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688 Pediatric Obstructive Sleep Apnea (OSA) and COVID-19-Related Adverse Clinical Outcomes
Introduction The relationship of OSA and human coronavirus (COVID-19) in the pediatric population is unknown. We postulate that OSA is associated with SARS-CoV-2 positivity and with adverse COVID-19 outcomes in children. Methods A retrospective review of 120 consecutive patients (
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| Published in: | Sleep (New York, N.Y.) N.Y.), 2021-05, Vol.44 (Supplement_2), p.A269-A269 |
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| container_title | Sleep (New York, N.Y.) |
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| creator | Shah, Vaishal Foldvary-Schaefer, Nancy Wang, Lu Jehi, Lara Obrea, Cynthia Pena Milinovich, Alex Mehra, Reena |
| description | Introduction The relationship of OSA and human coronavirus (COVID-19) in the pediatric population is unknown. We postulate that OSA is associated with SARS-CoV-2 positivity and with adverse COVID-19 outcomes in children. Methods A retrospective review of 120 consecutive patients ( |
| doi_str_mv | 10.1093/sleep/zsab072.686 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8135638</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2780330033</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1686-3abe2b722a876b104f93854d4ed6ea806f2a956b5f2f060b72c984afef2de8d3</originalsourceid><addsrcrecordid>eNpVkU9Lw0AQxRdRsFY_gLcFL3pIu5tNNpuLEOq_QiFiiwcvyyY7qylpEneTgn56t7YIHoZhmMdv3vAQuqRkQknKpq4G6KbfThUkCSdc8CM0onFMgtSvj9GIUE4DQUl8is6cWxM_RykboTcuBH4GXaneViXOC9fboeyrLeDlDomzrgGFr_NldoNVo_Esf53fBTQNXqBWPWic6S1YB3hWV01VqhrnQ1-2G3Dn6MSo2sHFoY_R6uF-NXsKFvnjfJYtgpJ6nwFTBYRFEoZKJLygJDIpE3GkI9AclCDchCqNeRGb0BBOvLJMRaQMmFCD0GyMbvfYbig2oEtoeqtq2dlqo-yXbFUl_2-a6kO-t1spKIs5Ex5wdQDY9nMA18t1O9jGW5ZhIghjxJdX0b2qtK1zFszfBUrkLgL5G4E8RCD9a-wHQxJ75A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2780330033</pqid></control><display><type>article</type><title>688 Pediatric Obstructive Sleep Apnea (OSA) and COVID-19-Related Adverse Clinical Outcomes</title><source>Oxford Journals Online</source><source>Alma/SFX Local Collection</source><creator>Shah, Vaishal ; Foldvary-Schaefer, Nancy ; Wang, Lu ; Jehi, Lara ; Obrea, Cynthia Pena ; Milinovich, Alex ; Mehra, Reena</creator><creatorcontrib>Shah, Vaishal ; Foldvary-Schaefer, Nancy ; Wang, Lu ; Jehi, Lara ; Obrea, Cynthia Pena ; Milinovich, Alex ; Mehra, Reena</creatorcontrib><description>Introduction The relationship of OSA and human coronavirus (COVID-19) in the pediatric population is unknown. We postulate that OSA is associated with SARS-CoV-2 positivity and with adverse COVID-19 outcomes in children. Methods A retrospective review of 120 consecutive patients (<18 years) with prior polysomnogram (PSG) and COVID-19 testing from the Cleveland Clinic COVID-19 registry was conducted. Using a case control design of SARS-CoV-2 positive and negative pediatric patients, we examined COVID-19 and pre-existing OSA (dichotomized AHI≥1) using logistic (OR,95%CI) regression and as continuous measures: AHI, oxygen(SpO2) nadir, %time SpO2<90%) using linear regression(beta+/-SE). In those positive for SARS-CoV-2(cases only), we assessed the association of OSA and World Health Organization(WHO) COVID-19 clinical outcome composite score (hospitalization, requiring supplemental oxygen, non-invasive ventilation/high-flow oxygen, invasive ventilation/ECMO or death) using Wilcoxon rank sum test for ordinal data. Results Cases (n=36) were 11.8±4.4 years, 61% male, 27.8% black and 88.9% with OSA, while 85.7% of controls (n=84) had OSA. OSA was not associated with increased SARS-CoV-2 positivity: OR=1.33(0.40, 