Global 30-day outcomes after bariatric surgery during the COVID-19 pandemic (GENEVA): an international cohort study

Singhal, Rishi; Tahrani, Abd A; Ludwig, Christian; Mahawar, Kamal

doi:10.1016/s2213-8587(20)30375-2

Cited by 60 publications

(59 citation statements)

References 10 publications

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“…This study is one of the first to the authors' knowledge to examine perioperative outcomes of patients hospitalized during the COVID-19 pandemic for non-COVID-19 diagnoses. Other recent studies, performed among patients undergoing bariatric surgery, head/neck cancer resection, and colorectal surgical procedures, have noted that the overall safety profile of surgery during the COVID-19 pandemic is acceptable [46][47][48]. However, in one study of patients undergoing colorectal surgery, the postoperative mortality rate was noted to be higher during the pandemic [47].…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID‐19 Restrictions on Demographics and Outcomes of Patients Undergoing Medically Necessary Non‐Emergent Surgeries During the Pandemic

et al. 2021

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Background The COVID-19 pandemic has resulted in large-scale healthcare restrictions to control viral spread, reducing operating room censuses to include only medically necessary surgeries. The impact of restrictions on which patients undergo surgical procedures and their perioperative outcomes is less understood. Methods Adult patients who underwent medically necessary surgical procedures at our institution during a restricted operative period due to the COVID-19 pandemic (March 23-April 24, 2020) were compared to patients undergoing procedures during a similar time period in the pre-COVID-19 era (March 25-April 26, 2019). Cardinal matching and differences in means were utilized to analyze perioperative outcomes. Results 857 patients had surgery in 2019 (pre-COVID-19) and 212 patients had surgery in 2020 . The COVID-19 era cohort had a higher proportion of patients who were male (61.3% vs. 44.5%, P \ 0.0001), were White (83.5% vs. 68.7%, P \ 0.001), had private insurance (62.7% vs. 54.3%, p 0.05), were ASA classification 4 (10.9% vs. 3%, P \ 0.0001), and underwent oncologic procedures (69.3% vs. 42.7%, P \ 0.0001). Following 1:1 cardinal matching, COVID-19 era patients (N = 157) had a decreased likelihood of discharge to a nursing facility (risk difference-8.3, P \ 0.0001) and shorter median length of stay (risk difference-0.6, p 0.04) compared to pre-COVID-19 era patients. There was no difference between the two patient cohorts in overall morbidity and 30-day readmission.Conclusions COVID-19 restrictions on surgical operations were associated with a change in the racial and insurance demographics in patients undergoing medically necessary surgical procedures but were not associated with worse postoperative morbidity. Further study is necessary to better identify the causes for patient demographic differences.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID‐19 Restrictions on Demographics and Outcomes of Patients Undergoing Medically Necessary Non‐Emergent Surgeries During the Pandemic

et al. 2021

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“…Concerns regarding the difficulty of treatment of Covid-19 in postbariatric surgery patients related to oral intake/absorption problems have been appropriately raised [11]. The aforementioned mind-shift, therefore, has to be balanced by the risk of acquiring Covid-19 in the early postoperative period which is a reality as shown herein and by others [1][2][3][4][5][6]. Notably, any benefit to patients in terms of outcome of Covid-19 infection will not become relevant for at least a few months after surgery, until appreciable weight loss has occurred.…”

Section: Discussionmentioning

confidence: 97%

“…Incidence remains unknown. No information, except for a recent survey [6] and case reports [4,5], is available regarding the outcome of bariatric procedures during the pandemic. Many parts of the world are experiencing a second and even worse surge of infections at present.…”

Section: Introductionmentioning

confidence: 99%

Eighty-Seven Consecutive Sleeve Gastrectomies Between the Two Peaks of the Covid-19 Pandemic. An Opening-Phase Experience

