Association of Obstructive Sleep Apnea with Post-Acute Sequelae of SARS-CoV-2 infection (PASC).
Association of Obstructive Sleep Apnea with Post-Acute Sequelae of SARS-CoV-2 infection (PASC).
复制标题
阻塞性睡眠呼吸暂停与 SARS-CoV-2 感染急性后遗症 (PASC) 的关联。
DOI：
10.1101/2023.12.30.23300666
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Cz
中科院分区：
文献类型：
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作者：
Quan,StuartF;Weaver,MatthewD;Czeisler,MarkÉ;Barger,LauraK;Booker,LaurenA;Howard,MarkE;Jackson,MelindaL;Lane,RashonI;McDonald,ChristineF;Ridgers,Anna;Robbins,Rebecca;Varma,Prerna;Wiley,JoshuaF;Rajaratnam,ShanthaMW;Cz
背景阻塞性睡眠呼吸暂停 (OSA) 与 COVID-19 感染有关。很少有研究将 OSA 评估为 SARS-CoV-2 感染 (PASC) 急性后遗症的可能风险。研究问题在一般人群中，OSA 是否与 PASC 相关症状的发生几率增加以及 PASC 的总体定义相关？研究设计对 24,803 名美国成年人的一般人群进行横断面调查。结果 10,324 名成年人感染了 COVID-19 (41.6%) 参与者。各种持续性（感染后 3 个月以上）假定的 PASC 相关身心健康症状的患病率范围为 6.5%（外周水肿）至 19.6%（紧张/焦虑）。在针对人口、人体测量、共病医疗和社会经济因素进行调整的逻辑回归模型中，OSA 与所有假定的 PASC 相关症状相关，最高调整比值比 (aOR) 分别为发烧 (2.053) 和紧张/焦虑 (1.939)。弹性网络回归确定了 37 种症状中与 COVID-19 感染最密切相关的 13 种。 PASC 的四种定义是使用这些症状通过其回归系数等权重或按比例权重而制定的。在使用这些定义的所有 4 个逻辑回归模型中，OSA 与 PASC 相关（aOR 范围：1.934–2.071）；在接受 OSA 治疗的患者中，这种关联性有所减轻。在需要 ≥ 3 个症状的最佳拟合整体模型中，PASC 患病率为 21.9%。结论在一般人群样本中，OSA 与 PASC 相关症状的发生以及 PASC 的全球定义相关。要求存在 3 种或更多症状的 PASC 定义可能有助于识别病例和未来的研究。
BackgroundObstructive sleep apnea (OSA) is associated with COVID-19 infection. Fewer investigations have assessed OSA as a possible risk for the development of Post-Acute Sequelae of SARS-CoV-2 infection (PASC).Research QuestionIn a general population, is OSA associated with increased odds of PASC-related symptoms and with an overall definition of PASC?Study DesignCross-sectional survey of a general population of 24,803 U.S. adults.ResultsCOVID-19 infection occurred in 10,324 (41.6%) participants. Prevalence rates for a wide variety of persistent (> 3 months post infection) putative PASC-related physical and mental health symptoms ranged from 6.5% (peripheral edema) to 19.6% (nervous/anxious). In logistic regression models adjusted for demographic, anthropometric, comorbid medical and socioeconomic factors, OSA was associated with all putative PASC-related symptoms with the highest adjusted odds ratios (aOR) being fever (2.053) and nervous/anxious (1.939) respectively. Elastic net regression identified the 13 of 37 symptoms most strongly associated with COVID-19 infection. Four definitions of PASC were developed using these symptoms either weighted equally or proportionally by their regression coefficients. In all 4 logistic regression models using these definitions, OSA was associated with PASC (range of aORs: 1.934–2.071); this association was mitigated in those with treated OSA. In the best fitting overall model requiring ≥3 symptoms, PASC prevalence was 21.9%.ConclusionIn a general population sample, OSA is associated with the development of PASC-related symptoms and a global definition of PASC. A PASC definition requiring the presence of 3 or more symptoms may be useful in identifying cases and for future research.