Association of sleep quality before and after SARS-CoV-2 infection with clinical outcomes in hospitalized patients with COVID-19 in China

Li Zhang; Tingting Li; Liangkai Chen; Feng Wu; Wenguang Xia; Min Huang; Zhenli Guo; Lin Song; Hongxiang Yin; Yangpu Zhang; Yongfei Yu; Sijie Cai; Zijian Lu; Shuang Rong; Wei Bao

doi:10.17179/excli2021-3451

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Association of sleep quality before and after SARS-CoV-2 infection with clinical outcomes in hospitalized patients with COVID-19 in China

Journal article

Peer reviewed

Association of sleep quality before and after SARS-CoV-2 infection with clinical outcomes in hospitalized patients with COVID-19 in China

Li Zhang, Tingting Li, Liangkai Chen, Feng Wu, Wenguang Xia, Min Huang, Zhenli Guo, Lin Song, Hongxiang Yin, Yangpu Zhang, …

EXCLI journal, Vol.20, pp.894-906

04/14/2021

DOI: 10.17179/excli2021-3451

PMCID: PMC8192881

PMID: 34121976

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https://www.ncbi.nlm.nih.gov/pmc/articles/8192881View

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Abstract

Sleep is believed to benefit the host defense against pathogens. We aimed to investigate the association of sleep quality with clinical outcomes among hospitalized patients with COVID-19. We conducted a prospective cohort study in 205 adult hospitalized patients with diagnosed moderate COVID-19, with follow-up until hospital discharge or death. Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality before and after infection. The primary outcome was the incidence of severe or critical pneumonia, and the secondary outcomes were duration of hospital stay and laboratory measurements during the follow up. Among the 205 included hospitalized patients, 185 (90.2 %) experienced poorer sleep quality after infection than before according to the PSQI score, and 25 (12.2 %) developed severe or critical pneumonia during follow-up. In Cox regression models, the adjusted hazard ratio of developing severe or critical pneumonia associated with each 1 score increment in the PSQI score before and after infection was 1.23 (95% CI: 1.09, 1.39) and 1.35 (95 % CI: 1.08, 1.67), respectively. Poorer sleep quality was also significantly associated with a prolonged hospital stay and more serious dysregulations in immune system indicated by several laboratory markers. Poorer sleep quality, either in the daily time or after infection with SARS-CoV-2, was associated with worse clinical outcomes. These findings highlight the importance of good sleep in confronting the emerging pandemic of COVID-19.

Epidemiology

Coronavirus disease 2019

Original

SARS-CoV-2

sleep

COVID-19

Details

Title: Subtitle: Association of sleep quality before and after SARS-CoV-2 infection with clinical outcomes in hospitalized patients with COVID-19 in China
Creators: Li Zhang - Integrated Chinese Medicine (China)
Tingting Li - University of Iowa
Liangkai Chen - Huazhong University of Science and Technology
Feng Wu - Integrated Chinese Medicine (China)
Wenguang Xia - Integrated Chinese Medicine (China)
Min Huang - Integrated Chinese Medicine (China)
Zhenli Guo - Integrated Chinese Medicine (China)
Lin Song - Integrated Chinese Medicine (China)
Hongxiang Yin - Integrated Chinese Medicine (China)
Yangpu Zhang - Integrated Chinese Medicine (China)
Yongfei Yu - University of Iowa
Sijie Cai - Wuhan University of Science and Technology
Zijian Lu - University of Iowa
Shuang Rong - Wuhan University of Science and Technology
Wei Bao - University of Iowa
Resource Type: Journal article
Publication Details: EXCLI journal, Vol.20, pp.894-906
DOI: 10.17179/excli2021-3451
PMID: 34121976
PMCID: PMC8192881
NLM abbreviation: EXCLI J
ISSN: 1611-2156
eISSN: 1611-2156
Publisher: Leibniz Research Centre for Working Environment and Human Factors
Language: English
Date published: 04/14/2021
Academic Unit: Epidemiology
Record Identifier: 9984364532902771

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