Obstructive sleep apnea is a risk comorbidity for COVID-19 fatality: A review. Part I

Abstract

The COVID-19 outbreak caused by the SARS-CoV-2 virus became a pandemic, and since the first cases reported in December 2019 to 28 October 2020, more than 44 million positive cases have been recorded with an accumulated fatality of 1,172,086 people due to the complication of mild infection of the upper airway to a severe disease of the lower airway, such as the acute respiratory distress syndrome, and death from multiple organ failure Comorbidities such as age over 40 years, obesity, and diabetes mellitus play an important role in the response inflammatory and immunological that can accelerate the production of pro-inflammatory cytokines causing endothelial dysfunction that produces endotheliitis, hypercoagulability, and fibrinolysis not only at lung level but also in other organs such as the heart and central nervous system Obstructive sleep apnea (OSA), which has a high prevalence in older adults with obesity, is a risk factor for endothelial dysfunction due to hypoxia that may favor hyper inflammation in response to SARS-CoV-2 and therefore OSA should be considered serious comorbidity for COVID-19 fatality A review of the pathophysiology of SARS-CoV-2, obesity, and OSA may contribute to have more tools in the prevention and treatment of serious complications of COVID-19 (English) [ABSTRACT FROM AUTHOR] El brote de COVID-19 causado por el virus SARS-CoV-2 se convirtio en una pandemia y desde los primeros casos reportados en diciembre de 2019 hasta el 28 de octubre de 2020, se han reportado mas de 44 millones de casos positivos con una fatalidad acumulada de 1,172,086 personas debido a la complicacion de una infeccion leve de las vias respiratorias superiores, a una enfermedad grave de las vias respiratorias inferiores, como el Sindrome de dificultad respiratoria aguda y muerte por insuficiencia organica multiple Comorbilidades como la edad mayor de 40 anos, la obesidad y la diabetes mellitus juegan un papel importante en la respuesta inflamatoria e inmunologica que puede acelerar la produccion de citosinas proinflamatorias provocando disfuncion endotelial que produce endotelitis, hipercoagulabilidad y fibrinolisis, no solo a nivel pulmonar sino tambien en otros organos como el corazon y el sistema nervioso central La apnea obstructiva del sueno (AOS), que tiene una alta prevalencia en adultos mayores con obesidad, es un factor de riesgo de disfuncion endotelial por la hipoxia que puede favorecer la hiperinflamacion en respuesta al SARS-CoV-2 y, por tanto, la AOS debe considerarse una comorbilidad grave para la letalidad de COVID-19 Una revision de la fisiopatologia del SARS-CoV-2, la obesidad y la AOS puede contribuir a tener mas herramientas en la prevencion y el tratamiento de las complicaciones graves del COVID-19 (Spanish) [ABSTRACT FROM AUTHOR] Copyright of Revista Mexicana de Neurociencia is the property of Academia Mexicana de Neurologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder s express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )