Causal associations between obstructive sleep apnea and COVID-19: A bidirectional Mendelian randomization study

Area of Science:

• Genetics
• Epidemiology
• Respiratory Medicine

Background:

• The COVID-19 pandemic has profoundly affected global health.
• The relationship between obstructive sleep apnea (OSA) and COVID-19 risk remains uncertain.
• Large-scale cohort studies are needed to investigate this association.

Purpose of the Study:

• To determine the causal relationship between obstructive sleep apnea (OSA) and COVID-19.
• To investigate whether OSA is a risk factor for COVID-19.
• To explore the potential causal effect of COVID-19 on the risk of developing OSA.

Main Methods:

• Utilized bidirectional two-sample Mendelian randomization (MR) analysis.
• Employed single-nucleotide polymorphisms (SNPs) from genome-wide association studies (GWAS) as instrumental variables.
• Applied inverse-variance weighted (IVW) as the primary analysis method, with MR-Egger, MR-PRESSO, and weighted median as sensitivity analyses.

Main Results:

• Forward MR analyses found no evidence of a causal link between OSA and any COVID-19 phenotype.
• Reverse MR analysis indicated a potential causal effect of severe COVID-19 on increased OSA risk (OR, 1.049; P=0.002).
• Sensitivity analyses confirmed the robustness of the findings for the reverse association.

Conclusions:

• No significant evidence supports a causal association between obstructive sleep apnea and COVID-19.
• Potential evidence suggests a causal effect of severe COVID-19 on the risk of developing obstructive sleep apnea.
• Further research may be warranted to elucidate the complex interplay between severe COVID-19 and OSA development.