Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 27
Filter
1.
Cells ; 11(9)2022 05 06.
Article in English | MEDLINE | ID: covidwho-1847275

ABSTRACT

The novel corona virus that is now known as (SARS-CoV-2) has killed more than six million people worldwide. The disease presentation varies from mild respiratory symptoms to acute respiratory distress syndrome and ultimately death. Several risk factors have been shown to worsen the severity of COVID-19 outcomes (such as age, hypertension, diabetes mellitus, and obesity). Since many of these risk factors are known to be influenced by obstructive sleep apnea, this raises the possibility that OSA might be an independent risk factor for COVID-19 severity. A shift in the gut microbiota has been proposed to contribute to outcomes in both COVID-19 and OSA. To further evaluate the potential triangular interrelationships between these three elements, we conducted a thorough literature review attempting to elucidate these interactions. From this review, it is concluded that OSA may be a risk factor for worse COVID-19 clinical outcomes, and the shifts in gut microbiota associated with both COVID-19 and OSA may mediate processes leading to bacterial translocation via a defective gut barrier which can then foster systemic inflammation. Thus, targeting biomarkers of intestinal tight junction dysfunction in conjunction with restoring gut dysbiosis may provide novel avenues for both risk detection and adjuvant therapy.


Subject(s)
COVID-19 , Gastrointestinal Microbiome , Sleep Apnea, Obstructive , COVID-19/complications , Humans , Inflammation/complications , Risk Factors , SARS-CoV-2 , Sleep Apnea, Obstructive/complications
2.
Medicina (Kaunas) ; 58(3)2022 Feb 25.
Article in English | MEDLINE | ID: covidwho-1765784

ABSTRACT

Background and Objectives: The aim of this study was to evaluate short-term continuous positive air pressure (CPAP) treatment for health-related quality of life (HRQL) in patients with obstructive sleep apnea. Materials and Methods: Our subjects were 18-65 years old, diagnosed with moderate-to-severe obstructive sleep apnea and treated with CPAP between January 2020 and June 2021 in Hospital of Lithuanian University of Health Sciences Kaunas clinics. All the patients completed the Epworth Sleepiness Scale (ESS), the 36-Item Short Form Health Survey (SF-36), the and Pittsburgh Sleep Quality Index (PSQI) before and after 3 months of treatment. Polysomnography was also repeated. Statistical analyses were performed using SPSS 27.0 software. The value of p < 0.05 was considered as statistically significant. Results: The active-treatment group comprised 17 subjects with a mean age of 51.9 ± 8.9 years. The total SF-36 questionnaire score improved from 499.8 ± 122.3 to 589.6 ± 124.7 (p = 0.012). The SF-36 role limitations due to emotional problems (p = 0.021), energy (fatigue) (p = 0.035), and general health (p = 0.042) domains score significantly improved after CPAP treatment for 3 months. The PSQI mean score at baseline was 12.6 ± 2.9 and in the post-treatment group, it was -5.5 ± 2.3 (p = 0.001). The ESS also changed significantly from a pretreatment mean score of 10.9 ± 5.7 to -5.3 ± 3.2 (p = 0.002) after 3 months. Conclusions: Improvement in HRQL is seen even after a short treatment period with CPAP. Questionnaires are a good tool to evaluate CPAP treatment efficacy.


Subject(s)
Quality of Life , Sleep Apnea, Obstructive , Adolescent , Adult , Aged , Air Pressure , Continuous Positive Airway Pressure , Humans , Middle Aged , Quality of Life/psychology , Sleep , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/therapy , Young Adult
3.
Lung ; 200(2): 161-168, 2022 04.
Article in English | MEDLINE | ID: covidwho-1748493

ABSTRACT

INTRODUCTION: The prevalence of chronic cough increases with age. However, data on the prevalence and background disorders of cough subtypes in the elderly are scarce. The objective of this study was to identify the point prevalence and risk factors of acute, subacute, and chronic cough in an elderly community-based population. METHODS: This was a cross-sectional email survey amongst 26,205 members of the Finnish Pensioners' Federation during the COVID-19 pandemic in spring 2021. RESULTS: The response rate was 23.6% (6189). 5983 subjects aged at least 64 years were included in the analyses (mean 72.6 years, 66.3% female). The point prevalence of daily acute, subacute, and chronic cough were 1.4%, 0.7%, and 9.6%, respectively. Only 0.4% of the subjects had a COVID-19 infection. In the multivariate analyses, chronic rhinosinusitis, and obstructive sleep apnoea were common risk factors for all cough subtypes. Chronic cough had several risk factors; Bronchiectasis (OR 5.79 (CI95% 2.70-12.41)), current asthma (2.67 (2.02-3.54)), chronic rhinosinusitis (2.51 (1.94-3.24)), somatic symptom score (1.13 per symptom (1.07-1.19)), family history of chronic cough (1.88 (1.54-2.30)), gastro-oesophageal reflux disease (1.86 (1.50-2.32)), advanced age (1.20 per decade (1.02-1.40)), chronic obstructive pulmonary disease (1.74 (0.99-3.05)), dog ownership (1.42 (1.07-1.89)), and obstructive sleep apnoea (1.41 (1.16-1.73)). CONCLUSION: Acute and subacute cough, as well as previous COVID-19 infection, were uncommon in this Finnish elderly population. The prevalence of chronic cough was higher than that previously found in younger adults. Chronic cough is a multifactorial disorder in the elderly.


