Abstract
BackgroundObesity and several obesity-related co-morbidities are risk factors for severe COVID-19 disease. Because bariatric surgery successfully treats obesity-related conditions, we hypothesized that prior bariatric surgery may be associated with less severe COVID-19 disease.ObjectivesTo examine the association between prior bariatric surgery and outcomes in patients with obesity admitted with COVID-19.SettingUnited StatesMethodsThe Vizient database was used to obtain demographic and outcomes data for adults with obesity admitted with COVID-19 from May 2020 to January 2021. Patients were divided into 2 groups: those with and those without prior bariatric surgery. The primary outcome was in-hospital mortality. Secondary outcomes were mortality by age, sex, race/ethnicity, and co-morbidity; intubation rate; hemodialysis rate; and length of stay. Because the database only provides aggregate data and not patient-level data, multivariate analysis could not be performed.ResultsAmong the 124,699 patients with obesity admitted with COVID-19, 2,607 had previous bariatric surgery and 122,092 did not. The proportion of patients ≥65 years of age was higher in the non–bariatric surgery group (36.0% versus 27.6%, P < .0001). Compared with patients without prior bariatric surgery, patients with prior bariatric surgery had lower in-hospital mortality (7.8 versus 11.2%, P < .0001) and intubation rates (18.5% versus 23.6%, P = .0009). Hemodialysis rate (7.2% versus 6.9%, P = .5) and length of stay (8.8 versus 9.6 days, P = .8) were similar between groups. Mortality was significantly lower in the bariatric surgery group for patients 18–64 years of age (5.9% versus 7.4%, P = .01) and ≥65 years of age (12.9% versus 17.9%, P = .0006).ConclusionsThis retrospective cohort study found that inpatients with obesity and COVID-19 who had prior bariatric surgery had improved outcomes compared with a similar cohort without prior bariatric surgery. Further studies should examine mechanisms for the association between bariatric surgery and less severe COVID-19.
Highlights
: Background: Obesity and several obesity-related co-morbidities are risk factors for severe COVID19 disease
Because bariatric surgery is so successful in treating these conditions that are implicated as risk factors for severe COVID-19, it is plausible that a history of bariatric surgery may have a protective effect in patients infected with the novel coronavirus
We found that 2.1% of patients with obesity admitted with COVID-19 had a history of bariatric surgery, which is similar to reports that approximately 1.1% of patients who qualify for bariatric surgery in the United States undergo surgery [14]
Summary
: Background: Obesity and several obesity-related co-morbidities are risk factors for severe COVID19 disease. Because bariatric surgery successfully treats obesity-related conditions, we hypothesized that prior bariatric surgery may be associated with less severe COVID-19 disease. Compared with patients without prior bariatric surgery, patients with prior bariatric surgery had lower in-hospital mortality (7.8 versus 11.2%, P , .0001) and intubation rates (18.5% versus 23.6%, P 5 .0009). Because bariatric surgery is so successful in treating these conditions that are implicated as risk factors for severe COVID-19, it is plausible that a history of bariatric surgery may have a protective effect in patients infected with the novel coronavirus. A nationwide retrospective study from France evaluated patients with obesity admitted with COVID-19 and found that patients with a history of bariatric surgery had significantly lower rates of intubation and mortality [9]. The aim of this study was to compare the characteristics and outcomes of patients with obesity hospitalized with COVID-19 with and without a history of bariatric surgery
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