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

Liu, Daniel; Cheng, Qiuye; Suh, Hyerim; Magdy, Mark; Loi, Ken

doi:10.1016/j.soard.2021.07.015

Cited by 4 publications

(7 citation statements)

References 40 publications

(49 reference statements)

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“…The planning of adequate pathways allows on the one hand to reduce the rate of infections and on the other guarantees the use of health resources for the restoration of elective surgical activity. The reduction of surgical activities could represent a significant pitfall for public health expenditure, entailing a potentially greater cost than managing the patient with SARS-CoV-2 [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

Timing of surgery and elective perioperative management of patients with previous SARS-CoV-2 infection: a SIAARTI expert consensus statement

Cortegiani

Tripodi

Castioni

et al. 2022

J Anesth Analg Crit Care

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Background The appropriate timing of surgery and perioperative management of patients with previous SARS-CoV-2 infection are open issues. The purpose of this document is to support the clinical decision-making process regarding the patient with previous Sars-CoV-2 infection to undergo elective surgery. The recipients of this document are physicians, nurses, healthcare personnel, and other professionals involved in the patient’s surgical process. Methods The Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) selected 11 experts to reach a consensus on key aspects of this theme in adult and pediatric population. The methods of this process document were in accordance to the principles of rapid review of the scientific literature and modified Delphi method. The experts produced statements and supporting reasons in the form of an informative text. The overall list of statements was subjected to a vote in order to express the degree of consent. Results Patients should not undergo elective surgery within 7 weeks of infection unless there is the risk of a negative evolution of the disease. To mitigate the risk of postsurgical mortality, a multidisciplinary approach seemed useful in addition to the use of validated algorithms to estimate the risk of perioperative morbidity and mortality; the risk related to SARS-CoV-2 infection should be added. The risk of potential nosocomial contagion from a positive patients should also be considered when deciding to proceed with surgery. Most of the evidence came from previous SARS-CoV-2 variants, so the evidence should be considered indirect. Conclusion A balanced preoperative multidisciplinary risk–benefit evaluation is needed in patients with previous infection by SARS-CoV-2 for elective surgery.

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Section: Resultsmentioning

confidence: 99%

Timing of surgery and elective perioperative management of patients with previous SARS-CoV-2 infection: a SIAARTI expert consensus statement

Cortegiani

Tripodi

Castioni

et al. 2022

J Anesth Analg Crit Care

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“…In this context, bariatric surgery is essential in reducing obesity-related complications of SARS-CoV-2 infection. Specifically, a multicenter study showed that patients who had undergone bariatric surgery at least 12 months earlier developed COVID-19 in less severe forms than obese patients not treated with bariatric surgery [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…In 2014, a report by the McKinsey Global Institute estimated that the economic impact on the world economy due to obesity amounts to US$2 trillion, equivalent to 2.8% of global gross domestic product (GDP) [ 16 ]. In this era, when it is becoming increasingly important to pay attention to the distribution of health care investments and beyond, it seems clear that proper care of patients with obesity is necessary to derive an economic benefit as well.…”

Section: Discussionmentioning

confidence: 99%

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Impact of COVID-19 on the Destiny of Bariatric Patients

et al. 2022

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Obese patients reported worse outcomes of COVID-19 related to prothrombotic and low-grade inflammation status. During the SARS-CoV-2 outbreak, all non-elective surgeries were postponed, including bariatric surgery (BS). This umbrella review wants to underline obesity as a condition provoking low-grade chronic inflammation, and increasing severe COVID-19 risk; to relaunch the prioritization of BS. The literature search was conducted in March 2022 via Pubmed (MEDLINE) and focused on reviews, systematic reviews, and meta-analyses published in peer-reviewed journals. Terms “bariatric surgery” OR “obesity surgery” OR “metabolic surgery” were analyzed with “COVID-19” OR “SARS-CoV-2” using the AND modifier. Only 13 studies of the 406 screened met the objective. The procrastination of BS over the past two years determined a delay in obesity treatment and severe consequences. The COVID-19 pandemic has had a huge impact on economic costs. Although BS has high costs, a lifetime cost advantage over conventional weight loss methods was demonstrated. As the pandemic continues, health policies must recognize obesity as a disease-predisposing factor for SARS-CoV-2 infection, considering COVID-19 as a new comorbidity mitigable by BS. Care pathways for obese patients in COVID/post-COVID era should be revitalized and the concept of elective surgery attributed to BS should be reformulated.

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“…A recent meta-analysis by Liu et al [ 2 ] revealed that postponement of in-person clinical care affected the management of patients with chronic diseases, such as the postponement of bariatric surgeries for chronic obesity [ 3 ]. A worldwide survey of bariatric surgeons revealed that 84.6% had postponed primary or redo bariatric procedures under COVID-19 restrictions [ 4 ].…”

Section: Introductionmentioning

confidence: 99%