Analysis of the association between subjective sleep quality and the duration of viral shedding in patients with COVID-19: A cohort study

Abstract

Background: Shanghai reported more than 600,000 Omicron COVID-19 cases between March 1, 2022, and June 30, 2022. Omicron-infected patients with no, mild, or moderate symptoms were transferred to the nearest Fangcang hospital, buildings constructed exclusively for the isolation and treatment of COVID-19 patients, according to the protocol for COVID‐19 diagnosis in China during that period. Methods: This was a cohort study with data collected via online questionnaires and electronic medical records (EMR) from April 15, 2022, to May 7, 2022, from a block in a Shanghai Fangcang hospital. The Insomnia Severity Index (ISI) and the Hospital Anxiety and Depression Scale (HADS) were used. Survival analysis techniques, including Kaplan–Meier (KM) curves and univariate and multivariate Cox regression models with time-varying coefficients, were used to analyze the association between sleep quality during SARS-CoV-2 infection and the duration of viral shedding (DVS). Results: Data from 688 participants were used in the data analysis. KM curves showed that COVID-19 patients with insomnia generally had a longer DVS than those without insomnia. Cox proportional hazards regression models suggested that the insomnia group was significantly less likely to recover from SARS-CoV-2 infection within 7 days after diagnosis than the noninsomnia group. A higher probability of rapid recovery from COVID-19 was also associated with younger age, higher HADS-A scores (i.e., increased anxiety), and lower HADS-D scores (i.e., lower depression). Conclusions: For COVID-19 patients, sleep status, anxiety and depression symptoms, and age merit greater attention. Future studies should investigate whether lifestyle interventions can reduce the risk of developing postinfection syndromes or mitigating such symptoms.

Keywords

• Insomnia
• COVID-19
• Omicron
• Viral shedding