Introduction: Coronavirus Disease 2019(COVID-19) and obstructive sleep apnea(OSA) share many demographic characteristics and comorbidities. We aimed to evaluate the prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)infection in patients diagnosed with OSA and the effect of OSA on the severity of the infection in these patients.
Materials and Methods: In this retrospective observational study, the records of cases who had polysomnography(PSG) confirmed OSA in the last five years were reviewed. OSA was diagnosed using overnight PSG. Whether the subjects have been tested for SARS-CoV-2 with PCR and the test results were recorded. The electronic medical records were queried for the results of the SARS CoV-2 polymerase-chain-reaction(PCR) tests in this population. For patients with positive tests, the demographic data, PSG results, clinical, laboratory, and radiological findings of COVID-19 were recorded. Comorbidities were ascertained by ICD-10-CM coding and medical record data. A case of Covid-19 was defined by a positive result on a PCR assay of a specimen collected on a nasopharyngeal swab.
Results: Our analysis included 1317 OSA patients diagnosed by PSG. A review of the medical records demonstrated that 51 patients have been tested for SARS-CoV-2 with PCR. The reasons for testing were suspicion of infection, contact tracing, scanning before hospital admission or interventional procedures, or screening for travel. We identified 14 patients with positive PCR results for SARS-CoV-2. The mean age of the 14 patients was 48.9 ± 12.1 years. The majority of the patients were male (n=13, 93%). The mean BMI was 29.7 ± 2.4 kg/m2. Eight(57%) cases had mild OSA, three(21%) had moderate OSA, and three(21%) had severe OSA. Three cases were asymptomatic. Main complaints were chest pain(n=6, 43%), fever(n=5, 36%), fatigue(n=3, 21%), cough(n=3, 21%), shortness of breath(n=3, 21%), loss of taste and smell(n=2, 14%), and diarrhea(n=1, 7 %). Two patients(14%) had DM and two (14%) had hypertension. Two patients(14%) did not need radiological evaluation. Others underwent computed tomography(CT) scanning; normal CT findings was observed in six cases(43%); involvement was unilateral in three cases(21%) and bilateral in three (21%) cases. The mean percentage of oxygen saturation was 97.4±3.0(90-99) on initial evaluation. All the patients underwent outpatient treatment and no hospital or intensive care unit(ICU) admission, progression to respiratory failure or mortality was observed.
Conclusions: We have observed that the prevalence of COVID-19, the need for hospitalization, and progression to respiratory failure, namely severe infection did not seem to increase in OSA patients. In our large OSA population, no hospital admission or death occurred due to COVID-19. In conclusion, our results provide some initial data regarding COVID-19 risk in a large OSA population. We demonstrated that OSA can not be considered as one of the underlying medical conditions predisposing to increased risk or poor outcome in COVID-19. Poor COVID-19 related prognosis, if exists, may be attributed to other risk factors or comorbidities accompanying OSA