{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:42:13Z","timestamp":1793310133131,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["Dnr: 2019\u201002081"],"award-info":[{"award-number":["Dnr: 2019\u201002081"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20210030"],"award-info":[{"award-number":["20210030"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20210529"],"award-info":[{"award-number":["20210529"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20210581"],"award-info":[{"award-number":["20210581"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["2022068624"],"award-info":[{"award-number":["2022068624"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20230392"],"award-info":[{"award-number":["20230392"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20240726"],"award-info":[{"award-number":["20240726"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006636","name":"Forskningsr\u00e5det om H\u00e4lsa, Arbetsliv och V\u00e4lf\u00e4rd","doi-asserted-by":"publisher","award":["2024\u201001711"],"award-info":[{"award-number":["2024\u201001711"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The impact of obstructive sleep apnea (OSA) and positive airway pressure (PAP) treatment on COVID\u201019 severity is unclear. In this population\u2010based, nationwide study using multi\u2010register data, we aimed to assess if OSA is a risk factor for COVID\u201019 severity and how adherence to PAP treatment and clinical characteristics affect the risk. Swedish residents with COVID\u201019 infection January 2020\u2013May 2022 were included. An exposed group of OSA (starting PAP treatment 2015\u20132019) was identified. COVID\u201019 severity outcome was defined as mild (non\u2010hospitalised), severe (hospitalised) or critical (intensive care or death). Covariates included comorbidities and sociodemographics. Conditional odds ratios (COR) with 95% confidence intervals (95% CI) were estimated using multinomial logistic regression. Among 8,894,162 individuals in Sweden, 1,932,081 (21.7%) had registered COVID\u201019 January 2020\u2013May 2022. OSA was identified in 11,407 (0.6%) and was associated with an increased risk of severe (COR 1.34; 95% CI 1.25\u20131.43) and critical (1.25; 1.11\u20131.42) COVID\u201019 after adjustment for age, sex, education and comorbidities. Stratified by PAP adherence, age and COVID\u201019 wave, OSA was a risk factor for more severe COVID\u201019 in PAP\u2010adherent and non\u2010adherent individuals, in people aged 40\u201360 but not &gt;\u200960\u2009years and not after June 2021. OSA severity, assessed with the oxygen desaturation index (ODI), was independently associated with COVID\u201019 severity, with the highest risks for severe (1.23; 1.01\u20131.52) and critical (1.76; 1.17\u20132.63) COVID\u201019 observed in ODI \u2265\u200930 (vs. ODI\u2009&lt;\u200915). We conclude that patients with moderate to severe OSA have an increased risk of severe COVID\u201019, also when PAP\u2010treated, with an independent dose\u2013response relationship between the severity of intermittent hypoxia and COVID\u201019 severity.<\/jats:p>","DOI":"10.1111\/jsr.70082","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:54:28Z","timestamp":1746492868000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Moderate to Severe Obstructive Sleep Apnea Is a Risk Factor for Severe\n                    <scp>COVID<\/scp>\n                    \u201019\u2014A Nationwide Cohort Study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8486-6746","authenticated-orcid":false,"given":"Mirjam","family":"Ljunggren","sequence":"first","affiliation":[{"name":"Department of Medical Sciences, Respiratory, Allergy and Sleep Research Uppsala 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