RESUMO
BACKGROUND AND AIM: Obstructive sleep apnea (OSA), having an increased inflammatory state due to an imbalance between sympathetic and parasympathetic activity, intermittent hypoxia, and increased cytokines, may aggravate the immune response for COVID-19 infection. Our aim was to evaluate the effect of OSA upon inflammatory response and length of stay in patients with favorable outcomes. METHODS: Patients admitted to an outpatient clinic after being hospitalized for treatment of COVID-19 were included consecutively in this cross-sectional multicenter observational study. STOP-Bang Questionnaire and a cut-off value of 3 points were used to identify patients with a high risk of OSA. RESULTS: Study population consisted of 201 patients with a median STOP-Bang score of 2.0 (1.0-4.0) points. According to the cut-off value of 3 points, 94 (46.8%) patients were classified as high-risk OSA patients. High-risk OSA patients were older, had many comorbidities such as hypertension, coronary artery disease, and diabetes mellitus, had higher serum D-dimer, ferritin, C-reactive protein, and procalcitonin measurements, and had a longer hospital stay. Possible risk factors associated with length of stay were age, lymphocyte count, and total STOP-Bang score. Multivariable analysis revealed that a 1 point increase in STOP-Bang score results in a 0.43 day longer hospital stay. CONCLUSIONS: Prevalence of OSA within COVID-19 patients with favorable outcomes is similar to the general population. However, the length of stay is related to the presence of high-risk OSA. Our study, therefore, suggests that OSA is related to delayed improvement of COVID-19 infection.
RESUMO
On 31 December 2019, the Wuhan Municipal Committee of Health and Healthcare (Hubei Province, China) reported that there were 27 cases of pneumonia of unknown origin with symptoms starting on the 8 December. On 7 January 2020, the Chinese authorities identified that the agent causing the outbreak was a new type of virus of the Coronaviridae family, temporarily called 'new coronavirus, 2019-nCoV'. On January 30th, 2020, the World Health Organisation (WHO) declared the outbreak an international emergency and described it as a pandemic in March 2020. While it was previously referred to as 2019-nCoV by WHO, on February 11, 2020, the disease was named as severe acute respiratory syndrome-coronavirus2. The disease was confirmed to have reached Turkey on 11 March 2020, after a patient who had returned to Turkey from Europe, tested positive. The most appropriate treatment approach to treating COVID-19 remains unclear. Current treatment protocols are based on limited data and are evolving rapidly as clinical data emerge. A large volume of data and publications from randomized controlled trials, observational cohorts, and case series are emerging promptly, some in peer-reviewed journals, others as manuscripts that have not yet been peer reviewed. The Republic of Turkey Ministry of Health invited the specialties societies to prepare a clinical protocol for the management of COVID-19. The Turkish Pandemic Working Group prepare the present recommendations with the evidence available at the time of preparing them. It is aimed to summarize the treatment management of COVID-19 in line with the current treatment recommendations in national and international guidelines. Keywords: COVID-19;pandemic;treatment.