Article Text
Abstract
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.
- sleep apnoea
- COVID-19
Data availability statement
Data are available upon reasonable request. The FinnGen individual level data may be accessed through applications to the Finnish Biobanks’ FinnBB portal, Fingenious (www.finbb.fi). Summary data can be accessed through the FinnGen site https://www.finngen.fi/en/access_results.
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Data availability statement
Data are available upon reasonable request. The FinnGen individual level data may be accessed through applications to the Finnish Biobanks’ FinnBB portal, Fingenious (www.finbb.fi). Summary data can be accessed through the FinnGen site https://www.finngen.fi/en/access_results.
Supplementary materials
Supplementary Data
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Footnotes
Correction notice This article has been corrected since it first published. The provenance and peer review statement has been included.
Contributors HO is the guarantor of the manuscript. TK, HO, SR and SS conceived the study and designed the study protocol. TK, HO and SS conducted the literature review, statistical analysis and drafted the manuscript. MB and SRu contributed statistical analysis and TK phenotyped study samples. AB, MB, JK, SR, SRu, AP, TP and SR reviewed the manuscript for intellectual content, made revisions as needed and approved the final version for publication. HO, TP and SR supervised the study.
Funding SR was supported by the Academy of Finland Center of Excellence in Complex Disease Genetics (Grant No 312062), the Finnish Foundation for Cardiovascular Research, the Sigrid Juselius Foundation and University of Helsinki HiLIFE Fellow and Grand Challenge grants and Juho Vainio Foundation & Academy of Finland Covid-19 research funding. AP was supported by the Academy of Finland Center of Excellence in Complex Disease Genetics (Grant No 312074), and the Sigrid Juselius Foundation. HMO was supported by the Academy of Finland (Grant No 309643, 340539), Oskar Öfflund foundation, Yrjö Jahnsson foundation, Signe and Ane Gyllenberg foundation and Instrumentarium science foundation and TP by the HUCH research grant. The FinnGen project is funded by two grants from Business Finland (HUS 4685/31/2016 and UH 4386/31/2016) and the following industry partners: AbbVie, AstraZeneca UK, Biogen MA, Celgene Corporation, Celgene International II Sàrl, Genentech, Merck Sharp & Dohme Corp, Pfizer, GlaxoSmithKline Intellectual Property Development, Sanofi US Services, Maze Therapeutics, Janssen Biotech. Following biobanks are acknowledged for the project samples: Auria Biobank (https://www.auria.fi/biopankki/en/), THL Biobank (https://thl.fi/en/web/thl-biobank), Helsinki Biobank (https://www.helsinginbiopankki.fi/en/home), Biobank Borealis of Northern Finland (https://www.ppshp.fi/Tutkimus-ja-opetus/Biopankki/Pages/Biobank-Borealis-briefly-in-English.aspx), Finnish Clinical Biobank Tampere (https://www.tays.fi/en-US/Research_and_development/Finnish_Clinical_Biobank_Tampere), Biobank of Eastern Finland (https://ita-suomenbiopankki.fi/en/), Central Finland Biobank (https://www.ksshp.fi/fi-FI/Potilaalle/Biopankki), Finnish Red Cross Blood Service Biobank (https://www.bloodservice.fi/Research_Projects/biobanking) and Terveystalo Biobank (https://www.terveystalo.com/fi/Yritystietoa/Terveystalo-Biopankki/Biopankki/). All Finnish Biobanks are members of BBMRI.fi infrastructure (http://www.bbmri.fi/).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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