Sleep apnea and chronic illness increase long-term COVID-19 risk

CNN
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Adults with obstructive sleep apnea have an average up to 75% increased risk of developing long-term COVID-19 after SARS-CoV-2 infection compared to those without sleep apnea. A new study found that there is.

An analysis of electronic health data on about 1.8 million people found that women with obstructive sleep apnea had an increased risk of up to 89% and men a 59% increased risk.

Obstructive sleep apnea is a potentially dangerous disorder in which breathing stops for about 10 seconds several times during the night due to airway obstruction by heavy or loose soft tissues in the mouth and throat.

A second analysis of the medical records of a small group of 330,000 adults found the risk to be only 12%, according to the study. The study is part of the “Novel Coronavirus Research to Accelerate Recovery.” RECOVER is a National Institutes of Health initiative dedicated to understanding why some people develop long-lasting COVID-19 and how best to detect, treat, and prevent the condition.

Why are the numbers so different? Participants in this large study had additional health concerns and comorbidities, including obesity, diabetes, hypertension and heart disease, said Lorna Thorpe, lead author of the study. Co-leader of the RECOVER Clinical Science Core at NYU Langone Health.

“The range of 12% to 75% is likely due to a combination of different study populations and different levels of comorbidities, but also to differences in the definition of COVID-19 over time.” she said. “Until October 2021, we didn’t even have a valid definition of long-term Covid.

“I think the risk is likely in the middle, but additional research will be needed to figure it out,” added Thorpe, a professor and head of the department of epidemiology at New York University’s Grossman School of Medicine. rice field.

A third analysis of the medical records of 102,000 children with sleep apnea found no correlation between sleep apnea and long-term COVID-19 after multiple confounders. was not “Of course, this is great news,” Thorpe said.

“Using three very large networks of electronic medical records allowed us to do this study three times, which is one of the strengths of this study,” she added. “This study is the first collaborative study of this focus and scale to find that adults with sleep apnea are at higher long-term risk of COVID-19.”

Sairam Parthasarathy said this is a “significant study” on the long-term novel coronavirus. Principal Investigator, Arizona University of Health Sciences Restorative Adult Studies and Professor of Medicine.

“Prospective studies are needed to test this association, and if found to be true, these findings will have implications for long-term COVID-19 treatment.” said Parthasarathy, who was not involved in the study.

“Some of the long-lasting COVID-19 symptoms, such as fatigue, may be associated with obstructive sleep apnea, and treatment of obstructive sleep apnea may reduce these long-term COVID-19-related symptoms.” It’s important to keep in mind that the symptoms of the disease may improve,” he added.

The study was published in Sleep on Thursday and is one of several studies to be published since then. Congress allocated $1.15 billion to NIH in January In 2021, we plan to study the long-term effects of the novel coronavirus over a four-year period.According to the agency, so far about $811 million To fund research.

The researchers wanted to investigate the role of sleep apnea in long-term COVID-19 because of the well-known association between sleep apnea and poor prognosis after COVID-19. I was thinking

“People with sleep apnea are at higher risk of more severe COVID-19, admission to hospital intensive care units, and death,” Thorpe said.

“Obstructive sleep apnea can lead to increased inflammation, which can interfere with sleep and increase the risk of infection,” said Bhanu Prakash Khola, Ph.D., a sleep medicine specialist at the Mayo Clinic Center for Sleep Medicine in Rochester. It may lead to an increase in the tendency to develop the disease and a decrease in immunity.” Minnesota.

“This could explain the pathway that obstructive sleep apnea leads to an increased risk of COVID-19,” said Korra, who was not involved in the study.

According to University of Arizona professor Parthasarathy, sleep apnea is an underdiagnosed condition in both genders.

“Conservatively, 80% of patients No one has been diagnosed with obstructive sleep apnea (OSA),” he said. Furthermore, “The assumption of these analyzes is that patients with OSA are more likely to be treated. almost half of them I’m not using any therapy. ”

Why are women at up to 89% higher risk compared to 59% for men? That issue was not addressed in the study.

However, “we can hypothesize that this difference may be based on what we know about sex differences in sleep and immune responses,” said circadian researchers at Northwestern University Feinberg School of Medicine in Chicago.・ Phyllis Gee, Ph.D., director of the Center for Sleep Medicine, said:

Gee was not involved in the new studies, but co-authored one of them. first published research About the relationship between sleep apnea syndrome and serious new coronavirus infections.

“Women are also vulnerable to post-infection inflammation because they typically have stronger immune responses to viral infections,” Gee said. “In general, women often have insomnia, and if the new coronavirus infection is prolonged, they tend to experience symptoms of fatigue and insomnia, which are also common symptoms of prolonged new coronavirus infections. ”

Another reason may be that sleep apnea has historically been considered a male disease, meaning that by the time women are diagnosed, their apnea is more advanced. Thorpe said it could be.

“Since doctors often look for sleep apnea in men, it’s possible that women on electronic health records have more severe sleep apnea,” she says.

More information will become available as scientists continue to study the long-term novel coronavirus, Thorpe said. On the other hand, people with sleep apnea, or people who snore, snore, or hold their breath at night (all signs of the condition), are more susceptible to contracting the novel coronavirus. You have to be very careful.

“People with sleep apnea who are infected with COVID-19 should be treated early and should be considered for treatment.” pax robid, is an oral medication prescribed to reduce the risk of serious outcomes,” Thorpe said. “We also need to continue vaccinations to reduce the risk of infection in the first place.”