Metabolic

Earlier bariatric surgical procedure can cut back the severity of COVID-19

December 21, 2020

2 min read

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Obese adults who tested positive for COVID-19 were significantly less likely to have serious disease complications if they had previously undergone bariatric surgery, according to a cohort analysis.

“We know obesity is a major risk factor for the severity of COVID-19, and we wanted to see if weight loss could change the severity of COVID-19 infection.” Ali Aminian, MD, associate professor of surgery and The director of the Cleveland Clinic’s Bariatric and Metabolic Institute said Healio. “We examined patients who had bariatric surgery prior to being diagnosed with COVID-19, who had lost significant weight, had improved metabolic conditions and kept their weight low for a long period of time. We wanted to see if long-term weight loss could improve results. “

Aminian is a associate professor of surgery and Director of the Bariatric and Metabolic Institute at Cleveland Clinic.

In a retrospective study, Aminian and colleagues analyzed data from 4,365 patients who tested positive for COVID-19 between March 8 and July 22 in the Cleveland Clinic healthcare system. Within the COVID-19 cohort, 33 patients had previously had bariatric surgery.

Researchers matched the slope 1:10 with non-surgical COVID-19 patients to create a cohort of control patients (n = 330) with a BMI of at least 40 kg / m² at the time of the COVID-19 test. The primary endpoint was hospitalization rate. Exploratory endpoints included ICU admission, the need for mechanical ventilation and dialysis during the index hospital stay, and mortality.

The mean BMI of the surgical group before bariatric surgery was 49.1 kg / m2 and decreased to a mean of 37.2 kg / m2 at the time of the COVID-19 test, compared to the mean BMI of the control group of 46.7 kg / m². The mean interval between bariatric surgery and a positive COVID-19 test was 46 months.

In the univariate analysis, six patients in the bariatric surgery group and 139 patients in the control group were hospitalized (18.2% versus 42.1%; P = 0.013). In the multivariate analysis, a history of bariatric surgery was associated with a lower rate of hospital admission compared to control patients with obesity (OR = 0.31; 95% CI, 0.11-0.88).

None of the four test results occurred in the bariatric surgery group; In the control group, however, 43 patients (13%) required admission to the intensive care unit (P = 0.021), 22 patients (6.7%) required mechanical ventilation, five patients (1.5%) required dialysis and eight patients (2, 4%) died.

“This pandemic was a wake-up call to uncover the health consequences of obesity,” said Aminian. “If a person with obesity can lose weight and become healthier, the risk of developing a severe form of COVID-19 drops significantly. The takeaway message is that care for people with obesity should continue throughout the pandemic, including behavior changes, medical and surgical treatment for obesity. Hopefully these services can continue uninterrupted and … if we can deal with obesity we will get much better results for our patients. “

For more informations:

Ali Aminian, MD, can be reached at aminiaa@ccf.org.

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