Subject(s)
COVID-19 , Sleep Apnea, Obstructive , Aged , Animals , COVID-19/epidemiology , Chronic Disease , Cough/etiology , Cross-Sectional Studies , Dogs , Female , Humans , Male , Pandemics , Sleep Apnea, Obstructive/complications
5.
J Clin Sleep Med ; 18(6): 1573-1581, 2022 06 01.
Article in English | MEDLINE | ID: covidwho-1687344

ABSTRACT

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) in children is associated with acute metabolic, cardiovascular, and neurocognitive abnormalities. The long-term outcomes of childhood OSA into adulthood have not been established. We performed a 20-year follow-up of patients with polysomnography-documented OSA in childhood compared to a healthy control group to evaluate the long-term anthropometric, sleep, cognitive, and cardiovascular outcomes. METHODS: Children diagnosed with severe OSA between ages 1 and 17 years (mean, 4.87 ± 2.77) were prospectively contacted by telephone as young adults after approximately 20 years. Data collected included reported anthropometric information, educational level, health history, and Berlin questionnaire scores. RESULTS: Young adults with confirmed severe OSA in childhood had significantly higher adulthood body mass index (P = .038), fewer academic degrees (P < .001), and more snoring (P = .045) compared to control patients. The apnea-hypopnea index during childhood trended toward predicting cardiovascular outcomes and the results of the Berlin questionnaire in adulthood. CONCLUSIONS: Adults with a history of severe childhood OSA have a high risk of snoring, elevated body mass index, and lower academic achievement in adulthood. Thus, children with severe OSA may be at increased risk of chronic diseases later in life. The intervening coronavirus disease 2019 (COVID-19) pandemic has introduced considerable additional neurobehavioral morbidity complicating the identification of the full long-term consequences of childhood OSA. CITATION: Nosetti L, Zaffanello M, Katz ES, et al. Twenty-year follow-up of children with obstructive sleep apnea. J Clin Sleep Med. 2022;18(6):1573-1581.


Subject(s)
COVID-19 , Sleep Apnea, Obstructive , Adolescent , Adult , Child , Child, Preschool , Follow-Up Studies , Humans , Infant , Polysomnography , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/epidemiology , Snoring/complications , Snoring/epidemiology
6.
Sleep ; 45(3)2022 03 14.
Article in English | MEDLINE | ID: covidwho-1522323

ABSTRACT

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) has been proposed as a risk factor for severe COVID-19. Confounding is an important consideration as OSA is associated with several known risk factors for severe COVID-19. Our aim was to assess the association of OSA with hospitalization due to COVID-19 using a population-based cohort with detailed information on OSA and comorbidities. METHODS: Included were all community-dwelling Icelandic citizens 18 years of age and older diagnosed with SARS-CoV-2 infection in 2020. Data on demographics, comorbidities, and outcomes of COVID-19 was obtained from centralized national registries. Diagnosis of OSA was retrieved from the centralized Sleep Department Registry at Landspitali - The National University Hospital. Severe COVID-19 was defined as the composite outcome of hospitalization and death. The associations between OSA and the outcome were expressed as odds ratios (OR) with 95% confidence intervals (95% CI), calculated using logistic regression models and inverse probability weighting. RESULTS: A total of 4,756 individuals diagnosed with SARS-CoV-2 infection in Iceland were included in the study (1.3% of the Icelandic population), of whom 185 had a diagnosis of OSA. In total, 238 were hospitalized or died, 38 of whom had OSA. Adjusted for age, sex, and BMI, OSA was associated with poor outcome (OR 2.2, 95% CI 1.4-3.5). This association was slightly attenuated (OR 2.0, 95% CI 2.0, 1.2-3.2) when adjusted for demographic characteristics and various comorbidities. CONCLUSIONS: OSA was associated with twofold increase in risk of severe COVID-19, and the association was not explained by obesity or other comorbidities.


