Children With OSA Face Higher Influenza, COVID-19 Risk
Real-world analysis finds higher risk of influenza and COVID-19 diagnoses over five years, with no evidence of reduced risk after adenotonsillectomy
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By
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Alun Evans
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February 27, 2026
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Clinical Scorecard: Children With OSA Face Higher Influenza, COVID-19 Risk
At a Glance
| Category | Detail |
|---|
| Condition | Obstructive Sleep Apnea (OSA) |
| Key Mechanisms | Persistent immune dysregulation affecting antiviral responses. |
| Target Population | Children aged 2 to 18 years diagnosed with OSA. |
| Care Setting | Pediatric healthcare settings. |
Key Highlights
- Children with OSA have a 1.80 risk ratio for influenza and a 2.50 risk ratio for COVID-19.
- Five-year influenza-free survival is 90.3% in OSA children vs 93% in controls.
- COVID-19 pneumonia risk is significantly higher in OSA children with a risk ratio of 25.96.
- Adenotonsillectomy does not reduce the risk of influenza or COVID-19.
- OSA may serve as a clinical risk marker for viral susceptibility.
Guideline-Based Recommendations
Diagnosis
- Monitor children with OSA for influenza and COVID-19 symptoms.
Management
- Prioritize seasonal influenza vaccination and ensure up-to-date COVID-19 immunization.
Monitoring & Follow-up
- Conduct regular follow-ups for respiratory infections in children with OSA.
Risks
- Increased risk of pneumonia due to influenza and COVID-19 in children with OSA.
Patient & Prescribing Data
Children aged 2 to 18 years with newly diagnosed OSA.
Adenotonsillectomy does not mitigate infection risk.
Clinical Best Practices
- Encourage vaccination against influenza and COVID-19 in children with OSA.
- Consider OSA as a risk marker for increased susceptibility to viral infections.
References
