Association of Sleep-Related Hypoxia With Risk of COVID-19 Hospitalizations and Mortality in a Large Integrated Health System
| Autor: | Alex Milinovich, Vaishal Shah, Loutfi S. Aboussouan, Lara Jehi, Lu Wang, Cinthya Pena Orbea, Mina K. Chung, Nancy Foldvary-Schaefer, Kelsey Seidel, Saif Mashaqi, Reena Mehra |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Polysomnography Severity of Illness Index Hypoxemia Extracorporeal Membrane Oxygenation Sleep Apnea Syndromes Risk Factors Cause of Death Internal medicine Severity of illness Positive airway pressure Odds Ratio Pulmonary Medicine medicine Humans Hospital Mortality Continuous positive airway pressure Sleep study Risk factor Hypoxia Aged Ohio Original Investigation Cardiopulmonary disease Continuous Positive Airway Pressure medicine.diagnostic_test Delivery of Health Care Integrated SARS-CoV-2 business.industry Research COVID-19 General Medicine Middle Aged Respiration Artificial respiratory tract diseases Hospitalization Online Only Logistic Models Case-Control Studies Florida Female medicine.symptom Sleep business |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| DOI: | 10.1001/jamanetworkopen.2021.34241 |
| Popis: | Key Points Question Are sleep-disordered breathing and sleep-related hypoxia associated with SARS-CoV-2 infection and COVID-19 outcomes? Findings In this case-control study of 5402 patients in a large integrated health system, sleep-disordered breathing and sleep-related hypoxia were not associated with an increased likelihood of contracting SARS-CoV-2. After accounting for confounding factors including cardiopulmonary disease, cancer, and smoking exposure, sleep-related hypoxia indices were associated with more severe COVID-19 clinical outcomes, including hospitalization and mortality, in time-to-event analyses. Meaning These results suggest that baseline sleep-related hypoxia may portend worse clinical prognosis in COVID-19. This case-control study investigates the association of sleep-disordered breathing and sleep-related hypoxia with SARS-CoV-2 infection and COVID-19 outcomes. Importance The influence of sleep-disordered breathing (SDB) and sleep-related hypoxemia in SARS-CoV-2 viral infection and COVID-19 outcomes remains unknown. Controversy exists regarding whether to continue treatment for SDB with positive airway pressure given concern for aerosolization with limited data to inform professional society recommendations. Objective To investigate the association of SDB (identified via polysomnogram) and sleep-related hypoxia with (1) SARS-CoV-2 positivity and (2) World Health Organization (WHO)-designated COVID-19 clinical outcomes while accounting for confounding including obesity, underlying cardiopulmonary disease, cancer, and smoking history. Design, Setting, and Participants This case-control study was conducted within the Cleveland Clinic Health System (Ohio and Florida) and included all patients who were tested for COVID-19 between March 8 and November 30, 2020, and who had an available sleep study record. Sleep indices and SARS-CoV-2 positivity were assessed with overlap propensity score weighting, and COVID-19 clinical outcomes were assessed using the institutional registry. Exposures Sleep study–identified SDB (defined by frequency of apneas and hypopneas using the Apnea-Hypopnea Index [AHI]) and sleep-related hypoxemia (percentage of total sleep time at |
| Databáze: | OpenAIRE |
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