Background

Long COVID is defined as the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection. As it is a diagnosis of exclusion with no validated biomarkers, it is important that other conditions are ruled out.

In the Leeds Long COVID Rehabilitation Service, UK, we recognised that some patients referred to our service who presented with fatigue also displayed Obstructive Sleep Apnoea Syndrome (OSAS) features. This led us to our hypothesis; that OSAS should be considered as a differential diagnosis in some Long COVID patients.

Aim

To provide insight into the diagnostic yield of sleep studies when applied to a population with Long COVID.

Methods

We identified patients in a retrospective case series who presented with fatigue and a minimum of two additional features for OSAS. Sleep studies were carried out, and confirmed OSAS diagnoses were classified by severity (mild, moderate or severe).

Results

Over a 9-month period, 33 patients were found to be at high risk of OSAS and referred for sleep studies. The median BMI was 36 and the median Epworth score was 15.5. 30 patients completed sleep studies. 24 (80%) had OSAS (13 mild, 8 moderate and 3 severe) and 2 patients (6.6%) were diagnosed with hypoventilation syndrome. 15 (50%) patients have commenced CPAP, 9 received lifestyle modification advice and the rest await review.

Conclusion

OSAS should be actively investigated as a differential diagnosis in Long COVID patients when other features are present to ensure appropriate management. Further research is needed to determine if this is due to causation or correlation.