People with obstructive sleep apnoea (OSA) could be at increased risk of adverse outcomes from COVID-19, according to a new study from the University of Warwick.
A systematic review, published in Sleep Medicine Review, looked at 18 studies on OSA and COVID-19 published up to June 2020, of which eight were mainly related to the risk of death from COVID-19 and 10 were related to diagnosis, treatment and management of sleep apnoea.
Although few studies of OSA in COVID-19 had been performed at the time, there was evidence to suggest that many patients who presented to intensive care had OSA; in diabetic patients, it may confer an increased risk that is independent of other risk factors.
In a large study in patients with diabetes who were hospitalised for COVID-19, those being treated for sleep apnoea had a 2.8-fold greater risk of dying on the seventh day after hospital admission.
Lead author Dr Michelle Miller of Warwick Medical School said: “It is likely that COVID-19 increases oxidative stress and inflammation and has effects on the bradykinin pathways, all of which are also affected in obstructive sleep apnoea patients. When you have individuals in which these mechanisms are already affected, it wouldn’t be surprising that COVID-19 affects them more strongly.”
The researchers say further research is required to determine whether these individuals need to be added to the list of vulnerable groups that may need to shield if transmission rates increase.
“Hospitals and doctors should also be recording whether their patients have obstructive sleep apnea as a potential risk factor, and it should be included in studies and outcomes data for COVID-19. We need more data to determine whether this is something we should be more concerned about,” Dr Miller said.