OSA Risk Factor for Severe COVID-19 & Hospitalization

[TimG]

I just saw this article from last week: https://www.ajmc.com/view/obstructive-s ... plications
"Of the patients requiring hospitalization for severe COVID-19 (n = 91; 36.3% male; mean age, 65.9 years), more than 1 in 5 had OSA (n = 19; 20.9%), which was shown to be associated with COVID-19 hospitalization independent from age, sex, BMI, and comorbidities. However, there was no significant difference in risk for contracting COVID-19 between patients with OSA and those without.

The meta-analysis also showed that among 15,835 control patients with COVID-19, the patients who had OSA and severe cases of COVID-19 (n = 1294) had more than double the risk of hospitalization (odds ratio, 2.37; 95% CI, 1.14-4.95; P = .021)."

In Washington state they are using the CDC Guidelines for higher risk factors to determine priority for getting the vaccine. It has other factors like obesity, COPD and smoking but so far has not considered OSA. Are you seeing OSA included in screening questions in other states? Is there some way to bring this to the attention of the people determining risk factors? My wife does not have OSA but is 65 and will get her vaccine soon. I suspect I will be at the end of the line for the vaccine.

[chunkyfrog]

It was when we signed up.

[Miss Emerita]

Many thanks for the information, TimG. I hope your doctor will pay attention and find a way to give you priority. (I’m assuming you have apnea.)

[elsueno]

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[TimG]

Many thanks for the information, TimG. I hope your doctor will pay attention and find a way to give you priority. (I’m assuming you have apnea.)

I do have OSA. Thanks!

[TimG]

As OP said--They find that OSA doesn't predict a higher chance of getting COVID-19, but that OSA does predict severity (e.g., those requiring hospitalization, mortality, etc). I think it is nice that that they could estimate the influence of OSA independent of all sorts of other variables, such as age, sex, BMI and medical comorbidities.(They used logistic regression). But the fact that these other variables are intercorrelated with the prevalence of OSA means that that 1 in 5 number for OSA specifically isn't as ominous as it sounds.

I think an essential, unanswered question for all of us here would be, 'does CPAP use reduce the severity or incidence of COVID-19 in people with OSA?' 'And if so, does CPAP just reduce the increased risk due to OSA, or could it also reduce the risk of other variables (e.g., age, sex, BMI, medical comorbidities)'. I'm guessing that all that CPAP-related restorative sleep and normal oxygenation (etc) reduces or eliminates the severity of COVID-19 compared to those without OSA. And it wouldn't surprise me if the risk reduction was for more than simple OSA. Looking forward to more studies on this.

First, it would probably only be people who have been diagnosed with OSA that would be counted for the study. I am not sure if we can assume that most of them would be using a CPAP.

On a separate note, I would also imagine that if I get COVID-19 and am using a CPAP it might cause my wife to get it due to higher air pressure. I wonder if someone who has OSA and contracts COVID-19 can have their CPAP in the hospital.

[raisedfist]

I can only imagine if you are hemodynamically unstable due to COVID-19, having OSA just makes it worse. The one "benefit" is that the patient would already be used to CPAP, so if it's needed for oxygenation purposes, it wouldn't be much of a learning curve.

[elsueno]

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[Architect]

I stay away from any articles pertaining to Covid19,. Reason being, I am in category for high risk, been a smoker for 45 years, type II diabetic, no thyroid, fibro, high bp, osa.... since Covid began, I've been out in public daily, came down which I believed were Covid symptoms, coughing, tight chest, etc... felt awful.... Covid test 3 times, results were negative. Diagnosis was sinus infection twice, upper respiratory infection once.

We cannot avoid Covid pandemic, but can do our best to live without getting it.