Obstructive sleep apnea is a risk factor for incident COVID-19 infection.

PURPOSE: Cross-sectional studies suggest that obstructive sleep apnea (OSA) is a potential risk factor for incident COVID-19 infection, but longitudinal studies are lacking. METHODS: Two surveys from a large general population cohort, the COVID-19 Outbreak Public Evaluation (COPE) Initiative, undertaken 147 ± 58 days apart were analyzed to determine whether the pre-existing OSA was a risk factor for the incidence of COVID-19. RESULTS: Of the 24,803 respondents completing the initial survey, 14,950 were negative for COVID-19; data from the follow-up survey were available for 2,325 respondents. Those with incident COVID-19 infection had a slightly higher prevalence of OSA (COVID-19+: 14.3 vs. COVID-19-: 11.5%, p = 0.068). Stratification by treatment status revealed that those untreated for their OSA were at greater risk for developing COVID-19 infection (OSA Untreated: 14.2 vs. OSA Treated: 7.4%, p ≤ 0.05). In a logistic regression model adjusted for comorbidities, demographic, socioeconomic factors, days between surveys and the interaction between vaccination status and OSA, incident COVID-19 infection was 1.94 times more likely in those with OSA (aOR: 1.94, 95% CI: 1.07–3.51, p ≤ 0.05). Stratification by treatment status revealed only untreated OSA participants were at greater risk for COVID-19 (aOR: 3.21, 95% CI: 1.25–8.23, p ≤ 0.05). CONCLUSION: The evidence from this study confirms untreated OSA as a risk factor for acquiring COVID-19 infection and highlights the importance of actively treating and managing OSA as a preventative mechanism against COVID-19 disease.