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

Authors

  • Li Zhang Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
  • Tingting Li Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
  • Liangkai Chen Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
  • Feng Wu Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
  • Wenguang Xia Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
  • Min Huang Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
  • Zhenli Guo Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
  • Lin Song Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
  • Hongxiang Yin Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
  • Yangpu Zhang Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
  • Yongfei Yu Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
  • Sijie Cai Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
  • Zijian Lu Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
  • Shuang Rong Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, 2 Huangjiahu Road, Wuhan 430065, China; E-mail: rongshuang@wust.edu.cn http://orcid.org/0000-0002-8363-0862
  • Wei Bao Department of Epidemiology, College of Public Health, University of Iowa, 145 N Riverside Dr, Iowa City, IA 52242, USA; E-mail: wei-bao@uiowa.edu http://orcid.org/0000-0002-7301-5786

DOI:

https://doi.org/10.17179/excli2021-3451

Keywords:

coronavirus disease 2019, SARS-CoV-2, sleep, epidemiology

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.

Author Biography

Lin Song, Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China

wrong e-mail: firstlinlin@sohu.com

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Published

2021-05-14

How to Cite

Zhang, L., Li, T., Chen, L., Wu, F., Xia, W., Huang, M., … Bao, W. (2021). Association of sleep quality before and after SARS-CoV-2 infection with clinical outcomes in hospitalized patients with COVID-19 in China. EXCLI Journal, 20, 894–906. https://doi.org/10.17179/excli2021-3451

Issue

Vol. 20 (2021)

Section

Original articles

License

Copyright (c) 2021 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

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