The association between high risk of sleep apnea, comorbidities, and risk of COVID-19: a population-based international harmonized study.
PURPOSE
Obstructive sleep apnea (OSA) may increase the risk of severe COVID-19; however, the level of potential modulation has not yet been established. The objective of the study was to determine the association between high risk of OSA, comorbidities, and increased risk for COVID-19, hospitalization, and intensive care unit (ICU) treatment.


METHODS
We conducted a cross-sectional population-based web survey in adults in 14 countries/regions. The survey included sociodemographic variables and comorbidities. Participants were asked questions about COVID-19, hospitalization, and ICU treatment. Standardized questionnaire (STOP questionnaire for high risk of OSA) was included. Multivariable logistic regression was conducted adjusting for various factors.


RESULTS
Out of 26,539 respondents, 20,598 (35.4% male) completed the survey. Mean age and BMI of participants were 41.5 ± 16.0 years and 24.0 ± 5.0 kg/m2, respectively. The prevalence of physician-diagnosed OSA was 4.1% and high risk of OSA was 9.5%. We found that high risk of OSA (adjusted odds ratio (aOR) 1.72, 95% confidence interval (CI): 1.20, 2.47) and diabetes (aOR 2.07, 95% CI: 1.23, 3.48) were associated with reporting of a COVID-19 diagnosis. High risk for OSA (aOR 2.11, 95% CI: 1.10-4.01), being male (aOR: 2.82, 95% CI: 1.55-5.12), having diabetes (aOR: 3.93, 95% CI: 1.70-9.12), and having depression (aOR: 2.33, 95% CI: 1.15-4.77) were associated with increased risk of hospitalization or ICU treatment.


CONCLUSIONS
Participants at high risk of OSA had increased odds of having COVID-19 and were two times more likely to be hospitalized or treated in ICU.
['Chung|Frances|F|http://orcid.org/0000-0001-9576-3606', 'Waseem|Rida|R|', 'Pham|Chi|C|', 'Penzel|Thomas|T|', 'Han|Fang|F|', 'Bjorvatn|Bjørn|B|', 'Morin|Charles M|CM|', 'Holzinger|Brigitte|B|', 'Espie|Colin A|CA|', 'Benedict|Christian|C|', 'Cedernaes|Jonathan|J|', 'Saaresranta|Tarja|T|', 'Wing|Yun Kwok|YK|', 'Nadorff|Michael R|MR|', 'Dauvilliers|Yves|Y|', 'De Gennaro|Luigi|L|', 'Plazzi|Guiseppe|G|', 'Merikanto|Ilona|I|', 'Matsui|Kentaro|K|', 'Leger|Damien|D|', 'Sieminski|Mariusz|M|', 'Mota-Rolim|Sergio|S|', 'Inoue|Yuichi|Y|', 'Partinen|Markku|M|', '|||']
D000328:Adult D000086382:COVID-19 D000086742:COVID-19 Testing D015897:Comorbidity D003430:Cross-Sectional Studies D003863:Depression D003924:Diabetes Mellitus, Type 2 D005260:Female D006304:Health Status D006801:Humans D008297:Male D008875:Middle Aged D015995:Prevalence D012307:Risk Factors D012737:Sex Factors D020181:Sleep Apnea, Obstructive D012913:Snoring
COVID-19 Obstructive sleep apnea STOP questionnaire Diabetes Depression