Effect of the COVID-19 pandemic on bariatric surgery in North America: a retrospective analysis of 834,647 patients

Comment on: Effect of the COVID-19 pandemic on bariatric surgery in North America: a retrospective analysis of 834,647 patients

“…Significant morbidity and mortality with perioperative COVID-19 [2], higher mortality with COVID-19 in those with obesity, diversion of health care resources to dealing with the pandemic, and guidelines from the International Federation for the Surgery of Obesity and Metabolic Disorders at the beginning of the pandemic to cease all elective BMS severely affected the provision of BMS worldwide. In this context, a 12.1% reduction in the volume of bariatric surgery during 2020 in North America as reported in this study [1] in comparison with 2019 seems hardly surprising. Several other studies [3] have also shown a significant reduction in volumes of bariatric surgery globally as a result of the pandemic.…”

“…A slight increase in the proportion of sleeve gastrectomy (SG) during the pandemic in this study [1] might suggest a preference for a less risky procedure. It could, however, also represent the upward trajectory of SG over the past decade at the expense of Roux-en-Y gastric bypass (RYGB) in North America.…”

“…Rubino et al [4] had recommended that patients at the highest risk of death from COVID-19 should be prioritized during the pandemic. However, this study [1] and the findings of the GENEVA (Global 30-day outcomes after bariatric surgery during the COVID-19 pandemic) study [5], which reported on 30-day morbidity and mortality of BS worldwide during the pandemic, suggest that this advice was largely ignored and that surgical teams prioritized fewer at-risk patients. This may be because the frequency and outcome of perioperative COVID-19 were unknown in this group of patients when BMS resumed.…”

“…Interestingly, only 43 (.56%) patients developed symptomatic postoperative COVID-19 in the GENEVA cohort, and only 1 patient (out of 7734) died owing to postoperative COVID-19. It would have been interesting to know how many patients developed symptomatic COVID-19 (and mortality as a consequence of that) after BMS during the pandemic in North America, but this study [1] does not report those numbers.…”

“…This is the first large study [1] reporting on the effect of the COVID-19 pandemic on bariatric and metabolic surgery (BMS) in North America, making it highly interesting. Significant morbidity and mortality with perioperative COVID-19 [2], higher mortality with COVID-19 in those with obesity, diversion of health care resources to dealing with the pandemic, and guidelines from the International Federation for the Surgery of Obesity and Metabolic Disorders at the beginning of the pandemic to cease all elective BMS severely affected the provision of BMS worldwide.…”