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Bariatric Surgery and COVID-19: a Change of Perspective in a New Phase of the Pandemic

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Abstract

Purpose

The protective role of bariatric surgery (BS) against COVID-19 has been reported by several studies, showing, in the first pandemic waves, better outcome of the infection in patients that had undergone BS. With the virus progressive endemicity, BS benefits on COVID-19 clinical course could appear less evident, while COVID-19 effects on BS outcomes must be investigated.

In this national multicentric cross-sectional study, we compared COVID-19 incidence and clinical course between a cohort of patients that had undergone BS (OP) and a cohort of candidates to BS (WS); moreover, we analyzed BS outcomes based on SARS-CoV-2 positivity/negativity.

Methods

From June to December 2021, 522 patients from five Italian referral centers were administered an 87-item telephonic questionnaire completing the analysis of electronic medical records. Demographics, COVID-19 “tested” incidence, suggestive symptoms and clinical outcome parameters of OP and WS were compared. BS outcomes parameters were compared between OP that developed the disease or not.

Results

COVID-19 incidence was the same in OP and WS, while symptoms and clinical course seemed milder in OP, with no data individually reaching statistical significance. OP who developed SARS-CoV-2 infection had higher excess weight loss than negative OP (66.8% ± 22.1 vs. 57.7% ± 22.8, p = 0.029). Positive OP had had gastric-bypass (RYGB/OAGB) more frequently than negative ones (38.4% vs. 18.2%, p = 0.025).

Conclusion

With the disease becoming endemic, BS protective role against COVID-19 seems clinically less relevant. BS outcomes can be affected by COVID-19, thus imposing careful follow-up for positive patients, especially if undergoing gastric-bypass.

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Authors and Affiliations

  1. Unit of General Surgery, Department of Surgery, Parma University Hospital, Parma, Italy

    Federico Marchesi, Concetta Prioriello, Lucia Ballabeni & Paolo Del Rio

  2. Unit of General Surgery, Parma University Hospital, Parma, Italy

    Giorgio Dalmonte, Francesco Tartamella & Marina Valente

  3. Dipartimento di Sanità Pubblica/Public Health, AUSL-IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy

    Matteo Riccò

  4. Unit of General Surgery “M. Rubino”, Azienda Ospedaliero Universitaria Policlinico Bari, Bari, Italy

    Gennaro Martines & Rigers Dibra

  5. Centro di Chirurgia Metabolica e dell’Obesità, IRCCS Azienda Ospedaliera Universitaria di Bologna Policlinico di Sant Orsola, Bologna, Italy

    Paolo Bernante & Francesca Balsamo

  6. UOSD Nutrizione Clinica, Ausl Bologna, Bologna, Italy

    Francesca Anzolin

  7. Centro di Chirurgia Metabolica e dell’Obesità Ausl-Aosp, Bologna, Italy

    Stefano Gagliardi

  8. UO Chirurgia Generale, Vascolare e Toracica, Dipartimento Chirurgico, Ospedale G. Da Saliceto, AUSL, Piacenza, Italy

    Luigi Conti

  9. UO Medicina Interna, Malattia Metaboliche e DCA, Ospedale G. Da Saliceto, AUSL, Piacenza, Italy

    Alessandro Rampulla

Authors
  1. Federico Marchesi
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  2. Giorgio Dalmonte
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  16. Marina Valente
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Corresponding author

Correspondence to Federico Marchesi.

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Ethics Approval

All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration as amended or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Key Points

• COVID-19 may cause higher excess weight loss in post-bariatric surgery patients.

• RYGB/OAGB patients had twofold incidence of COVID-19 infection compared with SG ones.

• BS outcomes can be affected by COVID-19, thus imposing a tailored follow-up.

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Marchesi, F., Dalmonte, G., Riccò, M. et al. Bariatric Surgery and COVID-19: a Change of Perspective in a New Phase of the Pandemic. OBES SURG 33, 4049–4057 (2023). https://doi.org/10.1007/s11695-023-06923-6

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