Infectious Disease

Previous bariatric surgery can lower the risk of poor COVID-19 results

November 24, 2021

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Pattou does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Adults with type 2 diabetes who had previously undergone bariatric surgery for obesity were less likely to need mechanical ventilation or die after hospitalization for COVID-19 compared to those who hadn’t, according to study data.

In the post hoc analysis of the French multicenter statewide CORONADO study, adults with a history of bariatric surgery who were hospitalized for COVID-19 in the first month of the pandemic were significantly less likely to have poor outcomes compared to controls with BMI comparison that did not have surgery. The results provide yet another reason why people with severe obesity may choose to have surgery, so Francois Pattou, MD, PhD, Professor of Surgery at Lille University Hospital in France.

Pattou is Professor of Surgery at Lille University Hospital in France.

“Obesity is a major risk factor for severe COVID-19, but effective obesity reduction through surgery will reduce the severity of subsequent COVID-19 infection,” Pattou told Healio. “This pandemic and others to come is another reason to actively promote the reduction of severe obesity.”

Pattou and colleagues obtained data from 20 adults in the CORONADO study with diabetes between March 10 and 10 years). The group was matched 3: 1 by gender, age and BMI, which were measured either before surgery or at hospital admission with other people in CORONADO who had not undergone bariatric surgery. The primary endpoints were invasive mechanical ventilation and death on day 7. For those who stayed in the hospital on day 7, the researchers collected results up to day 28.

The results were published in Obesity.

Of the 20 participants in the bariatric surgery group, 16 underwent a single procedure and eight achieved weight loss of 50% or more. The operation was performed a median of 8.5 years prior to hospitalization for COVID-19.

On day 7, four people in the bariatric surgery group required invasive mechanical ventilation and one person died. Another participant died on the 28th day.

Compared to a control group whose preoperative BMI was adjusted, participants who had undergone bariatric surgery were less likely to receive invasive mechanical ventilation or they died of COVID-19 on day 7 (adjusted OR = 0.15; 95 % CI 0.01-0.94; P = 0.03.). ) and day 28 (aOR = 0.11; 95% CI, 0.01-0.71; P = 0.02). The researchers found that the bariatric surgery group included only 16 out of 20 participants, as four did not have a preoperative BMI available.

In the secondary analysis matching the bariatric surgery group with controls by admission BMI, there was no difference in mechanical ventilation and mortality rates on day 7 and day 28.

The researchers wrote that the study had a small number of people who had bariatric surgery and had an adverse COVID-19 outcome. Pattou said the results needed to be replicated in a clinical cohort study.

“We need to understand the exact reasons why obesity promotes severe forms and what mechanisms are responsible for this apparent protective effect of surgical weight loss. whether it’s weight loss itself or some more complex biological mechanism, ”Pattou said.

For more informations:

Francois Pattou, MD, PhD, reachable at francois.pattou@univ-lille.fr.

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