Prior bariatric surgery in COVID-19-positive patients may be protective.
Surg Obes Relat Dis
; 17(11): 1840-1845, 2021 11.
Article
in English
| MEDLINE | ID: covidwho-1347829
ABSTRACT
BACKGROUND:
Patients infected with novel COVID-19 virus have a spectrum of illnesses ranging from asymptomatic to death. Data have shown that age, sex, and obesity are strongly correlated with poor outcomes in COVID-19-positive patients. Bariatric surgery is the only treatment that provides significant, sustained weight loss in the severely obese.OBJECTIVES:
Examine if prior bariatric surgery correlates with increased risk of hospitalization and outcome severity after COVID-19 infection.SETTING:
University hospitalMETHODS:
A cross-sectional retrospective analysis of a COVID-19 database from a single, New York City-based, academic institution was conducted. A cohort of COVID-19-positive patients with a history of bariatric surgery (n = 124) were matched in a 14 ratio to a control cohort of COVID-19-positive patients who were eligible for bariatric surgery (BMI ≥40 kg/m2 or BMI >35 kg/m2 with a co-morbidity at the time of COVID-19 diagnosis) (n = 496). A comparison of outcomes, including mechanical ventilation requirements and deceased at discharge, was done between cohorts using χ2 test or Fisher's exact test. Additionally, overall length of stay and duration of time in intensive care unit (ICU) were compared using Wilcoxon rank sum test. Conditional logistic regression analyses were done to determine both unadjusted (UOR) and adjusted odds ratios (AOR).RESULTS:
A total of 620 COVID-19-positive patients were included in this analysis. The categorization of bariatric surgeries included 36% Roux-en-Y gastric bypass (RYGB, n = 45), 36% laparoscopic adjustable gastric banding (LAGB, n = 44), and 28% laparoscopic sleeve gastrectomy (LSG, n = 35). The body mass index (BMI) for the bariatric group was 36.1 kg/m2 (SD = 8.3), which was significantly lower than the control group, 41.4 kg/m2 (SD = 6.5, P < .0001). There was also less burden of diabetes in the bariatric group (32%) compared with the control group (48%) (P = .0019). Patients with a history of bariatric surgery were less likely to be admitted through the emergency room (UOR = .39, P = .0001), less likely to require a ventilator during the admission (UOR=.42, P = .028), had a shorter length of stay in both the ICU (P = .033) and overall (UOR = .44, P = .0002), and were less likely to be deceased at discharge compared with the control group (OR = .42, P = .028).CONCLUSION:
A history of bariatric surgery significantly decreases the risk of emergency room admission, mechanical ventilation, prolonged ICU stay, and death in patients with COVID-19. Even when adjusted for BMI and the co-morbidities associated with obesity, patients with a history of bariatric surgery still have a significant decrease in the risk of emergency room admission.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Obesity, Morbid
/
Gastric Bypass
/
Laparoscopy
/
Bariatric Surgery
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
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Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Language:
English
Journal:
Surg Obes Relat Dis
Journal subject:
Metabolism
Year:
2021
Document Type:
Article
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