News — A study helmed by the National Institutes of Health's RECOVER Initiative and backed by NYU Langone Health as the base for the initiative's Clinical Science Core (CSC) has revealed that sleep apnea could considerably heighten the danger of long COVID in grown-ups.
By April 2023, over 100 million individuals in America had contracted the virus responsible for COVID-19. According to the U.S. Government's Household Pulse survey in April, approximately 6% of American adults are presently encountering symptoms associated with long COVID, such as depression, fatigue, sleep issues, and brain fog. Earlier researches have demonstrated that patients with obstructive sleep apnea (OSA) are more likely to experience a severe disease when first infected with COVID-19. OSA is prevalent among about 1 in 8 adults, but frequently goes undiagnosed.
The study, which was published in the journal Sleep on May 11, revealed that patients with a prior diagnosis of sleep apnea in the PCORnet group had a 12% higher risk of experiencing long-term symptoms several months after their initial COVID-19 infection. Among the N3C patient group, who had higher levels of other chronic illnesses compared to those in PCORnet, sleep apnea was associated with a 75% increased risk of long COVID in contrast to patients without sleep apnea. Even after taking into account obesity, hypertension, diabetes, and hospitalization during the time of initial COVID-19 infection, all of which are known to independently contribute to long COVID risk, the observed increases in risk for long COVID among adults with sleep apnea remained significant.
The researchers put forward a hypothesis that the differences in the percentage increases in long COVID risk between the study groups may be further clarified by variations in the definitions of long COVID, study populations, and the analysis methods of patient records throughout the extensive study. In contrast to the findings in adults, the impact of sleep apnea on the risk of long COVID was no longer significant in children when the researchers accounted for other risk factors, including obesity.
Lorna Thorpe, PhD, MPH, Professor and Director of the Division of Epidemiology at NYU Langone Health, and the senior author of the study, emphasized that a strength of the work is that the link between sleep apnea and long COVID remained consistent regardless of how long COVID was defined or data was collected by the researchers. She is also co-leading efforts to comprehend long COVID using electronic health record networks for the RECOVER CSC at NYU Langone. According to Thorpe, "This study is the first collaboration of this focus and scale to find that adults with sleep apnea are at greater risk for long COVID."
RECOVER, which stands for Researching COVID to Enhance Recovery, is a research initiative aimed at comprehending why some individuals develop long-term symptoms after a COVID-19 infection, and how to detect, treat, and prevent long COVID. As the Clinical Science Core (CSC) of RECOVER, NYU Langone Health is responsible for integrating research activities from various clinical sites across the United States.
Hannah Mandel, a senior research scientist for the electronic health record studies arm of the RECOVER CSC at NYU Langone Health, and the corresponding author of the study, suggests that this study will contribute to clinical care by identifying patients who require closer monitoring for long COVID. She also recommends that people with sleep apnea who contract COVID-19 should seek prompt treatment, closely monitor their symptoms, and maintain up-to-date vaccinations to reduce the risk of infection. There is still much to learn about long COVID, but this study's findings have implications for clinical practice.
The study found an interesting gender difference in the N3C group, where women with sleep apnea were found to be at a higher risk for long COVID than men with sleep apnea. Specifically, women had an 89% increased likelihood of developing long COVID compared to a 59% increased chance for men. While the reasons for this are not fully understood, the researchers suggest that women with diagnosed sleep apnea in their medical records may have more severe conditions than men. Additionally, women with sleep apnea tend to be diagnosed with OSA later than men, which could contribute to the higher risk. Further research is necessary to better understand the gender disparities in long COVID risk among those with sleep apnea.
The study was funded by RECOVER () and received additional support from the National Center for Advancing Translational Sciences (). For more information on RECOVER, visit . In addition, the CSC at NYU Langone Health is co-led by RECOVER co-principal investigators , Helen L. and Martin S. Kimmel Professor of Advanced Cardiac Therapeutics and founding director of NYU Langone’s heart failure program; , director of the ; , director of the and professor in the ; and , director of pediatric research for RECOVER CSC and assistant professor of pediatrics and population health at the and Bellevue Hospital Center.
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Along with Thorpe and Mandel, study authors from the NYU Langone Health were Gunnar Colleen, Yu Chen, and Jeff Radwell in the Department of Population Health, Stuart Katz in the Division of Cardiology, Jasmin Divers in the Department of Medicine at New York University Long Island School of Medicine, and Shari Brosnahan in the Division of Pulmonary, Critical Care and Sleep Medicine. Authors at Weill Cornell Medicine included Sajjad Abedian in the Information Technologies and Services Department; Ana Krieger in the departments of Medicine, Neurology and Genetic Medicine; and Mark Weiner in Department of Medicine. At the Children's Hospital of Philadelphia, authors included L Charles Bailey, Kathryn Hirabayashi, Vitaly Lorman, and Hanieh Razzaghi at the Applied Clinical Research Center. From the University of Colorado’s Anschutz Medical Campus, authors included Melissa Haendel and Julie McMurry of Biomedical Informatics.
Additional co-authors included Margaret Hall, Richard Moffitt, and Yun Jae Yoo in the Department of Biomedical Informatics at Stony Brook University; and Johanna Loomba, Andrea Zhou, and Suchetha Sharma in the Integrated Translational Health Research Institute at the University of Virginia; Nariman Ammar at the University of Tennessee Health Science Center College of Medicine, Tellen Bennett in the Department of Pediatrics at Children's Hospital Colorado, M Daniel Brannock of the Center for Data Science and AI in Durham, Christopher Chute of Johns Hopkins School of Medicine, Michael Evans of the Clinical and Translational Science Institute at the University of Minnesota, Mady Hornig of Columbia University’s Mailman School of Public Health, Diego Mazzotti of the Division of Pulmonary Critical Care and Sleep Medicine at the University of Kansas Medical Center, Nathan Pajor of the University of Cincinnati College of Medicine, Emily Pfaff of University of North Carolina at Chapel Hill School of Medicine, Susan Redline of Brigham and Women's Hospital, Elle Seibert of Rose International, Anisha Sekar of the Patient-Led Research Collaborative in Washington, D.C., and Tanayott Thaweethai of Massachusetts General Hospital and Harvard Medical School, and Andrea Zhou of the Integrated Translational Health Research Institute at of the University of Virginia, on behalf of the RECOVER Consortium.
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