Welcome to Waves of Evidence, a monthly research roundup where I highlight and break down key Long COVID studies through the lens of a physical therapist specializing in Long COVID rehabilitation. Most features will focus on recent research, with occasional deep dives into foundational concepts. I hope you find it as fascinating as I do.
Publication Date: May 11, 2023 (Vol. 46, Issue 9)
In Other Words: Does sleep apnea increase your risk of developing Long COVID?
Researchers wanted to know if having obstructive sleep apnea (OSA) before catching COVID-19 made someone more likely to develop Long COVID after acute infection. To date, there is evidence-based research that connects obstructive sleep apnea to a higher risk of severe acute COVID infection and hospitalization. Until this article, there wasn’t any research tying it to Long COVID. Breathing-related sleep disorders such as sleep apnea is not currently listed as an official risk factor for Long COVID. Age, sex, and pre-existing health conditions like obesity, diabetes and cardiovascular disease are known risk factors, but nothing about OSA. It should be noted that this article was printed before National Academies of Science, Engineering and Medicine determined Long COVID to be the official name. This is why the research article refers to is as post-acute sequelae of SARS-CoV-2 (PASC). The main questions asked in this study are:
Does obstructive sleep apnea increase the risk of Long COVID in adults?
Does obstructive sleep apnea increase the risk of Long COVID in children?
Study design: This was a large, retrospective electronic health record (EHR) study, which means researchers didn’t run an experiment, they mined existing medical records from millions of patients across three separate research networks (N3C, PCORnet, and PEDSnet) and compared outcomes between people who did and didn’t have a previous OSA diagnosis.
Study group: Adults and children with a confirmed COVID-19 infection (positive PCR or antigen test) between March 2020 and February 2022. This amounted to about 2.2 million patients (106,262 were children). Out of these individuals, they then identified those who had a prior history of OSA that was documented in the record within two years before COVID infection.
The control group: People were COVID-positive from the same networks and time periods who did not have a prior OSA diagnosis in their records.
Goal: There were two overarching goals. One was to determine if a pre-existing OSA diagnosis raises the odds of developing Long COVID. The other is whether that factor alone increases the risk when you overlap and account for other factors like obesity, hospitalization severity, and other chronic conditions.
Findings:
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