The Link Between Obstructive Sleep Apnea (OSA) and Post-Acute Sequelae of SARS-CoV-2 (PASC): A Comprehensive Analysis
Key Highlights :
Obstructive sleep apnea (OSA) is a common sleep disorder that affects nearly 20% of adults in the United States (US). Recent studies have identified a positive relationship between OSA and acute coronavirus disease 2019 (COVID-19) outcomes. This has raised the possibility that OSA could be a risk factor for post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [PASC], the long-term effects of COVID-19. In a recent article published in the journal Sleep, researchers generated a harmonized analysis to investigate the impact of preexisting OSA as a risk factor for PASC in children and adults.
The study used electronic health record (EHR) data from three research networks within the REsearching COVID to Enhance Recovery (RECOVER) initiative funded by the National Institutes of Health (NIH). The study was conducted between March 1, 2018, and March 1, 2020, across multiple data sources, using different Long COVID definitions and employing varying approaches to identify COVID-19 patients at a higher risk of developing PASC due to preexisting OSA. The researchers considered evidence of OSA diagnosed within two years before the study duration.
The study found that preexisting OSA increased the risk of PASC-like conditions among adult patients. Even after adjusting for other comorbidities, this positive association remained significant though it attenuated slightly. However, the apparent positive associations between preexisting OSA and probable PASC among children became insignificant after adjusting for comorbidities. Obesity was most prevalent in PCORnet and accounted for some visible differences in OSA-related PASC outcomes across all three networks. In part, obesity and similar comorbidities confounded and diminished the strength of association with PASC.
The researchers used a range of PASC definitions to overcome the challenges of examining associations between OSA and PASC risk among adults and children. They found positive associations between OSA and PASC risk consistently, irrespective of the data source, approach, and PASC definition applied.
The findings of this study suggest that OSA increases the risk of more severe PASC outcomes in adult patients. Future research should examine the association of OSA and other preexisting conditions with specific PASC variations and the trajectory of impacted COVID-19 patients. This can help in developing better strategies to prevent and manage the long-term effects of COVID-19.
