Snoring may transmit infectious aerosols from the upper to the lower respiratory tract

Migration to the lungs of an initial upper airway infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or other respiratory pathogens can lead to pneumonia, associated with progression from mild to severe symptoms. Chemical pneumonitis or bacterial pneumonia may be caused by the 'macroaspiration' of large volumes of oropharyngeal or gastroesophageal secretions into the lower respiratory tract. 'Microaspiration', i.e., a similar mechanism but involving much smaller amounts of oropharyngeal secretions, is considered the pathogenetic mechanism for most pneumonias, including that associated with COVID-19. Here, we hypothesize an alternative mechanism: Rather than by microaspiration, these fluids enter the lungs as microdroplets that are generated by snoring and then carried by the inspired airstream. Laboratory measurements indicate that snoring generates (a) comparable numbers and sizes of oral fluid droplets as loud speaking and (b) total fluid quantities that are similar to those reported for microaspiration. Snoring propensity is strongly correlated to known risk factors for severe COVID-19, including male gender, age, obesity, diabetes, obstructive sleep apnea, and pregnancy. Therefore, more research is urgently needed to determine if various methods that decrease snoring can prevent progression to pneumonia after initial infection of the upper airways.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:168

Enthalten in:

Medical hypotheses - 168(2022) vom: 19. Nov., Seite 110966

Sprache:

Englisch

Beteiligte Personen:

Bax, Adriaan [VerfasserIn]
Shen, Yang [VerfasserIn]
Kakeshpour, Tayeb [VerfasserIn]
Fennelly, Kevin P [VerfasserIn]

Links:

Volltext

Themen:

COVID-19
In-host transmission
Influenza
Journal Article
Microaspiration
Pneumonia
Respiratory droplet
Snoring

Anmerkungen:

Date Revised 21.12.2022

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.1016/j.mehy.2022.110966

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM348311168