver MD, Czeisler MÉ, et al. Associations between obstructive sleep apnea and COVID-19 infection and hospitalization among U.S. adults. J Clin Sleep Med. 2023;19(7):1303–1311.

Abstract

Background: Medical comorbidities increase the risk of severe COVID-19 infection. In some studies, obstructive sleep apnea (OSA) has been identified as a comorbid condition that is associated with an increased prevalence of COVID-19 infection and hospitalization, but few have investigated this association in a general population. Research Question: In a general population, is OSA associated with increased odds of COVID-19 infection and hospitalization and are these altered with COVID-19 vaccination? Study Design: Cross-sectional survey of a diverse sample of 15,057 U.S. adults Results: COVID-19 infection and hospitalization rates were 38.9% and 2.9% respectively. OSA or OSA symptoms were reported in 19.4%. In logistic regression models adjusted for demographic, socio-economic and comorbid medical conditions, OSA was positively associated with COVID-19 infection (aOR: 1.58, 95%CI: 1.39-1.79) and COVID-19 hospitalization (aOR: 1.55, 95% CI: 1.17-2.05). In fully adjusted models, boosted vaccination status was protective against both infection and hospitalization. Boosted vaccination status attenuated the association between OSA and COVID-19 related hospitalization, but not infection. Participants with untreated or symptomatic OSA were at greater risk for COVID-19 infection; those with untreated, but not symptomatic OSA were more likely to be hospitalized. Interpretation: In a general population sample, OSA is associated with a greater likelihood of having had a COVID-19 infection and a COVID-19 hospitalization with the greatest impact observed among persons experiencing OSA symptoms or who were untreated for their OSA. Boosted vaccination status attenuated the association between OSA and COVID-19 related hospitalization.

Keywords

Obstructive Sleep Apnea; COVID-19; Hospitalization; Infection; Epidemiology

Subject

Medicine and Pharmacology, Pulmonary and Respiratory Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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