Yüksel Peker1,2, Yeliz Celik1, Semih Arbatli1, Sacide Rana Isik3, Baran Balcan4, Ferhan Karataş5, Fatma Işıl Uzel5, Levent Tabak6, Betül Çetin7, Arzu Baygül1, Ayşe Bilge Öztürk8, Elif Altuğ3, Sinem İliaz5, Cetin Atasoy9, Mahir Kapmaz10, Duygu Yazici1, Hasan Bayram1, Birsen Durmaz Çetin11, Benan Çağlayan12. 1. Koc University School of Medicine, Koc University Research Center for Translational Medicine (KUTTAM) , Istanbul, Turkey. 2. United States; yuksel.peker@lungall.gu.se. 3. Koc Healthcare American Hospital, Istanbul, Turkey. 4. Medical Faculty, Marmara University, Dept. of Pulmonary Medicine, Istanbul, Turkey. 5. Koc University Hospital, Dept of Pulmonary Medicine, Istanbul, Turkey. 6. Koc University School of Medicine, Dept of Pulmonary Medicine , Istanbul, Turkey. 7. Medical Faculty, Marmara University, Istanbul, Turkey. 8. Koc University School of Medicine, Dept of Allergy and Immunology, Istanbul, Turkey. 9. Koc University Hospital, Dept of Radiology, Istanbul, Turkey. 10. Koc University Hospital, Dept of Infectious Diseases, Istanbul, Turkey. 11. Koc University School of Medicine, Dept of Infectious Diseases, Istanbul, Turkey. 12. Koc University School of Medicine, Dept of Pulmonary Medicine, Istanbul, Turkey.
Abstract
Rationale: Obstructive sleep apnea (OSA) may contribute to poor outcomes in adults with Coronavirus Disease 2019 (COVID-19). Objective: To determine the effect of OSA on clinical outcomes in patients with COVID-19. Methods: The current prospective observational study was conducted in three hospitals in Istanbul, Turkey from March 10 to June 22, 2020. The participants were categorized as modified high-risk (mHR), or low-risk (mLR)-OSA according to a modified version of the Berlin questionnaire. Snoring patterns (intensity and/or frequency), breathing pauses and morning/daytime sleepiness, without taking obesity and hypertension into account, were used in the regression models. Results: The primary outcome was clinical improvement defined as a decline of 2 categories from admission on a 7-category ordinal scale. Secondary outcomes included worsening (increase of 1 category), need for hospitalization, supplemental oxygen and intensive care. In total, 320 eligible patients were enrolled. According to the modified scoring, 70 (21.9%) had mHR-OSA. Among 242 patients requiring hospitalization, clinical improvement within 2 weeks occurred in 75.4 % of the mHR-OSA group compared to 88.4 % of the modified low-risk (mLR-OSA) group (P = 0.014). In multivariate regression analyses, mHR-OSA (adjusted OR 0.42; 95% CI 0.19-0.92) predicted the delayed clinical improvement. In the entire study population (n=320), mHR-OSA was associated with clinical worsening and need for supplemental oxygen. Snoring patterns, especially louder snoring, were significantly predicted delayed clinical improvement, worsening, need for hospitalization, supplemental oxygen, and intensive care. Conclusions: Adults with mHR-OSA in our Covid-19 cohort had poorer clinical outcomes than those with mLR OSA independent of age, sex and comorbidities. Clinical trial registered with ClinicalTrials.gov (NCT04363333).
Rationale: Obstructive sleep apnea (OSA) may contribute to poor outcomes in adults with Coronavirus Disease 2019 (COVID-19). Objective: To determine the effect of OSA on clinical outcomes in patients with COVID-19. Methods: The current prospective observational study was conducted in three hospitals in Istanbul, Turkey from March 10 to June 22, 2020. The participants were categorized as modified high-risk (mHR), or low-risk (mLR)-OSA according to a modified version of the Berlin questionnaire. Snoring patterns (intensity and/or frequency), breathing pauses and morning/daytime sleepiness, without taking obesity and hypertension into account, were used in the regression models. Results: The primary outcome was clinical improvement defined as a decline of 2 categories from admission on a 7-category ordinal scale. Secondary outcomes included worsening (increase of 1 category), need for hospitalization, supplemental oxygen and intensive care. In total, 320 eligible patients were enrolled. According to the modified scoring, 70 (21.9%) had mHR-OSA. Among 242 patients requiring hospitalization, clinical improvement within 2 weeks occurred in 75.4 % of the mHR-OSA group compared to 88.4 % of the modified low-risk (mLR-OSA) group (P = 0.014). In multivariate regression analyses, mHR-OSA (adjusted OR 0.42; 95% CI 0.19-0.92) predicted the delayed clinical improvement. In the entire study population (n=320), mHR-OSA was associated with clinical worsening and need for supplemental oxygen. Snoring patterns, especially louder snoring, were significantly predicted delayed clinical improvement, worsening, need for hospitalization, supplemental oxygen, and intensive care. Conclusions: Adults with mHR-OSA in our Covid-19 cohort had poorer clinical outcomes than those with mLR OSA independent of age, sex and comorbidities. Clinical trial registered with ClinicalTrials.gov (NCT04363333).
Authors: Saif Mashaqi; Rekha Kallamadi; Abhishek Matta; Stuart F Quan; Salma I Patel; Daniel Combs; Lauren Estep; Joyce Lee-Iannotti; Charles Smith; Sairam Parthasarathy; David Gozal Journal: Cells Date: 2022-05-06 Impact factor: 7.666
Authors: Gaia Pellitteri; Andrea Surcinelli; Maria De Martino; Martina Fabris; Francesco Janes; Francesco Bax; Alessandro Marini; Romina Milanic; Antonella Piani; Miriam Isola; Gian Luigi Gigli; Mariarosaria Valente Journal: Front Neurol Date: 2022-08-17 Impact factor: 4.086