Abstract: Nature and Science of Sleep Dovepress open access to scientific and medical research Open Access Full Text Article ORIGINAL RESEARCH Nature and Science of Sleep For personal use only. Reduced Sleep in the Week Prior to Diagnosis of COVID-19 is Associated with the Severity of COVID-19 This article was published in the following Dove Press journal: Nature and Science of Sleep Baozhen Huang 1 Yanlin Niu 2 Weiguo Zhao 3 Pengtao Bao 4 Diangeng Li 1,5 1 Nanlou Respiratory Diseases Department, 2nd Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Beijing Center for Disease Prevention and Control, Institute for Nutrition and Food Hygiene, Beijing, People’s Republic of China; 3Department of Respiratory Medicine, The Eighth Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China; 4Department of Pulmonary and Critical Care Medicine, The Eighth Medical Center of Chinese, Beijing, People’s Republic of China; 5 Department of Nephrology, Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, People’s Republic of China Background: The rapid outbreak of coronavirus disease 2019 (COVID-19) is a major health concern, in response to which widespread risk factor research is being carried out. Objective: To discover how physical activity and lifestyle affect the epidemic as well as the disease severity and prognosis of COVID-19 patients. Methods: This multicenter, retrospective cohort study included 203 adults infected with COVID-19 and 228 uninfected adults in three Chinese provinces, with 164 (80.7%) of the infected participants and 188 (82.5%) of the uninfected participants answering a doctoradministered telephone questionnaire on lifestyle. The binary logistic regression model and the ordinal logit model were used to observe relevance. Results: Comparing sick and non-sick patients, we found that irregular exercise (P=0.004), sedentary lifestyle (P=0.010), and overexertion (P<0.001) may be associated with the susceptibility to COVID-19. In symptomatic patients, using the recommended status as a reference, risk of severe infection increased with decreased sleep status, being 6.729 (95% CI=2.138–21.181) times higher for potentially appropriate sleep (P=0.001) and peak­ ing at 8.612 (95% CI=1.913–38.760) times higher for lack of sleep (P=0.005). Reduction in average daily sleep time significantly increased the likely severity (P=0.002). Discussion: Through further examination of damage of external lung organs, we found that lack of sleep affected not only disease severity but also prognosis. Based on these findings, the public should prioritize a healthy lifestyle and get adequate sleep in response to the outbreak. The study of life habits may bring new ideas for the prevention and treatment of COVID-19. Keywords: COVID-19, disease severity, sleep status, damage of external lung organs