94% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1472176
This article is part of the Research Topic Novel technologies in the diagnosis and management of sleep-disordered breathing: Volume III View all 7 articles
Impact of obstructive sleep apnea on inpatient outcomes of COVID-19: A propensity-score matching analysis of the US Nationwide Inpatient Sample 2020
Provisionally accepted- General Hospital of Southern Theater Command, Guangzhou, China
Background: Obstructive sleep apnea (OSA) is associated with health complications, but its impact on COVID-19 outcomes is not known. This study investigated the association between OSA and outcomes of hospitalized COVID-19 patients.The Nationwide Inpatient Sample 2020 was searched for adults hospitalized for COVID-19. The outcomes of interest were in-hospital mortality, non-routine discharge, prolonged length of stay (LOS), and complications. Patients with OSA were matched to those without OSA in a 1:4 ratio using propensity score matching (PSM) according to age, sex, and major comorbidities.Results: After PSM, there were 54,900 adult COVID-19 patients consisting of 10,980 with OSA and 43,920 without OSA. The mean age was 63.2 years and 62.8% were male. Patients with OSA had higher odds of respiratory failure (adjusted OR [aOR] = 1.20, 95% confidence interval [CI]: 1.14-1.25), heart failure (aOR = 1.71, 95% CI:1.60-1.82), and arrhythmias (aOR = 1.18, 95% CI: 1.08-1.30). Conversely, OSA was associated with lower odds of cerebrovascular accidents (CVAs) (aOR = 0.71, 95% CI: 0.62-0.81, p<0.001), and a reduced likelihood of in-hospital mortality among patients ≥ 70 years old (aOR = 0.82, 95% CI: 0.75-0.89, p<0.001) and males (aOR = 0.79, 95% CI: 0.72-0.88, p<0.001), but not females.OSA is associated with higher risks of respiratory failure, heart failure, and arrhythmias in patients hospitalized forwith COVID-19. However, patients with OSA who are ≥ 70 years old and those who are male are less likely to have CVAs and in-hospital mortality. These findings underscore the complex relationship between OSA and COVID-19. As the study focused on hospitalized patients, the findings may not apply to mild or asymptomatic COVID-19 cases. Future research should include community-based cohorts and prospective studies to better understand this association.
Keywords: Obstructive sleep apnea (OSA), COVID-19, Nationwide Inpatient Sample (NIS), in-patient outcome, Mortality, respiratory failure
Received: 29 Jul 2024; Accepted: 06 Mar 2025.
Copyright: © 2025 Du, Xu, Chang, Feng, Wang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Weifeng Li, General Hospital of Southern Theater Command, Guangzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.