Reentry to Metabolic and Bariatric Surgery During the COVID19 Pandemic

Patients with obesity and diabetes have higher risk for severe complications and mortality from COVID19 infection. In addition, unexpected mortalities were reported in a small series of asymptomatic COVID19-positive patients undergoing metabolic and bariatric surgery (MBS). Several organization including IFSO and the American College of Surgeons (ACS) endorsed recommendations to suspend elective nonessential surgery including MBS during the peak period of COVID19. However, both recommendations have no clear guidelines on how to prioritize MBS patients after the peak of COVID19 cases has passed, but there remain patients with asymptomatic COVID19 in the community. We present a tiered approach to restart MBS during the COVID19 pandemic once the peak of new cases has passed or the curve of new COVID19 cases has flattened.