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Meta-Analysis
. 2021 Jun:82:47-53.
doi: 10.1016/j.sleep.2021.03.029. Epub 2021 Apr 1.

Obstructive sleep apnea (OSA) and outcomes from coronavirus disease 2019 (COVID-19) pneumonia: a systematic review and meta-analysis

Timotius Ivan Hariyanto  1 , Andree Kurniawan  2
Affiliations
Meta-Analysis

Obstructive sleep apnea (OSA) and outcomes from coronavirus disease 2019 (COVID-19) pneumonia: a systematic review and meta-analysis

Timotius Ivan Hariyanto et al. Sleep Med. 2021 Jun.

Abstract

Background: Obstructive sleep apnea (OSA) is the most prevalent sleep-related breathing disorder which could impair someone's quality of life and is also associated with poor outcomes from many diseases. Currently, the evidence regarding the link between OSA and coronavirus disease 2019 (COVID-19) is still conflicting. This study aims to analyze the relationship between OSA and poor outcomes of COVID-19.

Materials and methods: We systematically searched the PubMed and Europe PMC database using specific keywords related to our aims until December 10th, 2020. All articles published on COVID-19 and OSA were retrieved. The quality of the study was assessed using the Newcastle-Ottawa Scale (NOS) tool for observational studies. Statistical analysis was done using Review Manager 5.4 software.

Results: A total of 21 studies with 54,276 COVID-19 patients were included in this meta-analysis. This meta-analysis showed that OSA was associated with composite poor outcome [OR 1.72 (95% CI 1.55-1.91), p < 0.00001, I2 = 36%, random-effect modeling] and its subgroup which comprised of severe COVID-19 [OR 1.70 (95% CI 1.18-2.45), p = 0.005], ICU admissions [OR 1.76 (95% CI 1.51-2.05), p < 0.00001], the need for mechanical ventilation [OR 1.67 (95% CI 1.48-1.88), p < 0.00001], and mortality [OR 1.74 (95% CI 1.39-2.19), p < 0.00001].

Conclusions: Extra care and close monitoring should be provided to patients with OSA to minimize the risk of infections. Simple questionnaires such as STOP-Bang questionnaire can be used for screening patients who may be at risk for severe adverse outcomes.

Keywords: COVID-19; Coronavirus disease 2019; OSA; Sleep apnea; Sleep disorder.

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Conflict of interest statement

Conflict of interest None declared.

Figures

Fig. 1
Fig. 1
PRISMA diagram of the detailed process of selection of studies for inclusion in the systematic review and meta-analysis.
Fig. 2
Fig. 2
Forest plot that demonstrates the association of obstructive sleep apnea (OSA) with composite poor outcome and its subgroup which comprises of severe COVID-19, ICU admission, the need for mechanical ventilation, and mortality.
Fig. 3
Fig. 3
Funnel plot analysis for the association of obstructive sleep apnea (OSA) with composite poor outcome of COVID-19.
See this image and copyright information in PMC

Comment in

References

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