Impact of home CPAP-treated obstructive sleep apnea on COVID-19 outcomes in hospitalized patients.

ABSTRACT

STUDY OBJECTIVES: To investigate the association between moderate or severe obstructive sleep apnea treated with home continuous positive airway pressure (CPAP) and severe coronavirus disease 2019 (COVID-19). METHODS: Retrospective study of patients admitted for COVID-19. Patients with obstructive sleep apnea treated with home CPAP were identified and for each of them we selected 5 patients admitted consecutively in the following hours. The main outcome of the study was the development of severe COVID-19, defined as 1) death or 2) a composite outcome of death or the presence of severe hypoxemic respiratory failure at or during admission. The association between CPAP-treated obstructive sleep apnea and these outcomes was estimated by logistic regression analysis after applying inverse probability of treatment weighting using a propensity score-weighting approach. RESULTS: Of the 2,059 patients admitted, 81 (3.9%) were receiving treatment with home CPAP. Among the 486 patients included in the study, 19% died and 39% presented the composite outcome. The logistic regression analysis did not show an association of CPAP treatment either with death (odds ratio [OR] 0.684; 95% confidence interval [CI] 0.332-1.409; P = .303) or with the composite outcome (OR 0.779; 95% CI 0.418-1.452; P = .432). Death was associated with age (OR 1.116; 95% CI 1.08-1.152; P < .001) and number of comorbidities (OR 1.318; 95% CI 1.065-1.631; P = .012), and the composite outcome was associated with male sex (OR 2.067; 95% CI 1.19-3.589; P = .01) and number of comorbidities (OR 1.241; 95% CI 1.039-1.484; P = .018). CONCLUSIONS: In hospitalized patients with COVID-19, prior obstructive sleep apnea treated with home CPAP is not independently associated with worse outcomes. CITATION Sampol J, Sáez M, Martí S, et al. Impact of home CPAP-treated obstructive sleep apnea on COVID-19 outcomes in hospitalized patients. J Clin Sleep Med. 2022;18(7)1857-1864.