SARS-CoV-2 Infection

Bariatric Surgery May Cut COVID Risk by More Than Half

The coronavirus pandemic has put a spotlight on obesity because it is clearly a risk factor for worse outcomes. But now it’s becoming ever more clear that patients have options. A new study from the Cleveland Clinic suggests that bariatric surgery may cut the risk of hospitalization from COVID-19 by half or more. The lead author on this study, Ali Aminian, explains why this finding is unsurprising:

“Patients after bariatric surgery become significantly healthier and can fight the virus better. If confirmed by future studies, this can be added to the long list of health benefits of bariatric surgery such as improvement of diabetes, hypertension, fatty liver disease, sleep apnea, and prevention of heart attack, stroke, kidney disease and death.”

Retrospective and Observational

To be sure, this study has limitations. It is retrospective and observational. The researchers found 33 bariatric surgery patients in the Cleveland Clinic Health System among 4,365 who had tested positive for the coronavirus. They assembled a cohort of 330 matched controls with a BMI ≥ 40. Their prespecified primary endpoint was hospital admissions.

The result was striking. Among the patients with a history of bariatric surgery diagnosed with COVID-19, only 18 percent required hospitalization. But in the matched control group, that number was 42 percent. In the multivariate analysis, the odds of hospitalization were almost 70 percent lower for patients with a history of bariatric surgery.

A larger, but not yet peer-reviewed, study by Antonio Iannelli et al found a lower risk of death associated with a history of bariatric surgery. In fact, the observed mortality rate was about 75 percent lower for the patients with prior bariatric surgery.

Safety of Surgery in the Pandemic?

Access to bariatric surgery has been more difficult during the pandemic, as has been true for many other surgeries. One obvious question, though, is how safe is bariatric surgery during the pandemic?

To answer that question, an international group of investigators have just published a study (GENEVA) in Lancet Diabetes and Endocrinology. They looked at 30-day outcomes in 2,116 surgery patients from 133 hospitals in 38 countries. Their surgeries took place during the first peak in the pandemic between May and July. What they found was that complications were no more common during the pandemic than before. In other words, bariatric surgery remains a relatively safe and effective option for treating severe obesity. Even during the pandemic.

Protect Your Health

The bottom line is quite straightforward. Now more than ever, protecting your health is important. For all of us that means limiting our exposure to the coronavirus – social distance, masks, and clean hands are critical. Plus, if we’re living with a chronic disease, it means taking care of that condition. Whether the condition is heart disease, diabetes, cancer, or obesity, now is the time to make sure we get the care we need.

Delaying care can be deadly.

Click here for the study by Aminian et al and here for further information from the Cleveland Clinic. For the GENEVA study, click here.

SARS-CoV-2 Infection, scanning electron micrograph by NIAID / flickr

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November 29, 2020

One Response to “Bariatric Surgery May Cut COVID Risk by More Than Half”

  1. November 29, 2020 at 9:52 am, David Brown said:

    Excerpt: Metabolic changes caused by obesity — such as insulin resistance and inflammation — make it difficult for individuals with obesity to fight some infections, a trend that can be seen in other infectious diseases, such as influenza and hepatitis.

    Is the writer confused about cause and effect? Does obesity cause metabolic changes that cause obesity? In other words, do insulin resistance and inflammation cause obesity? If so, what causes insulin resistance and inflammation? And what is the difference between insulin resistance and inflammation?

    Here’s what is known about insulin resistance.

    And here is what is known about inflammation.

    Note that insulin resistance has to do with mitochondrial disfunction and inflammation has to do with excessive cell signaling.