Is sleep apnea, which is a common comorbidity in patients with COVID-19, a susceptibility factor for the development of COVID-19 encephalopathy? Scientists tried to find out.

Results of the analysis were published in the journal CHEST.

In a cohort of patients experiencing COVID-19 encephalopathy who were hospitalized at Geneva University Hospitals in Geneva, Switzerland, an increased prevalence of gadolinium enhancement was detected in large arteries on brain magnetic resonance imaging (MRI; 90.6%), indicative of underlying endothelitis and an increased cerebrospinal fluid to plasma albumin ratio, which is suggestive of blood-brain barrier dysfunction. Pathologic findings in individuals with COVID-19 reported multisystemic endothelitis, including in the cerebral arteries.

It has been proposed that since individuals with OSAS share similar comorbidities (eg, older age, obesity, and cardiovascular disease, including hypertension) with patients with COVID-19 who experience a poor clinical outcome, chronic OSAS-related inflammation may expose the brain to systemic inflammation and thus pave the road for central nervous system injuries. It also has been suggested that the severity of OSAS, along with the treatment (type, adherence, and efficacy), may influence the association between OSAS and COVID-19 encephalopathy. Additionally, the association is likely underestimated, since OSAS is known to be underdiagnosed.

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