BMJ Open Respiratory Research (Nov 2021)

Sleep apnoea is a risk factor for severe COVID-19

  • Riitta Kaarteenaho,
  • Nina Hautala,
  • Athena Matakidou,
  • Jaakko Kaprio,
  • Ying Wu,
  • Kai Kaarniranta,
  • Peeter Karihtala,
  • Kari Pulkki,
  • Wei Zhou,
  • Caroline Fox,
  • Jussi Pihlajamäki,
  • Apinya Lertratanakul,
  • Juha Paloneva,
  • Johannes Kettunen,
  • Marita Kalaoja,
  • Markus Perola,
  • Veikko Salomaa,
  • Hilkka Soininen,
  • Mika Kähönen,
  • Hao Chen,
  • Andrey Loboda,
  • Soumitra Ghosh,
  • Anders Mälarstig,
  • Markku Laakso,
  • Marja Luodonpää,
  • Markus Juonala,
  • Xing Chen,
  • Marika Crohns,
  • Juhani Junttila,
  • Sirkku Peltonen,
  • Keith Usiskin,
  • Juha Sinisalo,
  • Aarno Palotie,
  • Samuli Ripatti,
  • Oili Kaipiainen-Seppänen,
  • Aki Havulinna,
  • Satu Strausz,
  • Tuomo Kiiskinen,
  • Martin Broberg,
  • Sanni Ruotsalainen,
  • Jukka Koskela,
  • Adel Bachour,
  • Tuula Palotie,
  • Hanna M. Ollila,
  • Mark Daly,
  • Howard Jacob,
  • Heiko Runz,
  • Sally John,
  • Robert Plenge,
  • Mark McCarthy,
  • Julie Hunkapiller,
  • Meg Ehm,
  • Dawn Waterworth,
  • Kathy Klinger,
  • Kathy Call,
  • Tomi Mäkelä,
  • Petri Virolainen,
  • Terhi Kilpi,
  • Jukka Partanen,
  • Anne Pitkäranta,
  • Seppo Vainio,
  • Kimmo Savinainen,
  • Veli-Matti Kosma,
  • Urho Kujala,
  • Outi Tuovila,
  • Minna Hendolin,
  • Raimo Pakkanen,
  • Jeff Waring,
  • States Bridget Riley-Gillis,
  • Jimmy Liu,
  • Shameek Biswas,
  • Dorothee Diogo,
  • Anders Pfizer,
  • Catherine Marshall,
  • Xinli Hu,
  • Matthias Gossel,
  • Johanna Schleutker,
  • Mikko Arvas,
  • Olli Carpen,
  • Reetta Hinttala,
  • Reijo Laaksonen,
  • Arto Mannermaa,
  • Valtteri Julkunen,
  • Anne Remes,
  • Reetta Kälviäinen,
  • Mikko Hiltunen,
  • Jukka Peltola,
  • Pentti Tienari,
  • Juha Rinne,
  • Adam Ziemann,
  • Jeffrey Waring,
  • Sahar Esmaeeli,
  • Nizar Smaoui,
  • Anne Lehtonen,
  • Susan Eaton,
  • Sanni Lahdenperä,
  • John Michon,
  • Geoff Kerchner,
  • Natalie Bowers,
  • Edmond Teng,
  • John Merck,
  • Vinay Mehta,
  • Padhraig Gormley,
  • Kari Linden,
  • Christopher Whelan,
  • Fanli Xu,
  • David Pulford,
  • Martti Färkkilä,
  • Sampsa Pikkarainen,
  • Airi Jussila,
  • Timo Blomster,
  • Mikko Kiviniemi,
  • Markku Voutilainen,
  • Bob Georgantas,
  • Graham Heap,
  • Fedik Rahimov,
  • Joseph Maranville,
  • Tim Lu,
  • Danny Oh,
  • Kirsi Kalpala,
  • Melissa Miller,
  • Linda McCarthy,
  • Kari Eklund,
  • Antti Palomäki,
  • Pia Isomäki,
  • Laura Pirilä,
  • Johanna Huhtakangas,
  • David Close,
  • Marla Hochfeld,
  • Nan Bing,
  • Jorge Esparza Gordillo,
  • Nina Mars,
  • Tarja Laitinen,
  • Margit Pelkonen,
  • Paula Kauppi,
  • Hannu Kankaanranta,
  • Terttu Harju,
  • Steven GreenbergCelgene,
  • Hubert Chen,
  • Jo Betts,
  • Teemu Niiranen,
  • Kaj Metsärinne,
  • Marja-Riitta Taskinen,
  • Tiinamaija Tuomi,
  • Jari Laukkanen,
  • Andrew Peterson Ben Challis,
  • Audrey Chu,
  • Jaakko Parkkinen,
  • Anthony Muslin,
  • Heikki Joensuu,
  • Tuomo Meretoja,
  • Lauri Aaltonen,
  • Annika Auranen,
  • Saila Kauppila,
  • Päivi Auvinen,
  • Klaus Elenius,
  • Relja Popovic,
  • Bridget Riley-Gillis,
  • Jennifer Schutzman,
  • Aparna Chhibber,
  • Heli Lehtonen,
  • Stefan McDonough,
  • Diptee Kulkarni,
  • Joni Turunen,
  • Terhi Ollila,
  • Sanna Seitsonen,
  • Hannu Uusitalo,
  • Vesa Aaltonen,
  • Hannele Uusitalo-Järvinen,
  • Erich Strauss,
  • Anna Podgornaia,
  • Joshua Hoffman,
  • Kaisa Tasanen,
  • Laura Huilaja,
  • Katariina Hannula-Jouppi,
  • Teea Salmi,
  • Leena Koulu,
  • Ilkka Harvima,
  • David Choy,
  • Anu Jalanko,
  • Risto Kajanne,
  • Ulrike Lyhs,
  • Mari Kaunisto,
  • Justin Davis,
  • Danjuma Quarless,
  • Slavé Petrovski,
  • Chia-Yen Chen,
  • Paola Bronson,
  • Robert Yang,
  • Diana Chang,
  • Tushar Bhangale,
  • Emily Holzinger,
  • Xulong Wang,
  • Åsa Hedman,
  • Kirsi Auro,
  • Clarence Wang,
  • Ethan Xu,
  • Franck Auge,
  • Clement Chatelain,
  • Mitja Kurki,
  • Juha Karjalainen,
  • Kimmo Palin,
  • Priit Palta,
  • Pietro Della,
  • Susanna Lemmelä,
  • Manuel Rivas,
  • Jarmo Harju,
  • Arto Lehisto,
  • Andrea Ganna,
  • Vincent Llorens,
  • Antti Karlsson,
  • Kati Kristiansson,
  • Kati Hyvärinen,
  • Jarmo Ritari,
  • Tiina Wahlfors,
  • Miika Koskinen,
  • Katri Pylkäs,
  • Minna Karjalainen,
  • Tuomo Mantere,
  • Eeva Kangasniemi,
  • Sami Heikkinen,
  • Eija Laakkonen,
  • Juha Kononen,
  • Anu Loukola,
  • Päivi Laiho,
  • Tuuli Sistonen,
  • Essi Kaiharju,
  • Markku Laukkanen,
  • Elina Järvensivu,
  • Sini Lähteenmäki,
  • Lotta Männikkö,
  • Regis Wong,
  • Hannele Mattsson,
  • Tero Hiekkalinna,
  • Manuel Jiménez,
  • Kati Donner,
  • Kalle Pärn,
  • Javier Nunez-Fontarnau,
  • Elina Kilpeläinen,
  • Timo Sipilä,
  • Georg Brein,
  • Alexander Dada,
  • Ghazal Awaisa,
  • Anastasia Shcherban,
  • Tuomas Sipilä,
  • Hannele Laivuori,
  • Harri Siirtola,
  • Javier Tabuenca,
  • Lila Kallio,
  • Sirpa Soini,
  • Kimmo Pitkänen,
  • Teijo Kuopio