Subject(s)
COVID-19 , Sleep Apnea, Obstructive , Adolescent , Adult , COVID-19/epidemiology , Comorbidity , Humans , Risk Factors , SARS-CoV-2 , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/epidemiology
7.
Sleep Breath ; 24(3): 791-799, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-1453831

ABSTRACT

OBJECTIVES: The purpose of this systematic review was to summarize and qualitatively analyze published evidence elucidating the prevalence of dysphagia and detail alterations in swallowing function in patients with OSAS. METHODS: Computerized literature searches were performed from four search engines. The studies were selected based on the inclusion and exclusion criteria. The studies were screened using Covidence (Cochrane tool) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards (PRISMA-2009). A total 2645 studies were initially retrieved, of which a total of 17 studies met inclusion criteria. Two reviewers, blinded to each other, evaluated level and strength of evidence using the Oxford Centre for Evidence-based Medicine Levels of Evidence and QualSyst, respectively. RESULTS: Dysphagia prevalence ranged from 16 to 78% among the eligible studies. Studies varied in operational definitions defining swallowing dysfunction (dysphagia) and method used to assess swallowing function. Approximately 70% of eligible studies demonstrated strong methodological quality. The majority of studies (n = 11; 65%) reported pharyngeal swallowing impairments in patients with OSAS, including delayed initiation of pharyngeal swallow and penetration/aspiration. CONCLUSION: This systematic review describes swallowing function in patients with OSAS. However, due to the variability in defining OSAS and dysphagia, in the assessment method used to determine dysphagia, and heterogeneity of study designs, true prevalence is difficult to determine. Clinicians involved in the management of OSAS patients should employ validated assessment measures to determine if swallow dysfunction is present.


Subject(s)
Deglutition Disorders/etiology , Deglutition/physiology , Oropharynx/physiopathology , Severity of Illness Index , Sleep Apnea, Obstructive/complications , Deglutition Disorders/diagnosis , Humans , Sleep Apnea, Obstructive/physiopathology
10.
Sleep Med ; 91: 253-261, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1313433

ABSTRACT

This chapter summarizes the known associations between COVID-19 and sleep dysfunction, including insomnia, excessive daytime sleepiness, restless legs syndrome and nightmares, and touches upon pandemic-related considerations for obstructive sleep apnea and continuous positive airway pressure treatment. Treatment strategies and management approaches are also briefly discussed.


Subject(s)
COVID-19 , Disorders of Excessive Somnolence , Sleep Apnea, Obstructive , Sleep Wake Disorders , Continuous Positive Airway Pressure , Disorders of Excessive Somnolence/therapy , Humans , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/epidemiology , Sleep Apnea, Obstructive/therapy , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/therapy
13.
J Clin Sleep Med ; 17(11): 2197-2204, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1239112

ABSTRACT

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is an extremely common sleep disorder. A potential association between OSA and coronavirus disease 2019 (COVID-19) severity has been proposed on the basis of similar comorbid medical conditions associated with both OSA and COVID-19. METHODS: We performed a retrospective review of 1,738 patients who were hospitalized with COVID-19 between March and October of 2020. Patients were classified based on the presence or absence of OSA diagnosis based upon the International Classification of Diseases (ICD; codes G47.33 and U07.1 for OSA and COVID-19, respectively). Other data were collected, including demographics, body mass index, and comorbid conditions. COVID-19 severity was compared between groups using the quick COVID-19 severity index. RESULTS: Quick COVID-19 severity index scores were higher in patients with OSA compared with those without OSA. However, the prevalence rates of type 2 diabetes (P < .0001), coronary artery disease (P < .0001), congestive heart failure (P < .0001), and chronic obstructive pulmonary diseases (P < .0001) were also significantly greater in the OSA group. Unadjusted models revealed higher risk of intensive care unit admission in patients with COVID-19 and OSA. However, such an association was attenuated and became nonsignificant after adjusting for age, sex, body mass index, and comorbid disease. CONCLUSIONS: In our study, OSA does not appear to be an independent risk factor for worse COVID-19 outcomes in hospitalized patients. Further studies with larger sample sizes are needed to delineate the potential role of OSA in determining outcomes in hospitalized patients with COVID-19. CITATION: Mashaqi S, Lee-Iannotti J, Rangan P, et al. Obstructive sleep apnea and COVID-19 clinical outcomes during hospitalization: a cohort study. J Clin Sleep Med. 2021;17(11):2197-2204.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Sleep Apnea, Obstructive , Cohort Studies , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Hospitalization , Humans , Retrospective Studies , Risk Factors , SARS-CoV-2 , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/epidemiology , Sleep Apnea, Obstructive/therapy
14.
Obes Res Clin Pract ; 15(3): 281-284, 2021.
Article in English | MEDLINE | ID: covidwho-1209648

