ArticleEXCLI journal2021
Association of sleep quality before and after SARS-CoV-2 infection with clinical outcomes in hospitalized patients with COVID-19 in China.
Article in EXCLI journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence of poor sleep quality in COVID-19 patients: a systematic review and meta-analysis.Frontiers in psychiatry · 2023Pooled it
- Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression.Sleep medicine reviews · 2022Pooled it
- Effects of lemborexant on sleep quality and its association with morning alertness: Post hoc analysis of two phase 3 trials.Sleep medicine: X · 2026Article
- Impact of Pressure Variability and Comorbidities on PAP Therapy Compliance and Adherence in Obstructive Sleep Apnea.Life (Basel, Switzerland) · 2025Article
- Does COVID-19 Infection Continue to Affect Self-Reported and Objective Sleep? A Longitudinal Study of Good Sleepers.Nature and science of sleep · 2025Article
- Parallel mediating effects of anxiety and depression on the relationship between sleep quality and fear of progression in individuals recovering from COVID-19.Frontiers in psychology · 2025Article
- Sleep Disturbance and Immunological Consequences of COVID-19.Patient preference and adherence · 2023Review
- Sleep During the COVID-19 Pandemic.Current psychiatry reports · 2022Review
- COVID-19 Infection, the COVID-19 Pandemic, and Changes in Sleep.Frontiers in public health · 2021Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
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.
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