Abstract
Study objectives: Sleep and circadian phenotypes are associated with several diseases. The present study aimed to investigate whether sleep and circadian phenotypes were causally linked with coronavirus disease 2019 (COVID-19)-related outcomes.
Methods: Habitual sleep duration, insomnia, excessive daytime sleepiness, daytime napping, and chronotype were selected as exposures. Key outcomes included positivity and hospitalization for COVID-19. In the observation cohort study, multivariable risk ratios (RRs) and their 95% confidence intervals (CIs) were calculated. Two-sample Mendelian randomization (MR) analyses were conducted to estimate the causal effects of the significant findings in the observation analyses. Odds ratios (ORs) and the corresponding 95% CIs were calculated and compared using the inverse variance weighting, weighted median, and MR-Egger methods.
Results: In the UK Biobank cohort study, both often excessive daytime sleepiness and sometimes daytime napping were associated with hospitalized COVID-19 (excessive daytime sleepiness [often vs. never]: RR = 1.24, 95% CI = 1.02-1.5; daytime napping [sometimes vs. never]: RR = 1.12, 95% CI = 1.02-1.22). In addition, sometimes daytime napping was also associated with an increased risk of COVID-19 susceptibility (sometimes vs. never: RR = 1.04, 95% CI = 1.01-1.28). In the MR analyses, excessive daytime sleepiness was found to increase the risk of hospitalized COVID-19 (MR IVW method: OR = 4.53, 95% CI = 1.04-19.82), whereas little evidence supported a causal link between daytime napping and COVID-19 outcomes.
Conclusions: Observational and genetic evidence supports a potential causal link between excessive daytime sleepiness and an increased risk of COVID-19 hospitalization, suggesting that interventions targeting excessive daytime sleepiness symptoms might decrease severe COVID-19 rate.
Keywords: COVID-19; Mendelian randomization; cohort study; sleep.
【저자키워드】 COVID-19, mendelian randomization, cohort study, Sleep., 【초록키워드】 coronavirus disease, Diseases, severe COVID-19, Hospitalization, UK biobank, Genetic, risk, Intervention, Symptom, outcome, outcomes, Cohort, Sleep, phenotype, COVID-19 hospitalization, Insomnia, COVID-19 susceptibility, Evidence, risk ratio, Support, observation, 95% CI, 95% confidence interval, increased risk, causal link, weighted median, hospitalized COVID-19, MR-Egger, Weighting, Effect, decrease, MR analyses, multivariable, selected, addition, conducted, supported, calculated, analysis, analyses, CIs, Habitual, IVW, RRs, 【제목키워드】 susceptibility, UK biobank, phenotype, Observational cohort study, with COVID-19,