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QUESTIONNAIRE AND POLYSOMNOGRAPHIC EVALUATION OF OBSTRUCTIVE SLEEP APNEA IN A COHORT OF POST-COVID-19 PATIENTS
Obstructive sleep apnea
Polysomnography
Post-COVID-19 syndrome
SARS-CoV-2
Sleep disorder questionnaires
Author
Affilliation
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Rio de Janeiro State University. Rio de Janeiro, RJ, Brazil.
Abstract
To evaluate the efficiency of 5 screening questionnaires for obstructive sleep apnea (OSA), OSA frequency, and the association between OSA and COVID-19 severity in recent COVID-19 cases, and to compare the use of the oxygen desaturation index (ODI) as an alternative measure for the respiratory disturbance index (RDI). This open cohort study recruited patients with recent COVID-19 (within 30-180 days) diagnosed using reverse transcription polymerase chain reaction. Participants were screened for OSA using the following 5 sleep disorder questionnaires prior to undergoing type I polysomnography: the Sleep Apnea Clinical Score (SACS), Epworth Sleepiness Scale (ESS), STOP-Bang score, No-Apnea score, and Berlin questionnaire. Polysomnography revealed that 77.5% of the participants had OSA and that these patients exhibited higher COVID-19-related hospitalization (58%) than those exhibited by non-apneic patients. The Kappa coefficient showed reasonable agreement between RDI > 5/h and No-Apnea score, RDI > 15/h and Berlin questionnaire score, and Epworth Sleepiness Scale and STOP-Bang score, but only moderate agreement between RDI > 15/h and No-Apnea score. An OSA-positive No-Apnea score increased the specificity of the SACS to 100% when RDI > 5/h. The intraclass correlation coefficient showed 95.2% agreement between RDI > 5/h and ODI > 10/h. The sequential application of the No-Apnea score and SACS was the most efficient screening method for OSA, which had a moderately high incidence among the post-COVID-19 group. We demonstrated an association between OSA and COVID-19 related hospitalization and that ODI could be a simple method with good performance for diagnosing OSA in this population. Abbreviations: AHI = apnea/hypopnea, CI = confidence interval, ESS = Epworth Sleepiness Scale, NPV = negative predictive values, ODI = oxygen desaturation index, OSA = obstructive sleep apnea, PPV = positive predictive values, PSG1 = type I polysomnography, RDI = respiratory disturbance index, SACS = sleep apnea clinical score, SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2, Spo2 = peripheral oxygen saturation.
Keywords
COVID-19Obstructive sleep apnea
Polysomnography
Post-COVID-19 syndrome
SARS-CoV-2
Sleep disorder questionnaires
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