Yerdel¹,

Özgen²

2021

OBES SURG

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Purpose During the Covid-19 pandemic, the outcome of symptomatic Covid-19 infection occurring early after elective operations is reportedly associated with fatalities. Incidence is unknown and data on bariatric practice is scarce. Covid-19 exposure status and outcomes of sleeve gastrectomy (SG) between the first two peaks of the pandemic are prospectively evaluated. Material and Methods During our "opening-phase," candidates for SG were enrolled after written informed consent was obtained which specifically emphasized the additional risks of the Covid-19. Viral exposure history and swab/RNA testing were obtained from all. Preoperative antibody testing was also performed, once became available. Preoperative workout, definitions, and surgical technique were standard. Patients were followed up with video-calls. All perioperative data is prospectively recorded. Results Between June 23 and November 20, 87 consecutive SGs were performed without mortality and conversion with a 1.2% major early complication rate. Single complication was due to Covid-19, acutely becoming symptomatic one day following the SG. During the first year of the pandemic, a minimum of 13.8% of the patients had encountered the virus and the rate of developing postoperative symptomatic Covid-19 was 6.3% including a patient with full-blown Covid-19 pneumonia 1 day after SG. Results on weight loss matched expectations. Conclusion Currently, differing from the first peak of pandemic, vaccines are underway although a more serious surge continues. Given the high rate of morbidity and mortality of Covid-19 infection early after elective operations, caution is warranted when balancing the expected benefit from an elective procedure against the risk of acquiring perioperative Covid-19 infection.

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“…An international multicenter cohort study (GENEVA) was conducted to determine the outcomes of bariatric surgery in the COVID-19 era [42]. In this study, the 30-day outcomes of 2001 adult patients (> 18 years) from 127 hospitals in 35 countries who underwent BMS between 1st May and 10th July 2020 were analyzed.…”

Section: Bariatric and Metabolic Surgery (Bms)mentioning

confidence: 99%

Impact of COVID-19 on the outcomes of gastrointestinal surgery

Gupta

Ammar

2021

Clin J Gastroenterol

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COVID-19 pandemic has brought a paradigm shift in the treatment of various surgical gastrointestinal disorders. Given the increasing number of patients requiring hospitalization and intensive care for SARS-CoV-2 infections, various surgical departments worldwide were forced to stop or postpone elective surgeries to save the health resources for COVID-19 patients. Since the declaration of the COVID-19 pandemic by the World Health Organization on 12th March 2020, the recommendations from the surgical societies kept evolving to help the surgeons in making informed decisions regarding patient care. Moreover, various socio-economic and epidemiological factors have come into play while deciding the optimal approach towards patients requiring gastrointestinal surgery. Surgeries for many abdominal diseases such as acute appendicitis and acute calculous cholecystitis were postponed. Elective surgeries were triaged based on the urgency of performing the surgical procedure, the hospital burden of COVID-19 patients, and the availability of healthcare resources. Various measures were adopted such as preoperative screening for SARS-CoV-2 infection, use of personal protective equipment, and the COVID-19-free surgical pathway to prevent perioperative SARS-CoV-2 transmission. In this article, we have reviewed the recent studies reporting the outcomes of various gastrointestinal surgeries in the COVID-19 pandemic era and the recommendations from various surgical societies on the safety precautions to be followed during gastrointestinal surgery.

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Global 30-day outcomes after bariatric surgery during the COVID-19 pandemic (GENEVA): an international cohort study

Cited by 60 publications

References 10 publications

Impact of COVID‐19 Restrictions on Demographics and Outcomes of Patients Undergoing Medically Necessary Non‐Emergent Surgeries During the Pandemic

Impact of COVID‐19 Restrictions on Demographics and Outcomes of Patients Undergoing Medically Necessary Non‐Emergent Surgeries During the Pandemic

Eighty-Seven Consecutive Sleeve Gastrectomies Between the Two Peaks of the Covid-19 Pandemic. An Opening-Phase Experience

Impact of COVID-19 on the outcomes of gastrointestinal surgery

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