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High-risk obstructive sleep apnea is related to longer hospital stay in COVID-19 patients
1Department of Pulmonology, Uludağ University Faculty of Medicine, Bursa, Türkiye
2Department of Pulmonology, Bursa Doruk Hospital, Bursa, Türkiye
3Department of Pulmonology, Bursa Şevket Yılmaz Teaching Hospital, Bursa, Türkiye
4Department of Radiology, Bursa Şevket Yılmaz Teaching Hospital, Bursa, Türkiye
5Department of Pulmonology, Bandırma State Hospital, Bursa, Türkiye
6Department of Pulmonology, Kestel State Hospital, Bursa, Türkiye
7Department of Pulmonology, Bursa Çekirge State Hospital, Bursa, Türkiye
8Department of Pulmonology, Bursa Medicana Hospital, Bursa, Türkiye
9Department of Pulmonology, Bursa State Hospital, Bursa, Türkiye
Eurasian Journal of Pulmonology 2022; 24(2): 95-100 DOI: 10.14744/ejp.2022.9921
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BACKGROUND AND AIM: Obstructive sleep apnea (OSA), having an increased inflammatory state due to an imbalance between sympathetic and parasympathetic activity, intermittent hypoxia, and increased cytokines, may aggravate the immune response for COVID-19 infection. Our aim was to evaluate the effect of OSA upon inflammatory response and length of stay in patients with favorable outcomes.

METHODS: 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 a cut-off value of 3 points were used to identify patients with a high risk of OSA.

RESULTS: Study population consisted of 201 patients with a median STOP-Bang score of 2.0 (1.0–4.0) points. According to the cut-off value of 3 points, 94 (46.8%) patients were classified as high-risk OSA patients. High-risk OSA patients were older, had many comorbidities such as hypertension, coronary artery disease, and diabetes mellitus, had higher serum D-dimer, ferritin, C-reactive protein, and procalcitonin measurements, and had a longer hospital stay. Possible risk factors associated with length of stay were age, lymphocyte count, and total STOP-Bang score. Multivariable analysis revealed that a 1 point increase in STOP-Bang score results in a 0.43 day longer hospital stay.

CONCLUSIONS: Prevalence of OSA within COVID-19 patients with favorable outcomes is similar to the general population. However, the length of stay is related to the presence of high-risk OSA. Our study, therefore, suggests that OSA is related to delayed improvement of COVID-19 infection.