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Diagnosis of COVID-19 and the bariatric surgery population: a single center experience
Gustavo Romero-Velez1, Xavier Pereira1, John Paul Skendelas1
1Montefiore Medical Center, 3400 Bainbridge Ave 4th Floor, Bronx, NY, 10467, USA.
Insights
Patients undergoing bariatric surgery during the COVID-19 pandemic experienced symptoms at a rate of 10.7%. While no severe outcomes occurred, elective surgery may increase disease risk for these high-risk individuals.
Area of Science:
- Medical research
- Surgical outcomes
- Infectious disease epidemiology
Background:
- Morbidly obese patients face higher COVID-19 risks.
- Bariatric surgery patients often have underlying conditions increasing COVID-19 severity.
- The impact of COVID-19 on bariatric surgery patients remains unclear.
Purpose of the Study:
- To evaluate the experience of patients undergoing bariatric surgery during the early COVID-19 pandemic.
- To assess COVID-19 exposure and outcomes in this high-risk population.
Main Methods:
- Cross-sectional study of 190 patients undergoing bariatric surgery (Jan-Mar 2020).
- Analysis of demographics, operative variables, and postoperative outcomes.
- Telephone surveys assessed COVID-19 exposure, symptoms, and testing pre- and post-surgery.
Main Results:
- 190 patients underwent bariatric surgery; laparoscopic sleeve gastrectomy was most common.
- 10.7% of patients reported COVID-19 compatible symptoms postoperatively.
- 3.4% tested positive for COVID-19; no COVID-19-related hospitalizations or deaths occurred.
Conclusions:
- Bariatric surgery patients reported COVID-19 symptoms at a 10.7% rate.
- No severe COVID-19 outcomes were observed in this cohort.
- Elective surgery may pose an increased risk for COVID-19 contraction in morbidly obese patients.
Background:
While many cases of the coronavirus disease 2019 (COVID-19) are mild, patients with underlying medical conditions such as hypertension (HTN), diabetes mellitus (DM), older age, and morbid obesity are at higher risk of hospitalization and death. These conditions are characteristic of patients eligible for bariatric surgery, many of whom underwent weight loss procedures in the months prior to cessation of elective surgery in March 2020. The effects of the virus on these high-risk patients who had increased healthcare exposure in the early days of the pandemic are currently unknown.
Objectives:
To describe the experience of patients who underwent bariatric surgery during the early evolution of the COVID-19 pandemic.
Methods:
This is a cross-sectional study including patients from a single center who underwent bariatric surgery from January 1st, 2020 to March 18th, 2020. A database was created to analyze patients' demographics, operative variables, and postoperative outcomes. All patients were contacted and a telephone survey was completed to inquire about COVID-19 exposure, symptoms, and testing 30 days before and after surgery.
Results:
A total of 190 patients underwent bariatric surgery during the study period. Laparoscopic sleeve gastrectomy was the most common procedure (71.6%). One hundred seventy-eight patients (93.7%) completed the telephone survey. Postoperatively, 19 patients (10.7%) reported COVID-19 compatible symptoms, and six patients (3.4%) went on to test positive for COVID-19. There were no COVID-19-related hospital admissions or mortalities in this population.
Conclusions:
Morbidly obese patients are at high risk of severe disease secondary to COVID-19, and those undergoing bariatric surgery during the evolution of the pandemic reported symptoms at a rate of 10.7% 30 days after the surgery. While none of these patients suffered severe COVID-19 disease, the temporal relationship of their symptomatology and increased exposure to the healthcare system as a result of their surgery suggest an increased risk of disease with elective surgery.