DOI
https://doi.org/10.1136/bmjresp-2020-000845
Journal volume & issue
Vol. 8, no. 1

Abstract

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Background Obstructive sleep apnoea (OSA) is associated with higher body mass index (BMI), diabetes, older age and male gender, which are all risk factors for severe COVID-19.We aimed to study if OSA is an independent risk factor for COVID-19 infection or for severe COVID-19.Methods OSA diagnosis and COVID-19 infection were extracted from the hospital discharge, causes of death and infectious diseases registries in individuals who participated in the FinnGen study (n=260 405). Severe COVID-19 was defined as COVID-19 requiring hospitalisation. Multivariate logistic regression model was used to examine association. Comorbidities for either COVID-19 or OSA were selected as covariates. We performed a meta-analysis with previous studies.Results We identified 445 individuals with COVID-19, and 38 (8.5%) of them with OSA of whom 19 out of 91 (20.9%) were hospitalised. OSA associated with COVID-19 hospitalisation independent from age, sex, BMI and comorbidities (p-unadjusted=5.13×10−5, OR-adjusted=2.93 (95% CI 1.02 to 8.39), p-adjusted=0.045). OSA was not associated with the risk of contracting COVID-19 (p=0.25). A meta-analysis of OSA and severe COVID-19 showed association across 15 835 COVID-19 positive controls, and n=1294 patients with OSA with severe COVID-19 (OR=2.37 (95% 1.14 to 4.95), p=0.021).Conclusion Risk for contracting COVID-19 was the same for patients with OSA and those without OSA. In contrast, among COVID-19 positive patients, OSA was associated with higher risk for hospitalisation. Our findings are in line with earlier works and suggest OSA as an independent risk factor for severe COVID-19.