The impact of bariatric and metabolic surgery on the morbidity and mortality of patients infected during the COVID-19 pandemic: a retrospective cohort study.

Abstract

Since the impact of the coronavirus disease 2019 (COVID-19) pandemic in March 2020, several studies have shown a strong relationship between obesity and severe cases of COVID-19. It is imperative to assess whether bariatric surgery exerts a protective effect in such cases. This study aimed to assess the impact of bariatric surgery on the morbidity and mortality in obese patients during the COVID-19 pandemic. A comprehensive search was performed using the PubMed and Cochrane Library databases. Retrospective cohort studies conducted in the Faculdade de Medicina da Universidade Cidade de São Paulo, São Paulo (SP), Brazil. The search comprised the following descriptors: "bariatric, surgery, COVID-19". Current retrospective cohort studies that examined the influence of bariatric surgery on the morbidity and mortality of obese patients during the COVID-19 pandemic were considered eligible. After removing duplicates, 184 studies were obtained from the databases. Of these, 181 were excluded from the analysis as they did not meet the eligibility criteria. Patients undergoing postoperative follow-up of bariatric surgery had a similar probability of SARS-CoV-2 infection compared to the general population, and persistent comorbidities were associated with an increased risk and severity of infection. Bariatric surgery has a protective effect against severe COVID-19 in the obese population, bringing the prevalence of severe disease cases to levels equivalent to those of the nonobese general population, with a positive impact on morbidity and mortality.