{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:08:54Z","timestamp":1770826134848,"version":"3.50.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003483","name":"Hebrew University of Jerusalem","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003483","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Clin Sleep Med"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Obstructive sleep apnea (OSA) is associated with impaired immune responses. Prior small-scale investigations suggested that pediatric OSA leads to a more severe clinical course of common childhood viruses. Whether OSA increases the risk of infection remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine whether children with OSA are at increased risk of influenza or COVID-19, and to assess the effect of adenotonsillectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using TriNetX, we compared children aged 2\u201318 years with incident OSA and matched controls without OSA. Outcomes were ICD-10\u2013coded influenza and COVID-19 over a five-year follow-up. We estimated risk ratios (RRs) and Kaplan\u2013Meier hazard ratios (HRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Matched cohorts included 539,127 children each (mean age 5.6\u2009\u00b1\u20093.6 years). Influenza was diagnosed in 5.1% of OSA vs. 2.8% of controls (RR 1.80; 95% CI, 1.765\u20131.836); five-year influenza-free survival was 90.27% vs. 93.04% (HR 1.45; 95% CI, 1.421\u20131.479). COVID-19 was diagnosed in 2.5% vs. 1.0% (RR 2.496; 95% CI, 2.418\u20132.576); five-year COVID-19-free survival was 95.02% vs. 97.49% (HR 1.986; 95% CI, 1.924\u20132.050). Effects were similar across age groups. In the treatment sub-analysis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200996,004 per group), adenotonsillectomy did not reduce risk. In secondary analyses, OSA was also associated with a higher risk of pneumonia due to influenza or COVID-19.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a period spanning 5 years after OSA diagnosis, children of all ages have a significantly higher risk of influenza and COVID-19 diagnoses. Although absolute risks are low, adenotonsillectomy does not lessen susceptibility, suggesting persistent immune dysregulation and supporting prioritization of seasonal vaccination in children with OSA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s44470-025-00035-x","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T15:20:35Z","timestamp":1770823235000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of influenza and COVID-19 illness and pediatric obstructive sleep apnea: a TriNetX cohort with 5-year follow-up"],"prefix":"10.1007","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0656-905X","authenticated-orcid":false,"given":"Alex","family":"Gileles-Hillel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Reiter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gozal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"35_CR1","doi-asserted-by":"publisher","unstructured":"Gileles-Hillel A, Bhattacharjee R, Gorelik M, Narang I. 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