4.45,p=0.64). No significant difference between cases and controls for mean AHI 3.7(1.5,6.0) vs 3.5(1.5,7.1),p=0.91,SpO2 nadir 88.6±5.4 vs 89.1±4.4,p=0.58,%time SpO2<90% 0.05[0.00,1.00) vs 0.10 (0.00,1.00, p=0.65) respectively was noted. WHO-7 COVID-19 clinical outcome did not meet statistical significance in relation to OSA due to the low event frequency (p=0.49). Of note, those with OSA vs without OSA had a higher WHO-7 outcome score of 2 vs 0 and prevalence of hospitalization: 12.5 vs 0% respectively. Of hospitalized patients, the following was observed: 23% had moderate/severe OSA vs 4.3% mild OSA, 50% required supplemental oxygen and 25% required intubation/invasive ventilation. No deaths or readmissions were reported. High risk conditions included: 75% obesity, 50% asthma, 25% sickle cell disease and 25% hypoplastic left heart. Conclusion In this first report of which we are aware focused on COVID-19 in pediatric OSA, we use a case control design leveraging COVID-19 and sleep laboratory registries. Albeit not statistically significant, pediatric patients with OSA had a higher percentage of worse clinical outcomes. Larger network studies are needed to clarify whether poorer COVID-19 outcomes may be attributable to OSA or modulated via high risk health conditions. Support (if any):</description><identifier>ISSN: 0161-8105</identifier><identifier>EISSN: 1550-9109</identifier><identifier>DOI: 10.1093/sleep/zsab072.686</identifier><language>eng</language><publisher>Westchester: Oxford University Press</publisher><subject>B. Clinical Sleep Science and Practice ; Clinical outcomes ; Coronaviruses ; COVID-19 ; COVID-19 diagnostic tests ; Pediatrics ; Severe acute respiratory syndrome coronavirus 2 ; Sleep apnea</subject><ispartof>Sleep (New York, N.Y.), 2021-05, Vol.44 (Supplement_2), p.A269-A269</ispartof><rights>Sleep Research Society 2021. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.</rights><rights>Sleep Research Society 2021. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids></links><search><creatorcontrib>Shah, Vaishal</creatorcontrib><creatorcontrib>Foldvary-Schaefer, Nancy</creatorcontrib><creatorcontrib>Wang, Lu</creatorcontrib><creatorcontrib>Jehi, Lara</creatorcontrib><creatorcontrib>Obrea, Cynthia Pena</creatorcontrib><creatorcontrib>Milinovich, Alex</creatorcontrib><creatorcontrib>Mehra, Reena</creatorcontrib><title>688 Pediatric Obstructive Sleep Apnea (OSA) and COVID-19-Related Adverse Clinical Outcomes</title><title>Sleep (New York, N.Y.)</title><description>Introduction The relationship of OSA and human coronavirus (COVID-19) in the pediatric population is unknown. We postulate that OSA is associated with SARS-CoV-2 positivity and with adverse COVID-19 outcomes in children. Methods A retrospective review of 120 consecutive patients (<18 years) with prior polysomnogram (PSG) and COVID-19 testing from the Cleveland Clinic COVID-19 registry was conducted. Using a case control design of SARS-CoV-2 positive and negative pediatric patients, we examined COVID-19 and pre-existing OSA (dichotomized AHI≥1) using logistic (OR,95%CI) regression and as continuous measures: AHI, oxygen(SpO2) nadir, %time SpO2<90%) using linear regression(beta+/-SE). In those positive for SARS-CoV-2(cases only), we assessed the association of OSA and World Health Organization(WHO) COVID-19 clinical outcome composite score (hospitalization, requiring supplemental oxygen, non-invasive ventilation/high-flow oxygen, invasive ventilation/ECMO or death) using Wilcoxon rank sum test for ordinal data. Results Cases (n=36) were 11.8±4.4 years, 61% male, 27.8% black and 88.9% with OSA, while 85.7% of controls (n=84) had OSA. OSA was not associated with increased SARS-CoV-2 