THU116 Characteristics Of Sleep Disturbance And The Related Hormonal Changes In Patients With Long COVID
Authors: Sunada Naruhiko , Nakano Yasuhiro , Otsuka Yuki , Tokumasu Kazuki , Honda Hiroyuki , Sakurada Yasue , Matsuda Yui , Hasegawa Toru , Omura Daisuke , Ochi Kanako , Hagiya Hideharu , Ueda Keigo , Kataoka Hitomi , Otsuka Fumio 
Published: October 2023

Abstract
Disclosure: N. Sunada: None. Y. Nakano: None. Y. Otsuka: None. K. Tokumasu: None. H. Honda: None. Y. Sakurada: None. Y. Matsuda: None. T. Hasegawa: None. D. Omura: None. K. Ochi: None. H. Hagiya: None. K. Ueda: None. H. Kataoka: None. F. Otsuka: None.
COVID-19 causes prolonged symptoms called either long COVID or post COVID-19 condition (PCC). Such prolonged conditions have been experienced in approximately one-third of COVID-19 patients even a few months after the acute phase of infection. In Japan, we have recently reported clinical characteristics of long COVID patients who visited our COVID-19 aftercare outpatient clinic (CAC). The major complaints in the early period of the COVID-19 pandemic were fatigue and anxiety and that the severity of the infection status affected the number and duration of persistent symptoms. We have also shown that endocrine factors including anterior pituitary, adrenal and thyroid hormones and male androgen levels might be related to the fatigue symptoms of long COVID. However, the characteristics of long COVID patients with sleep disturbance have yet to be elucidated. The aim of this study was to determine the characteristics of sleep disturbance in patients with long COVID by focusing on the clinical manifestations and the related endocrine data. This study was a single-center retrospective observational study for patients who visited the CAC established in Okayama University Hospital in Japan during the period from Feb. 2021 to Jul. 2022. Out of 363 patients with long COVID after excluding 6 patients, 60 patients (16.5%) (55% males, median age of 38 years) complaining of sleep disturbance were compared with 303 patients (83.5%) (43% males, median age of 40 years) without sleep-related symptoms. Although there were no significant differences in clinical backgrounds and severities of COVID-19 between the two groups, the percentage of long COVID patients with sleep disturbance was significantly increased (50%) among patients infected in the Omicron-dominant phase. Also, the prevalence rate of sleep disturbance in patients when infected in the Omicron phase (24.8%) was two-times higher than that in patients infected in the Delta phase (12.8%). Of note, the percentages of patients with sleep disturbance who also complained of general fatigue, headache, concentration loss, anxiety, low-grade fever and brain-fog symptoms were higher than the percentages of patients without sleep disturbance who had the same complaints. Among the types of sleep disturbance, the percentage of patients who complained of loss of sleep induction (75%) was much higher than the percentage of patients with early-awaking sleep disturbance (6.7%). Endocrine examinations revealed that long COVID patients with sleep disturbance had significantly higher levels of plasma ACTH and lower levels of serum GH, suggesting the presence of hypothalamo-pituitary stress. Collectively, we uncovered that 16.5% of total patients with long COVID, reaching up to half of those in Omicron-dominant phase, complained of sleep disturbance. Endocrine workup also indicated that these manifestations could be associated with increased stress of the hypothalamo-pituitary axis.
Presentation: Thursday, June 15, 2023