Assessment of the clinical and laboratorial profile of patients with obesity and asymptomatic COVID-19 undergoing bariatric surgery in Brazil.

PURPOSE: to outline the clinical and laboratorial profile of patients with obesity undergoing bariatric surgery who presented positive reverse transcription-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus-2 (Sars-CoV-2) in the preoperative period without symptoms presentation. METHODS: Case series of 17 patients undergoing bariatric surgery who presented positive RT-PCR for Sars-CoV-2 in the preoperative period, with no reported symptoms. Data collected included demographic characteristics, length of hospital stay, waiting time for surgery, inflammatory markers, serum levels of micronutrients and dengue virus (DENV) serology. RESULTS: In total, 219 patients underwent bariatric surgery in our institution during the study period. The incidence of asymptomatic cases was 7.7%. The sample comprised 88.2% of women, with mean age of 39.3 years and mean preoperative body mass index (BMI) of 37.7 kg/m2. Thirty five percent of the sample had previous diagnosis of diabetes and 29.4% had hypertension. The mean time elapsed between positive RT-PCR and the operation was 17 ± 7.5 days and the mean length of postoperative hospital stay was 1.9 ± 0.43 day. Mean lymphocytes count was 2,409.7/mm3 and the mean platelet-to-lymphocyte ratio was 126.3. Mean C-reactive protein value was 5.8 mg/dL, while ferritin marked 107.4 µg/L. DENV IgG was identified in all patients who tested for it. Mean levels of vitamin D and zinc were 25.6 ng/mL and 79.9 µg/dL, respectively. There were no postoperative complications reported. CONCLUSION: None of the included patients presented any of the laboratory markers related to disease severity. Moreover, it is important to notice that all patients who tested for DENV, had the specific IgG detected in their serum.

Is COVID-19 Severity Impacted by Bariatric Surgery in the Early Postoperative Period?

PURPOSE: The aim of this study was to determine the real influence of bariatric surgery on the clinical evolution of patients infected with SARS-Cov-2 in the postoperative period. METHODS: We conducted a retrospective analysis including two groups of patients: those who presented COVID-19 before bariatric surgery and those who presented it within 3 months of postoperative. Primary outcome was related to the severity of COVID-19, measured by the following variables: presence of symptoms, need for hospitalization, ICU admission, and invasive ventilation. Laboratory markers for inflammatory response, glycemic status, and micronutrients were analyzed as secondary outcomes. RESULTS: From the 222 individuals operated on within the study period, only 66 (29.7%) presented COVID-19, 42 (18.9%) in the preoperative period and 24 (10.8%) after the procedure. Mean age was 36.3 ± 9.5 years and mean preoperative BMI was 39.9 ± 4.2 kg/m2. There were no statistically significant differences between the groups regarding symptoms presentation (92.9% × 87.5%, p = 0.66), need for hospitalization (11.9% × 16.7%, p = 0.713), ICU admission (4.8% × 4.2%, p = 1.000), and invasive ventilation (2.4% × 0.0%, p = 1.000). Regarding the quantitative variables, absolute lymphocyte count was significantly lower in the group who presented COVID-19 after surgery (1822.9 ± 482.2 × 2158.6 ± 552.9, p = 0.035). CONCLUSION: Patients who had COVID-19 before and after sleeve gastrectomy did not differ with statistical significance for the presence of symptoms, need for hospitalization, ICU admission, and invasive ventilation.