Association Between Severity of COVID-19 Respiratory Disease and Risk of Obstructive Sleep Apnea

Giannicola Iannella; Claudio Vicini; Jerome R Lechien; Claudia Ravaglia; Venerino Poletti; Simona di Cesare; Elena Amicarelli; Lucia Gardelli; Carmela Grosso; Aria Patacca; Eleonora Magistrelli; Michele De Benedetto; Domenico Maurizio Toraldo; Michele Arigliani; Giovanni Cammaroto; Giuseppe Meccariello; Andrea De Vito; Giuseppe Magliulo; Antonio Greco; Marco de Vincentiis; Massimo Ralli; Annalisa Pace; Valentina Montincone; Antonino Maniaci; Salvatore Cocuzza; Matteo Seligardi; Ida di Giacinto; Ruggero Massimo Corso

doi:10.1177/01455613211029783

Association Between Severity of COVID-19 Respiratory Disease and Risk of Obstructive Sleep Apnea

Ear Nose Throat J. 2024 Jan;103(1):NP10-NP15. doi: 10.1177/01455613211029783. Epub 2021 Jul 28.

Authors

Giannicola Iannella¹, Claudio Vicini^{1

2}, Jerome R Lechien³, Claudia Ravaglia⁴, Venerino Poletti^{4

5}, Simona di Cesare⁶, Elena Amicarelli⁶, Lucia Gardelli⁶, Carmela Grosso⁷, Aria Patacca⁷, Eleonora Magistrelli⁷, Michele De Benedetto⁸, Domenico Maurizio Toraldo⁹, Michele Arigliani⁸, Giovanni Cammaroto², Giuseppe Meccariello², Andrea De Vito¹⁰, Giuseppe Magliulo¹¹, Antonio Greco¹¹, Marco de Vincentiis¹¹, Massimo Ralli¹¹, Annalisa Pace¹¹, Valentina Montincone¹², Antonino Maniaci¹³, Salvatore Cocuzza¹³, Matteo Seligardi¹⁴, Ida di Giacinto¹⁵, Ruggero Massimo Corso¹⁶

Affiliations

¹ Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy.
² Department of ENT & Audiology, University of Ferrara, Ferrara, Italy.
³ Faculty of Medicine, Laboratory of Anatomy and Cell Biology, University of Mons (UMONS), Mons, Belgium.
⁴ Pulmonology Unit, Thoracic Diseases Department, G.B. Morgagni Hospital, Forlì, Italy.
⁵ Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.
⁶ Medicine Department, G.B. Morgagni Hospital, Forlì, Italy.
⁷ Department of Infectious Diseases, G.B. Morgagni Hospital, Forlì, Italy.
⁸ ENT Unit, "V. Fazzi" Hospital, ASL Lecce, Italy.
⁹ Hospital Rehabilitation Department, Cardio-Respiratory Care Unit, "V. Fazzi", ASL Lecce, Italy.
¹⁰ Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Ospedale "Santa Maria delle Croci", Viale Vincenzo Randi, Ravenna, Italy.
¹¹ Department of "Organi di Senso," University "Sapienza," Rome, Italy.
¹² Otolaryngology Department, Azienda Sanitaria Locale CN2, Alba, Italy.
¹³ Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy.
¹⁴ Infectious Disease Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio, Emilia, Italy.
¹⁵ Anesthesia and Intensive Care, Anestesia e Terapia Intensiva Polivalente, Azienda Ospedaliero-Universitaria, Sant'Orsola-Malpighi - Alma Mater Studiorum, Bologna, Italy.
¹⁶ Intensive Care Unit, Morgagni-Pierantoni Hospital, AUSL of Romagna, Forlì, Italy.

PMID: 34318690
DOI: 10.1177/01455613211029783

Abstract

Objectives: The purpose of this observational retrospective study was to evaluate, in patients with a severe acute respiratory syndrome coronavirus 2 infection, the association between the severity of coronavirus disease 2019 (COVID-19) respiratory illness and the risk of infected patients to develop obstructive sleep apnea (OSA).

Methods: Ninety-six patients with confirmed COVID-19 infection were enrolled in the study. The STOP-BANG questionnaire to investigate the risk of the OSA syndrome was filled in by the patients at admission. The enrolled patients were divided into 2 groups according to the respiratory disease: group 1 (72 patients), hospitalized patients undergoing conventional oxygen therapy; group 2 (24 patients), patients requiring enhanced respiratory support. STOP-BANG results of these 2 groups were compared to observe whether patients with high OSA risk more frequently presented a severe form of COVID-19.

Results: 41.6% of the patients in group 2 had a STOP-BANG score between 5 and 8 (high risk of having apnea); in contrast, 20.8% of the patients in group 1 had a STOP-BANG score between 5 and 8, with a statistically significant difference between the 2 groups (P = .05). A complementary trend was observed regarding the proportion of patients in the range 0 to 2, which classifies patients at a low risk of OSA (48.6% vs 20.8% for groups 1 and 2, P = .01).

Conclusions: According to our data, the chances of having a severe case of COVID-19 should be considered in patients at high risk of OSA.

Current knowledge/study rationale: Emerging research suggests that OSA could represent a potentially important risk factor for the severe forms of COVID-19. The purpose of this observational retrospective study was to evaluate the potential association between OSA and the severity of COVID-19 disease.

Study impact: According to our data, the likelihood of contracting a severe form of COVID-19 disease should be considered in patients at high risk of OSA.

Keywords: COVID-19; infection; obstructive sleep apnea; respiratory disease.

Publication types

Observational Study

MeSH terms

COVID-19* / complications
COVID-19* / epidemiology
Humans
Polysomnography / methods
Retrospective Studies
Risk Factors
Sleep Apnea, Obstructive* / complications
Sleep Apnea, Obstructive* / epidemiology
Surveys and Questionnaires