Effects of Bariatric Surgery on COVID-19: a Multicentric Study from a High Incidence Area

Abstract

Introduction The favorable effects of bariatric surgery (BS) on overall pulmonary function and obesity-related comorbidities could influence SARS-CoV-2 clinical expression. This has been investigated comparing COVID-19 incidence and clinical course between a cohort of patients submitted to BS and a cohort of candidates for BS during the spring outbreak in Italy. Materials and Methods From April to August 2020, 594 patients from 6 major bariatric centers in Emilia-Romagna were administered an 87-item telephonic questionnaire. Demographics, COVID-19 incidence, suggestive symptoms, and clinical outcome parameters of operated patients and candidates to BS were compared. The incidence of symptomatic COVID-19 was assessed including the clinical definition of probable case, according to World Health Organization criteria. Results Three hundred fifty-three operated patients (Op) and 169 candidates for BS (C) were finally included in the statistical analysis. While COVID-19 incidence confirmed by laboratory tests was similar in the two groups (5.7% vs 5.9%), lower incidence of most of COVID-19-related symptoms, such as anosmia (p: 0.046), dysgeusia (p: 0.049), fever with rapid onset (p: 0.046) were recorded among Op patients, resulting in a lower rate of probable cases (14.4% vs 23.7%; p: 0.009). Hospitalization was more frequent in C patients (2.4% vs 0.3%, p: 0.02). One death in each group was reported (0.3% vs 0.6%). Previous pneumonia and malignancies resulted to be associated with symptomatic COVID-19 at univariate and multivariate analysis. Conclusion Patients submitted to BS seem to develop less severe SARS-CoV-2 infection than subjects suffering from obesity.

SARS-CoV-2 Seroprevalence Post-First Wave among Primary Care Physicians in Catania (Italy)

“…It is important to finalize strategies and procedures to prevent SARS-CoV-2 infection among GPs, for example, specific guidelines for GPs to safely guarantee care for patients during the spread of COVID-19. Another input could be the introduction of telemedicine procedures to reduce direct contact with patients [10,[25][26][27].…”

Effects of Bariatric Surgery on Influenza-Like Illness: a Two-Center Cross-sectional Study

“…Severe obesity could promote the clinical expression of influenza viruses, as recently reported for Sars-CoV-2 infection [19,20]. Obesity is in fact characterized by chronic low-grade inflammation, with subsequent impairment of the immune system, and it is also associated with reduced lung function and decreased respiratory compliance, leading to higher risk of obstructive syndrome and pneumonia [5,6].…”

Role of bariatric surgery in a COVID-19 era: a review of economic costs

“…In a recent systematic review on obesity and COVID-J o u r n a l P r e -p r o o f 19, obesity was shown to have a significant association to higher COVID-19 infection rates (OR 1.50, P<0.001), more severe COVID-19 disease (OR 3.13, 95%; P=0.005) and higher mortality (OR 1.36, 95% P = 0.006) 43 . Bariatric surgery again has an important role in managing obesity-related COVID-19 complications, with one multi-center study finding that patients who have undergone bariatric surgery 12 months or earlier developed less severe COVID-19-related symptoms than subjects who were currently obese 46 . Therefore, while the COVID-19 pandemic justly halted elective bariatric surgeries, efforts must be made to prioritize bariatric surgeries once it is practical to do so 47 .…”