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Pulmonology . Trajectories of lung recovery following COVID-19 in a prospective multicentric cohort study: Impact of sleep apnea and its treatment b

tetano

Editor, Senior Moderator
Pulmonology


. 2026 Dec;32(1):2641327.
doi: 10.1080/25310429.2026.2641327. Epub 2026 Mar 18.
Trajectories of lung recovery following COVID-19 in a prospective multicentric cohort study: Impact of sleep apnea and its treatment by continuous positive airway pressure

Sébastien Baillieul[SUP] 1 [/SUP], Lucile Sesé[SUP] 2 3 [/SUP], Laurent Boyer[SUP] 4 [/SUP], Bruno Chenuel[SUP] 5 6 [/SUP], Philippe Romand[SUP] 7 [/SUP], Carole Planes[SUP] 2 [/SUP], Geneviève Derumeaux[SUP] 4 [/SUP], Sam Bayat[SUP] 8 [/SUP], Marie Destors[SUP] 1 [/SUP], Thi Hong Van Ngo[SUP] 1 [/SUP], François Arbib[SUP] 9 [/SUP], Mathias Poussel[SUP] 5 6 [/SUP], Edem Allado[SUP] 5 6 [/SUP], Thomas Gille[SUP] 2 [/SUP], Jean-Louis Pépin[SUP] 1 [/SUP], Renaud Tamisier[SUP] 1 [/SUP]


Affiliations
Free article Abstract

Background: Obstructive sleep apnoea (OSA) is associated with more severe forms of COVID-19. We investigated the impact of OSA and its treatment on lung recovery trajectories over the year following acute care for different COVID-19 severities.
Methods: Prospective multicentric (5 centres) cohort study, recruiting from June 2020 to April 2022. All patients with a non-fatal pulmonary presentation of COVID-19 were eligible. OSA diagnosis (apnoea-hypopnoea index [AHI] >5/h) was performed at inclusion. Pulmonary function tests, including haemoglobin-corrected diffusing capacity of the lung for carbon monoxide (DLCO-Hb, expressed as % predicted), the primary endpoint, were conducted at 3 months and repeated at 6 and 12 months post-COVID-19 diagnosis only for patients with persisting abnormal values (conditional monitoring approach). Mixed models with subjects as a random effect were performed to assess the impact of OSA severity and treatment on DLCO-Hb recovery trajectories.
Results: Three hundred and eighteen patients were included in the cohort, 102 (32.1%) requiring outpatient care, and 216 (67.9%) requiring hospitalisation. OSA was not present in 75 (23.6%) patients, newly diagnosed or not treated in 203 (63.8%) and treated by continuous positive airway pressure in 40 (12.6%). 53.3% of tested patients presented a DLCO-Hb ≥80% of predicted values at 3 months. This proportion was significantly lower in non-treated OSA patients at 6 months (p < 0.01), but not at 12 months (p = 0.07), indicating comparable recovery. In multivariable analysis, OSA severity and its treatment but not COVID-19 severity significantly influenced the evolution of DLCO-Hb.
Conclusion: OSA severity and treatment affect the initial trajectories of lung recovery following COVID-19.

Keywords: COVID-19; Sleep apnoea, obstructive; continuous positive airway pressure; respiratory function tests.

 
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