Obstructive Sleep Apnea Linked to Increased Risk of Long COVID

An article published in SLEEP on May 11, 2023, reported a link between obstructive sleep apnea and an increased risk of long COVID. Using data from NIH’s Researching COVID to Enhance Recovery (RECOVER) initiative, the clinicians used a harmonized analytic approach to assess risk.

“We still have a lot to learn about the long-term effects of this virus, but this study could inform clinical care by identifying patients who may benefit from closer monitoring,” said Marishka K. Brown, PhD, director of the National Center on Sleep Disorders Research at the National Heart, Lung, and Blood Institute (NHLBI), in the NIH press release.

The researchers focused on specific subsets of data from the RECOVER initiative: the adult patient-centered research network (PCORnet Adult), pediatric patient-centered research network (PCORnet Pediatric), and National COVID Cohort Collaborative (N3C).

Comparing data on obstructive sleep apnea (OSA) and post-acute sequelae of SARS-CoV-2 (PASC), the researchers analyzed data from 1.7 million adults from N3C, 330,000 adults from PCORnet Adult, and 102,000 children from PCORnet Pediatrics. Data focused on individuals who had tested positive between March 2020 and February 2022.

Across the study, roughly 5% of adults and 2% of children had a diagnostic code for OSA in their electronic health records (EHR). Machine learning technology allowed researchers to determine that roughly 5% of adults in the N3C sector likely had long COVID. Additionally, 17% of adults and just under 5% of pediatric patients in the PCORnet subgroups had long COVID.

After collecting the information on each condition, researchers determined that OSA was linked to a 75% greater probability of long COVID in the N3C cohort. Additionally, among adults in the PCORnet study, OSA was associated with a 12% increased risk of long COVID. Finally, they determined no significant link between pediatric OSA and sleep apnea.

Beyond these general insights, the researchers identified sex differences in these outcomes, with women being roughly 30% more likely than men to experience a link between OSA and long COVID. However, the researchers did acknowledge that without controlling for the severity of sleep apnea, there is no way to determine the impact of sex on this study.

“People with obstructive sleep apnea should also keep up with their vaccinations to minimize the risk of infection,” said Lorna E. Thorpe, PhD, MPH, the study’s senior author and director of the Division of Epidemiology in the Department of Population Health at New York University’s Grossman School of Medicine, New York City, in the release.