Impact of COVID-19 Lockdown on Short-Term Results After Laparoscopic Sleeve Gastrectomy

Abstract

Background The recent COVID-19 pandemic has led several countries worldwide to confine the population. Consequently, people’s mobility and physical activity are limited in addition to a negative psychosocial effect. The aim of this study was to assess the impact of COVID-19 crisis on short-term weight loss and the remission of obesity-associated comorbidities in patients undergoing sleeve gastrectomy (SG). Methods A case-control study was conducted comparing percentage of total weight loss (%TWL), excess weight lost (%EWL), and the remission rate of obesity-related comorbidities at the first postoperative year between patients who underwent primary SG between June 2019 and October 2019 (1-year postoperative period affected by COVID-19 lockdown; COV-group), and a control group operated between June 2018 and October 2018 (1-year postoperative period not affected by COVID-19 lockdown; CONTROL-group). Results In total, 45 patients from COV-group were compared to 57 patients from CONTROL-group. Demographic data were similar between groups. The follow-up rate at 1 year was 100%. The mean %TWL and %EWL was lower at 28.2 ± 12.7% and 67.6 ± 23.5% in COV-group patients compared to 34.3 ± 14.1% and 78.3 ± 27.2% in CONTROL-group patients at 1 year from SG ( p =0.025 and p =0.036, respectively). The remission rate of obesity-related comorbidities at 1 year from SG including type 2 diabetes mellitus, hypertension, dyslipidemia, and obstructive sleep apnea syndrome was 57.1%, 60.0%, 71.4%, and 41.7% in COV-group and 66.7%, 72.4%, 85.3%, and 52.9% in CONTROL-group, respectively, without any statistically significant difference between groups. Conclusions The COVID-19 lockdown had a negative effect on weight loss in the first year after SG. Larger studies are needed to confirm these results, and we are expecting for a longer follow-up to evaluate the long-term impact on weight loss and comorbidities.

Impact of the COVID-19 Pandemic and Lockdown on Gastric Bypass Results at 1-Year Follow-up

“…Despite the differences observed in weight loss, patients’ comorbidities at 1-year follow-up were significantly reduced, without statistically significant differences between groups. This supports the results observed by El Moussaoui et al [ 9 ] and Vitiello et al [ 10 ]. Therefore, irrespective of the COVID-19 pandemic and lockdown, bariatric surgery remains an effective treatment against diabetes [ 2 , 3 , 22 ], hypertension [ 2 , 3 ], and obstructive sleep apnea [ 2 , 3 , 23 ].…”

“…There was a reduction in the excess weight loss of patients intervened prior to the pandemic (mean: 82.4% [SD: 21.6]) compared with patients of the non-COVID-19 period (91.7% [SD: 24.5]). This confirms the results obtained by El Moussaoui et al [ 9 ] for sleeve gastrectomy in Belgium at 1-year follow-up, where patients intervened before the pandemic outbreak had a %EWL of 67.6% (SD: 23.5) while patients of the control group had a %EWL of 78.3% (SD: 27.2). Similar results were attained by Vitiello et al [ 10 ] for sleeve gastrectomy and one anastomosis gastric bypass in Italy at 6-month follow-up, with an excess of BMI loss of patients in the COVID-19 period of 62.3% (SD: 18.9) vs. 77.1% (SD: 18.9) in the non-COVID-19 period.…”

“…Europe was severely affected by COVID-19, with many countries imposing a lockdown between March 2020 and May 2020 to reduce COVID-19 transmission [ 6 ]. These restrictions caused an increase on sedentary behavior [ 7 ] and negative changes in dietary habits [ 8 ], which affected the weight loss of patients undergoing bariatric surgery just before the lockdown [ 9 – 11 ]. Furthermore, hospital follow-up visits were unrecommended during this period [ 12 ], while some patients did not attend due to fear of being infected [ 10 ].…”

The COVID-19 Pandemic Did Not Affect Target Weight Loss 1 Year Post Bariatric Surgery

“…Little is known about how these factors affected patients who underwent bariatric surgery just before the pandemic. While mixed results have been published in small series after sleeve gastrectomy or one anastomosis gastric bypass (OAGB), inconclusive data exists on the effects of the pandemic on short-and long-term weight loss [19][20][21].…”

Impact of COVID-19 Lockdown on Short-Term Weight Loss in a Single Italian Institution: 1-Year Updated Data

“…Following our previous article [4], several studies started to report the impact of COVID-19 lockdown on weight loss after bariatric surgery. El Moussaoui et al [5] compared excess weight loss percent (%EWL) and remission rate from comorbidities at 1-year follow-up between patients who underwent primary SG from June 2019 to October 2019 (COV-group) and a control group operated between June 2018 and October 2018 in Belgium. %EWL was 67.6% in the COV-group and 78.3% in the CONTROL-group.…”