positivity: OR=1.33(0.40, 4.45,p=0.64). No significant difference between cases and controls for mean AHI 3.7(1.5,6.0) vs 3.5(1.5,7.1),p=0.91,SpO2 nadir 88.6±5.4 vs 89.1±4.4,p=0.58,%time SpO2<90% 0.05[0.00,1.00) vs 0.10 (0.00,1.00, p=0.65) respectively was noted. WHO-7 COVID-19 clinical outcome did not meet statistical significance in relation to OSA due to the low event frequency (p=0.49). Of note, those with OSA vs without OSA had a higher WHO-7 outcome score of 2 vs 0 and prevalence of hospitalization: 12.5 vs 0% respectively. Of hospitalized patients, the following was observed: 23% had moderate/severe OSA vs 4.3% mild OSA, 50% required supplemental oxygen and 25% required intubation/invasive ventilation. No deaths or readmissions were reported. High risk conditions included: 75% obesity, 50% asthma, 25% sickle cell disease and 25% hypoplastic left heart. Conclusion In this first report of which we are aware focused on COVID-19 in pediatric OSA, we use a case control design leveraging COVID-19 and sleep laboratory registries. Albeit not statistically significant, pediatric patients with OSA had a higher percentage of worse clinical outcomes. Larger network studies are needed to clarify whether poorer COVID-19 outcomes may be attributable to OSA or modulated via high risk health conditions. Support (if any):</description><subject>B. Clinical Sleep Science and Practice</subject><subject>Clinical outcomes</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 diagnostic tests</subject><subject>Pediatrics</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Sleep apnea</subject><issn>0161-8105</issn><issn>1550-9109</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpVkU9Lw0AQxRdRsFY_gLcFL3pIu5tNNpuLEOq_QiFiiwcvyyY7qylpEneTgn56t7YIHoZhmMdv3vAQuqRkQknKpq4G6KbfThUkCSdc8CM0onFMgtSvj9GIUE4DQUl8is6cWxM_RykboTcuBH4GXaneViXOC9fboeyrLeDlDomzrgGFr_NldoNVo_Esf53fBTQNXqBWPWic6S1YB3hWV01VqhrnQ1-2G3Dn6MSo2sHFoY_R6uF-NXsKFvnjfJYtgpJ6nwFTBYRFEoZKJLygJDIpE3GkI9AclCDchCqNeRGb0BBOvLJMRaQMmFCD0GyMbvfYbig2oEtoeqtq2dlqo-yXbFUl_2-a6kO-t1spKIs5Ex5wdQDY9nMA18t1O9jGW5ZhIghjxJdX0b2qtK1zFszfBUrkLgL5G4E8RCD9a-wHQxJ75A</recordid><startdate>20210503</startdate><enddate>20210503</enddate><creator>Shah, Vaishal</creator><creator>Foldvary-Schaefer, Nancy</creator><creator>Wang, Lu</creator><creator>Jehi, Lara</creator><creator>Obrea, Cynthia Pena</creator><creator>Milinovich, Alex</creator><creator>Mehra, Reena</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>5PM</scope></search><sort><creationdate>20210503</creationdate><title>688 Pediatric Obstructive Sleep Apnea (OSA) and COVID-19-Related Adverse Clinical Outcomes</title><author>Shah, Vaishal ; Foldvary-Schaefer, Nancy ; Wang, Lu ; Jehi, Lara ; Obrea, Cynthia Pena ; Milinovich, Alex ; Mehra, Reena</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1686-3abe2b722a876b104f93854d4ed6ea806f2a956b5f2f060b72c984afef2de8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>B. Clinical Sleep Science and Practice</topic><topic>Clinical outcomes</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 diagnostic tests</topic><topic>Pediatrics</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Sleep apnea</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shah, Vaishal</creatorcontrib><creatorcontrib>Foldvary-Schaefer, Nancy</creatorcontrib><creatorcontrib>Wang, Lu</creatorcontrib><creatorcontrib>Jehi, Lara</creatorcontrib><creatorcontrib>Obrea, Cynthia Pena</creatorcontrib><creatorcontrib>Milinovich, Alex</creatorcontrib><creatorcontrib>Mehra, Reena</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep (ProQuest)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database</collection><collection>ProQuest Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Sleep (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shah, Vaishal</au><au>Foldvary-Schaefer, Nancy</au><au>Wang, Lu</au><au>Jehi, Lara</au><au>Obrea, Cynthia Pena</au><au>Milinovich, Alex</au><au>Mehra, Reena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>688 Pediatric Obstructive Sleep Apnea (OSA) and COVID-19-Related Adverse Clinical Outcomes</atitle><jtitle>Sleep (New York, N.Y.)