Previously diagnosed obstructive sleep apnea is not associated with increased risk of SARS-CoV-2 infection in community-dwelling older adults living in a highly endemic setting

https://doi.org/10.1016/j.clineuro.2021.106639Get rights and content

Highlights

  • There is no evidence that OSA may favor SARS-CoV-2 infection.

  • We evaluated the relationship between previously diagnosed OSA and SARS-CoV-2 infection.

  • SARS-CoV-2 antibodies were determined in 180 older adults that underwent polysomnography previously to this pandemic.

  • This study shows no relationships between history of OSA and SARS-CoV-2 seropositivity or symptomatology.

Abstract

Objective

In view of the high prevalence of obstructive sleep apnea (OSA) and the increasing global pandemic of SARS-CoV-2 infection, it is likely that many patients with OSA get exposed to this virus. Besides theoretical assumptions, there is no evidence that OSA may favor SARS-CoV-2 acquisition or may lead to a more severe disease. Taking the opportunity of the Atahualpa Project cohort, we aimed to assess the relationship between previously diagnosed OSA and SARS-CoV-2 infection in older adults living in rural Ecuador.

Patients and methods

SARS-CoV-2 antibodies were determined in 180 individuals aged > 60 years that underwent polysomnography previously to this novel pandemic. Those with OSA remained untreated due to income limitations. Exposure-effect models were fitted with OSA as the exposure, SARS-CoV-2 seropositivity and symptomatology as the outcomes, and confounders – age, gender, obesity, arterial hypertension, diabetes mellitus, hypercholesterolemia, individuals per house, home confinement – as independent variables.

Results

A total of 87 (48%) individuals were seropositive to SARS-CoV-2, 77% of whom were symptomatic. The mean apnea/hypopnea index was 11.1 ± 11.7 episodes per hour, with 83 (46%) individuals having mild, and 38 (21%) moderate-to-severe OSA. Exposure-effect models demonstrated lack of relationship between OSA and SARS-CoV-2 seropositivity and symptomatology.

Conclusions

This study shows no relationship between history of OSA and SARS-CoV-2 seropositivity or symptomatology, opposing previous suggestions that persons with OSA are more prone to acquire the infection and have a more severe disease.

Keywords

Obstructive sleep apnea
Apnea hipopnea index
SARS-CoV-2
Coronavirus-19
Population study

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