Obstructive sleep apnea and COVID-19 clinical outcomes during hospitalization: a cohort study

Saif Mashaqi, Joyce Lee-Iannotti, Pooja Rangan, Melisa P. Celaya, David Gozal, Stuart F. Quan, Sairam Parthasarathy

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)2197-2204
Number of pages8
JournalJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
Issue number11
StatePublished - Nov 1 2021


  • COVID-19
  • comorbid conditions
  • hospitalization
  • obstructive sleep apnea
  • severity

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology


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