Obstructive Sleep Apnea and Risk of COVID-19 Infection, Hospitalization and Respiratory Failure

Matthew B. Maas*, Minjee Kim, Roneil G. Malkani, Sabra M. Abbott, Phyllis C. Zee

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

90 Scopus citations


Purpose: To study the relationship between OSA and risk of COVID-19 infection and disease severity, identified by the need for hospitalization and progression to respiratory failure. Methods: We queried the electronic medical record system for an integrated health system of 10 hospitals in the Chicago metropolitan area to identify cases of COVID-19. Comorbidities and outcomes were ascertained by ICD-10-CM coding and medical record data. We evaluated the risk for COVID-19 diagnosis, hospitalization, and respiratory failure associated with OSA by univariate tests and logistic regression, adjusting for diabetes, hypertension, and BMI to account for potential confounding in the association between OSA, COVID-19 hospitalization, and progression to respiratory failure. Results: We identified 9405 COVID-19 infections, among which 3185 (34%) were hospitalized and 1779 (19%) were diagnosed with respiratory failure. OSA was more prevalent among patients requiring hospitalization than those who did not (15.3% versus 3.4%, p < 0.0001; OR 5.20, 95% CI (4.43, 6.12)), and among those who progressed to respiratory failure (19.4% versus 4.5%, p < 0.0001; OR 5.16, 95% CI (4.41, 6.03)). After adjustment for diabetes, hypertension, and BMI, OSA was associated with increased risk for hospitalization (OR 1.65; 95% CI (1.36, 2.02)) and respiratory failure (OR 1.98; 95% CI (1.65, 2.37)). Conclusions: Patients with OSA experienced approximately 8-fold greater risk for COVID-19 infection compared to a similar age population receiving care in a large, racially, and socioeconomically diverse healthcare system. Among patients with COVID-19 infection, OSA was associated with increased risk of hospitalization and approximately double the risk of developing respiratory failure.

Original languageEnglish (US)
Pages (from-to)1155-1157
Number of pages3
JournalSleep and Breathing
Issue number2
StatePublished - Jun 2021


  • COVID-19
  • Coronavirus
  • Obstructive sleep apnea
  • Outcomes

ASJC Scopus subject areas

  • Clinical Neurology
  • Otorhinolaryngology


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