ABSTRACT

In our paper we aimed to increase the awareness among physicians, concerning coronavirus disease 2019 (COVID-19) severity, especially in patients with specific underlying comorbidities. Obesity is the second most common condition in hospitalized COVID-19 patients. Furthermore it has a major role in the development of obstructive sleep apnoea (OSA), which is highly involved in a severe COVID-19 development and its serious outcomes. Even though obese OSA patients had an increased pulmonary embolism (PE) risk, there is no enough evidence to support the interaction between obesity and OSA regarding PE development in the setting of COVID-19. Our patient is a 45-year-old obese male with COVID-19, who was admitted to the intensive care unit (ICU) with acute respiratory failure requiring high-flow nasal oxygenation. Clinical, laboratory and diagnostic findings pointed on severe COVID-19 form, complicated with PE. After recovery, the diagnosis of OSA was established. With this case, we wanted to alert the physicians on comorbidities, such as obesity and OSA, while those conditions, to some extent, may contribute to worse COVID-19 clinical presentation.


Subject(s)
COVID-19 , Hospitalization , Intensive Care Units , Obesity/complications , Severity of Illness Index , Sleep Apnea, Obstructive/complications , COVID-19/therapy , Comorbidity , Humans , Male , Middle Aged , Respiratory Insufficiency , Risk Factors , SARS-CoV-2
15.
BMJ Case Rep ; 14(3)2021 Mar 25.
Article in English | MEDLINE | ID: covidwho-1153657

ABSTRACT

A 54-year-old woman presented with pruritic rash and hives of 3 days' duration followed by shortness of breath for 1 day. SARS-CoV-2 PCR test for COVID-19 was positive. Cutaneous manifestations of COVID-19 include acral lesions, urticarial rash, erythematous maculopapular rash, vascular rashes and vesicular rash. The cutaneous manifestations are mostly described as self-limiting. Urticarial rashes are not reported as the initial presentation symptom of COVID-19 infection but mostly noted to occur at the same time or after the onset of non-cutaneous symptoms. Management of cutaneous manifestations of COVID-19 affecting quality of life has not been well studied. Antihistamine therapy is the primary recommended therapy. Role of antiviral therapy for severe cases of rash needs to be further assessed.


Subject(s)
COVID-19/complications , Exanthema/virology , Urticaria/virology , Antiviral Agents/therapeutic use , Atrial Fibrillation/complications , COVID-19/therapy , Exanthema/pathology , Exanthema/therapy , Female , Histamine Antagonists/therapeutic use , Humans , Hypertension, Pulmonary/complications , Middle Aged , Obesity/complications , Renal Insufficiency, Chronic/complications , SARS-CoV-2 , Skin/pathology , Sleep Apnea, Obstructive/complications , Treatment Outcome , Urticaria/pathology , Urticaria/therapy
18.
BMC Pediatr ; 20(1): 561, 2020 12 18.
Article in English | MEDLINE | ID: covidwho-992454

ABSTRACT

BACKGROUND: Down syndrome (DS) is characterized by a series of immune dysregulations, of which interferon hyperreactivity is important, as it is responsible for surging antiviral responses and the possible initiation of an amplified cytokine storm. This biological condition is attributed to immune regulators encoded in chromosome 21. Moreover, DS is also characterized by the coexistence of obesity and cardiovascular and respiratory anomalies, which are risk factors for coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CASE PRESENTATION: A total of 55 children were admitted to the pediatric ward in Bergamo, between February and May 2020 for COVID-19. Here, we describe the cases of two children with DS and a confirmed COVID-19 diagnosis who had a severe course. In addition, both cases involved one or more comorbidities, including cardiovascular anomalies, obesity, and/or obstructive sleep apnea. CONCLUSIONS: Our observations indicate that children with DS are at risk for severe COVID-19 disease course.


Subject(s)
COVID-19/complications , Down Syndrome/complications , Severity of Illness Index , Adolescent , Child, Preschool , Down Syndrome/immunology , Down Syndrome/therapy , Female , Heart Septal Defects/complications , Humans , Pediatric Obesity/complications , Risk Factors , SARS-CoV-2 , Sleep Apnea, Obstructive/complications
SELECTION OF CITATIONS
SEARCH DETAIL