The prevalence of Obstructive Sleep Apnea (OSA) in patients recovering from COVID-19

Abstract

Background: Fatigue is a common burden associated with COVID-19 and ~50% of patients still suffer from persistent fatigue 2 months after an acute infection. Within the first weeks of a rehabilitation program after COVID-19, we detected remarkable high rates of Obstructive Sleep Apnea (OSA) that might explain the common fatigue symptoms. The study was designed to further analyze the prevalence of OSA in patients recovering from COVID-19.

Methods: From May until October 2020 we screened all volunteering COVID-19-patients for the presence of OSA. We assessed the Apnea-Hypopnea-Index (AHI) using polygraphy screening and polysomnography, the sleepiness using the Epworth Sleepiness Scale, and the Body-Mass-Index (BMI).

Results: 69 patients were eligible for the study, of which 48 (69,6%) agreed to the diagnostical procedures. Mean age was 54,6 years (SD: 10,3; range: 33 to 88 years); 45,8% of the sample were female. 14 patients (29,2%) had no indications of OSA. 16 patients (33,3%) had an AHI between 5 and 15, indicating mild OSA. 10 patients (20,8%) had an AHI of 15 to <30, indicating moderate OSA, whereas 8 patients (16,7%) had signs of severe OSA (AHI of ≥15). AHI-scores were significantly correlated with the BMI (r=0,464; p=0,001) and with age (r=0,319; p=0,027), but not with sleepiness (r=-0,154; p=0,302).

Conclusion: Our results verify the extraordinarily high rate of OSA in COVID-19-patients that exceeds the expected prevalence of 5% OSA with daytime impairment and 20% minimally or asymptomatic OSA (Young, T. et al. Am. J. Respir. Crit. Care Med 2002; 165:1217–1239). This may be an explanation for the frequent fatigue symptoms. However, further studies are needed to analyze these associations in detail.