</jtitle><date>2021-05-03</date><risdate>2021</risdate><volume>44</volume><issue>Supplement_2</issue><spage>A269</spage><epage>A269</epage><pages>A269-A269</pages><issn>0161-8105</issn><eissn>1550-9109</eissn><abstract>Introduction The relationship of OSA and human coronavirus (COVID-19) in the pediatric population is unknown. We postulate that OSA is associated with SARS-CoV-2 positivity and with adverse COVID-19 outcomes in children. Methods A retrospective review of 120 consecutive patients (<18 years) with prior polysomnogram (PSG) and COVID-19 testing from the Cleveland Clinic COVID-19 registry was conducted. Using a case control design of SARS-CoV-2 positive and negative pediatric patients, we examined COVID-19 and pre-existing OSA (dichotomized AHI≥1) using logistic (OR,95%CI) regression and as continuous measures: AHI, oxygen(SpO2) nadir, %time SpO2<90%) using linear regression(beta+/-SE). In those positive for SARS-CoV-2(cases only), we assessed the association of OSA and World Health Organization(WHO) COVID-19 clinical outcome composite score (hospitalization, requiring supplemental oxygen, non-invasive ventilation/high-flow oxygen, invasive ventilation/ECMO or death) using Wilcoxon rank sum test for ordinal data. Results Cases (n=36) were 11.8±4.4 years, 61% male, 27.8% black and 88.9% with OSA, while 85.7% of controls (n=84) had OSA. OSA was not associated with increased SARS-CoV-2 positivity: OR=1.33(0.40, 4.45,p=0.64). No significant difference between cases and controls for mean AHI 3.7(1.5,6.0) vs 3.5(1.5,7.1),p=0.91,SpO2 nadir 88.6±5.4 vs 89.1±4.4,p=0.58,%time SpO2<90% 0.05[0.00,1.00) vs 0.10 (0.00,1.00, p=0.65) respectively was noted. WHO-7 COVID-19 clinical outcome did not meet statistical significance in relation to OSA due to the low event frequency (p=0.49). Of note, those with OSA vs without OSA had a higher WHO-7 outcome score of 2 vs 0 and prevalence of hospitalization: 12.5 vs 0% respectively. Of hospitalized patients, the following was observed: 23% had moderate/severe OSA vs 4.3% mild OSA, 50% required supplemental oxygen and 25% required intubation/invasive ventilation. No deaths or readmissions were reported. High risk conditions included: 75% obesity, 50% asthma, 25% sickle cell disease and 25% hypoplastic left heart. Conclusion In this first report of which we are aware focused on COVID-19 in pediatric OSA, we use a case control design leveraging COVID-19 and sleep laboratory registries. Albeit not statistically significant, pediatric patients with OSA had a higher percentage of worse clinical outcomes. Larger network studies are needed to clarify whether poorer COVID-19 outcomes may be attributable to OSA or modulated via high risk health conditions. Support (if any):</abstract><cop>Westchester</cop><pub>Oxford University Press</pub><doi>10.1093/sleep/zsab072.686</doi><oa>free_for_read</oa></addata></record> |
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| subjects | B. Clinical Sleep Science and Practice Clinical outcomes Coronaviruses COVID-19 COVID-19 diagnostic tests Pediatrics Severe acute respiratory syndrome coronavirus 2 Sleep apnea |
| title | 688 Pediatric Obstructive Sleep Apnea (OSA) and COVID-19-Related Adverse Clinical Outcomes |
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