High-risk obstructive sleep apnea is related to longer hospital stay in COVID-19 patients

Abstract

Introduction: Obstructive sleep apnea (OSA), having an increased inflammatory state due to unbalance between sympathetic and parasympathetic activity, intermittent hypoxia and increased cytokines, may aggravate the immune response for COVID-19 infection. Our aim with this study is to evaluate the effect of OSA upon inflammatory response and length of stay in patients with favorable outcomes. Method: Patients admitted to an outpatient clinic after being hospitalized for treatment of COVID-19 were included consecutively in this cross-sectional multicenter observational study. STOP-BANG questionnaire and cut-off value of 3 points were used to identify patients with high-risk of OSA. Results: Study population consisted 201 patients with median STOP-BANG score 2.0 [1.0 – 4.0] points. According to cut-off value of 3 points 94 (46.8%) patients as high-risk OSA patients. High-risk OSA patients were older, had more comorbidities such as hypertension, coronary artery disease and diabetes mellitus, had higher serum d-dimer, ferritin, CRP and procalcitonin measurements and longer hospital stay. Possible risk factors associated with length of stay were age, lymphocyte count and total STOP-BANG score. Multivariable analysis revealed that 1 point increase in STOP-BANG score results in 0.43 day longer hospital stay. Conclusion: Prevalence of OSA within COVID-19 patients with favorable outcomes is similar with general population. However, length of stay is related with the presence of high-risk OSA. Our study therefore suggests OSA is related with delayed improvement of COVID-19 infection.