PMC:7274970 / 29457-32259 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7274970","sourcedb":"PMC","sourceid":"7274970","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7274970","text":"To our knowledge, this report is the first case series to study the effects of sleep quality on the recovery from lymphopenia, deterioration based on an increased NLR, and clinical outcomes in hospitalized patients with COVID-19. Among the 135 patients included in this study, 44.4% of patients reported at least two weeks of good-sleep, and 55.6% patients reported at least two weeks of poor-sleep within three weeks after hospital admission. There were no significant between-group differences regarding demographic and baseline characteristics, as well as laboratory parameters upon admission and in-hospital treatment. Also, no significant differences between the good-sleep group and poor-sleep groups were detected regarding ALC and its recovery rate, as well as NLR on day 7 after hospital admission, indicating an equivalent immune function and its recovery rate between the two groups during the early phase of hospital admission. However, at least 2 weeks of poor sleep during hospitalization was associated with a slow recovery from lymphopenia and an increase in the deterioration of NLR. On day 14 and day 21 after hospital admission, patients in the poor-sleep group had reduced ALC and associated recovery rate, as well as increased NLR and associated deterioration percentage compared to patients in the good-sleep group, suggesting detrimental effects of a sustained period of poor sleep on recovery of immune function in patients with COVID-19. Furthermore, patients in the poor-sleep group had an increased incidence of HAI (seven [9.3%] vs one [1.7%]) compared to those in the poor-sleep group, which may be due to a slower recovery from lymphopenia in the poor-sleep group; however, this difference was not significant. Additionally, the health condition of 12.0% of patients with COVID-19 with poor-sleep deteriorated, requiring ICU care, whereas none of the patients in the good-sleep group required ICU care. Patients in the poor-sleep group spent an average of eight days longer in the hospital than those in the good-sleep group. Our present study confirms recent studies showing that a continuous and sustained decrease in the ALC, or increase in NLR, is closely associated with the disease aggravation in patients with COVID-19 (Tan et al., 2020, Wang et al., 2020, Zhou et al., 2020). However, SARS-CoV-2 could be detected in the cerebrospinal fluid by PCR in a case of COVID-19 encephalitis (Huang et al., 2020b), and neurologic syndrome was found after the onset of COVID-19, including Guillain-Barré Syndrome, polyneuritis cranialis, and stroke (Toscano et al., 2020, Gutierrez-Ortiz et al., 2020, Oxley et al., 2020). Therefore, bidirectional causality might exist between poor sleep quality during hospitalization and worse clinical outcomes in patients with 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