A Comparative Analysis of Safety and Efficacy of Bariatric Surgery During the COVID-19 Pandemic and Pre-Pandemic Period: Insights from the Tehran Obesity Treatment Study.

BACKGROUND: The COVID-19 pandemic has raised global health concerns and posed challenges for postoperative follow-up care for patients undergoing bariatric surgery due to social distancing rules. METHODS: This was a cohort study on patients with morbid obesity who underwent bariatric surgery and had been enrolled in Tehran Obesity Treatment Study. Patients who had surgery between March 2020 and March 2021 were classified as those undergoing the procedure amid the COVID-19 pandemic, while those who had surgery between March 2017 and March 2018 were categorized as the pre-pandemic group. RESULTS: The study included 982 patients in the pre-COVID-19 pandemic group and 602 patients in the COVID-19 pandemic group, with mean ages of 39.61 and 39.51 years, respectively. After adjusting for preoperative body mass index (BMI) and surgery type, the patients who underwent surgery during the COVID-19 pandemic demonstrated comparable results to the pre-COVID-19 group in terms of total weight loss %, excess weight loss %, BMI reduction, and fat mass reduction during the 12-month postoperative period. Additionally, the rate of complications with a grade≥III based on the Clavien-Dindo classification was significantly lower in patients who underwent surgery during the COVID-19 pandemic. Notably, there were no deaths reported in either group. CONCLUSION: Despite social isolation and unfavorable lifestyle modifications, bariatric surgery-induced weight loss after one year was the same in patients undergoing the procedure either before or after the implementation of social distancing measures. More research is needed to analyze the influence of the COVID-19 pandemic on the long-term outcomes of bariatric surgery.

The Association between COVID-19 and Reactive Arthritis: A Systematic Review of Case Reports and Case Series.

INTRODUCTION: Reactive arthritis (ReA) is a joint inflammation that follows an infection at a distant site, often in the gastrointestinal or urogenital tract. Since the emergence of COVID-19 in January 2020, several case reports have suggested a relation between reactive arthritis and severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), due to the novelty of the disease, most findings were reported in the form of case reports or case series, and a comprehensive overview is still lacking. METHODS: We searched PubMed/Medline and Embase to identify studies addressing the association between ReA and COVID-19. The following terms were used: ("Reactive Arthritis" OR "Post-Infectious Arthritis" OR "Post Infectious Arthritis") AND ("COVID-19" OR "SARS-CoV-2" OR "2019-nCoV"). RESULTS: A total number of 35 reports published up to February 16th, 2022, were included in this study. A wide range of ages was affected (mean 41.0, min 4 max 78), with a higher prevalence of males (61.0%) from 16 countries. The number and location of the affected joints were different in included patients, with a higher prevalence of polyarthritis in 41.5% of all cases. Cutaneous manifestations and visual impairments were found as the most common associated symptoms. Most patients (95.1%) recovered, with a mean recovery time of 24 days. Moreover, arthritis induced by COVID-19 seems to relieve faster than ReA, followed by other infections. CONCLUSION: ReA can be a possible sequel of COVID-19 infection. Since musculoskeletal pain is a frequent symptom of COVID-19, ReA with rapid onset can easily be misdiagnosed. Therefore, clinicians should consider ReA a vital differential diagnosis in patients with post-COVID-19 joint swelling. Additional studies are required for further analysis and to corroborate these findings.