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1.
Diabetes Res Clin Pract ; 177: 108919, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1267648

ABSTRACT

BACKGROUND: Sars-Cov-2 epidemic in Italy caused one of the greatest 2020 European outbreaks, with suspension of elective bariatric/metabolic surgery (BMS). From May 2020 a significant decline of the epidemic has been observed (phase 2); National Health Service protocols permitted elective BMS' resumption. A new, more severe COVID-19 surge, the "second wave", started on October 2020 (phase 3). AIM: The primary end point was to analyze the outcomes of any Sars-Cov-2 infection and related morbidity/mortality within 30 POD after laparoscopic BMS during phase 2-3; secondary end points were readmission and reoperation rates. METHODS: Study design prospective, multicenter, observational. SETTING: Eight Italian high-volume bariatric centers. All patients undergoing BMS from July 2020 through January 2021 were enrolled according to the following criteria: no Sars-Cov-2 infection; primary procedures; no concomitant procedure; age > 18 < 60 years; compensated comorbidities; informed consent including COVID-19 addendum; adherence to specific admission, in-hospital and follow-up protocols. Data were collected in a prospective database. Patients undergone BMS during July-December 2019 were considered a control group. RESULTS: 1258 patients were enrolled and compared with 1451 operated on in 2019, with no differences for demographics, complications, readmission, and reintervention rates. Eight patients (0·6%) tested positive for Sars-Cov-2 infection after discharge, as well as and 15 healthcare professionals, with no related complications or mortality. CONCLUSIONS: Introduction of strict COVID-19 protocols concerning the protection of patients and health-care professionals guaranteed a safe resumption of elective BMS in Italy. The safety profile was, also, maintained during the second wave of outbreak, thus allowing access to a cure for the obese population.


Subject(s)
Bariatric Surgery , COVID-19 , Laparoscopy , Adult , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Patient Safety , Prospective Studies , State Medicine
2.
Front Public Health ; 8: 582699, 2020.
Article in English | MEDLINE | ID: covidwho-965630

ABSTRACT

Background: From the beginning of March 2020, lockdown regimens prevented patients with obesity from receiving bariatric surgery. Surgical emergencies and oncological procedures were the only operations allowed in public hospitals. Consequently, patients with morbid obesity were put in a standby situation. With the aim at exploring the viewpoint of our future bariatric surgery patients, we built a questionnaire concerning obesity and COVID-19. Method: A total of 116 bariatric surgery candidates were approached using a telephonic interview during the Italian lockdown. Results: Of the total sample, 73.8% were favorable to regular bariatric surgery execution. Forty percent were concerned about their own health status due to the COVID-19 emergency, and 61.1% were troubled by the temporary closure of the bariatric unit. The majority of the sample were eating more. Forty-five percent and the 27.5% of patients reported a worsening of the emotional state and physical health, respectively. Most of the patients (52.2%) considered themselves more vulnerable to COVID-19, especially individuals with class III obesity. Patients who reported an increased consumption of food were younger (43.44 ± 12.16 vs. 49.18 ± 12.66; F = 4.28, p = 0.042). No gender difference emerged. Conclusion: The lockdown had a negative result on Italian patients' psychological well-being and eating habits. The majority of patients would have proceeded with the surgery even during the COVID-19 emergency. Effective management and bariatric surgery should be restarted as soon as possible.


Subject(s)
Bariatric Surgery/statistics & numerical data , COVID-19/psychology , Feeding Behavior/psychology , Mental Health , Obesity, Morbid/surgery , Waiting Lists , Adult , Bariatric Surgery/psychology , Female , Humans , Interviews as Topic , Italy , Male , Middle Aged , Obesity, Morbid/psychology , Patients/statistics & numerical data , SARS-CoV-2/isolation & purification , Surveys and Questionnaires
3.
Surg Obes Relat Dis ; 16(10): 1614-1618, 2020 10.
Article in English | MEDLINE | ID: covidwho-613421

ABSTRACT

In Italy elective bariatric and metabolic surgery was cancelled on February 21,2020 at the beginning of the so-called phase 1 of the SARS-CoV-2 outbreak. Gradually it was restarted on May 4,2020 at the beginning of the so-called phase 2, when epidemiological data showed containment of the infection. Before the outbreak in eight high-volume bariatric centers 840 patients were surgically treated developing a Covid-19 infection, during phase 1, in only 5 cases (0.6%) without mortality. The post-operative complication rate was similar when compared to the 836 subjects submitted to bariatric surgery the year before. Since the high prevalence of infection in subjects with BMI > 30, it was argued that early intervention on obesity during phase 2 could help to minimize the effects of the disease in the event of a possible reversion to a SARS-CoV-2 outbreak phase 1. At the same time a prospective observational study from July 1 till the WHO declaration of the end of the pandemic has started in the eight high volume centers to monitor the post-operative outcome and its effect on SARS-CoV-2 infection.


Subject(s)
Bariatric Surgery/statistics & numerical data , Betacoronavirus , Coronavirus Infections/epidemiology , Disease Transmission, Infectious/prevention & control , Obesity/surgery , Pandemics , Pneumonia, Viral/epidemiology , COVID-19 , Comorbidity , Coronavirus Infections/transmission , Humans , Obesity/epidemiology , Pneumonia, Viral/transmission , SARS-CoV-2 , Time Factors
4.
Updates Surg ; 72(2): 259-268, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-574895

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its related disease, coronavirus disease 2019 (COVID-19), has been rapidly spreading all over the world and is responsible for the current pandemic. The current pandemic has found the Italian national health system unprepared to provide an appropriate and prompt response, heavily affecting surgical activities. Based on the limited data available in the literature and personal experiences, the Società Italiana di Chirurgia dell'OBesità e Malattie Metaboliche (SICOB) provides recommendations regarding the triage of bariatric surgical procedures during the COVID-19 pandemic defining a dedicated path for surgery in morbidly obese patients with known or suspected COVID-19 who may require emergency operations. Finally, the current paper delineates a strategy to resume outpatient visits and elective bariatric surgery once the acute phase of the pandemic is over. Models developed during the COVID-19 crisis should be integrated into hospital practices for future use in similar scenarios. Surgeons are presented with a golden opportunity to embrace systemic change and to drive their professional future.


Subject(s)
Bariatric Surgery , Coronavirus Infections , Elective Surgical Procedures , Obesity/surgery , Pandemics , Pneumonia, Viral , Quarantine , Bariatric Surgery/methods , Bariatric Surgery/standards , COVID-19 , Decision Trees , Disease Outbreaks , Humans , Time Factors
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