Obstructive Sleep Apnea Tied to Nearly Doubled Risk for Flu, COVID-19 in Childhood

TUESDAY, Feb. 24, 2026 (HealthDay News) — Children with obstructive sleep apnea (OSA) are nearly twice as likely to contract the flu or COVID-19, according to a study published online Feb. 11 in the Journal of Clinical Sleep Medicine.

Alex Gileles-Hillel, M.D., from Hebrew University in Jerusalem, and colleagues assessed whether OSA increases the risk for infections from common childhood viruses. The analysis included 539,127 children (aged 2 to 18 years) with incident OSA and matched controls without OSA.

The researchers found that during a five-year follow-up period following OSA diagnosis, influenza was diagnosed in 5.1 percent of children with OSA versus 2.8 percent of controls (risk ratio [RR], 1.80), while five-year influenza-free survival was 90.27 versus 93.04 percent, respectively (hazard ratio [HR], 1.45). COVID-19 was diagnosed in 2.5 versus 1.0 percent (RR, 2.496), with five-year COVID-19-free survival of 95.02 and 97.49 percent, respectively (HR 1.986). Similar effects were seen across age groups. Adenotonsillectomy did not reduce infection risk. OSA was also associated with a higher risk for pneumonia due to influenza or COVID-19.

“Although absolute risks are low, adenotonsillectomy does not lessen susceptibility, suggesting persistent immune dysregulation and supporting prioritization of seasonal vaccination in children with OSA,” the authors write.

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