Obstructive sleep apnea and COVID-19 clinical outcomes during hospitalization: a cohort study.

STUDY OBJECTIVES Obstructive sleep apnea (OSA) is an extremely common sleep disorder. A potential association between OSA and coronavirus disease 2019 (COVID-19) severity has been proposed on the basis of similar comorbid medical conditions associated with both OSA and COVID-19. METHODS We performed a retrospective review of 1,738 patients who were hospitalized with COVID-19 between March and October of 2020. Patients were classified based on the presence or absence of OSA diagnosis based upon the International Classification of Diseases (ICD codes; G47.33 and U07.1 for OSA and COVID-19, respectively). Other data collected, including demographics, body mass index (BMI), and comorbid conditions. COVID-19 severity was compared between groups using the quick COVID-19 severity index. RESULTS Quick COVID-19 severity index scores were higher in patients with OSA compared to without OSA. However, the prevalence rates of type 2 DM (p<0.0001), coronary artery disease (p<0.0001), congestive heart failure (p<0.0001), and chronic obstructive pulmonary diseases (p<0.0001) were also significantly greater in the OSA group. Unadjusted models revealed higher risk of ICU admission in patients with COVID-19 and OSA. However, such an association attenuated and became non-significant after adjusting for age, sex, BMI, and comorbid disease. CONCLUSIONS In our study, OSA does not appear to be an independent risk factor for worse COVID-19 outcomes in hospitalized patients. Further studies with larger sample sizes are needed to delineate the potential role of OSA in determining outcomes in hospitalized patients with COVID-19.