Effects of bariatric surgery on COVID-19: a multicentric study from a high incidence area

Introduction: The favorable effects of bariatric surgery (BS) on overall pulmonary function and obesity-related comorbidities could play a role against SARS-CoV-2 infection. This has been investigated comparing Covid-19 incidence and clinical course between a cohort of patients submitted to BS and a cohort of obese candidates to BS during the spring outbreak in Italy.
Materials and Methods: From April to August 2020, 594 patients from 6 major bariatric centers in Emilia-Romagna were administered an 87-item telephonic questionnaire. Demographics, Covid-19 incidence, suggestive symptoms and clinical outcome parameters of operated patients and candidates to BS were compared. The incidence of symptomatic Covid-19 was assessed including the clinical definition of probable case, according to World Health Organization criteria.
Results: 353 operated patients (Op) and 169 candidates for BS (C) were finally included in the statistical analysis. While Covid-19 incidence confirmed by laboratory tests was similar in the two groups (5.7% vs 5.9%), lower incidence of most of Covid-19-related symptoms, such as anosmia (p: 0.046), dysgeusia (p: 0.049), fever with rapid onset (p: 0.046) were recorded among Op patients, resulting in a lower rate of probable cases (14,4% vs 23,7%; p: 0.009). Hospitalization was more frequent in C patients (2.4% vs 0.3%, p: 0.02). One death in each group was reported (0.3% vs 0.6%). Previous pneumonia and malignancies resulted to be associated with symptomatic Covid-19 at univariate and multivariate analysis.
Conclusion: patients submitted to BS seem to develop less severe SARS-CoV-2 infection than obese subjects.

引言：减重手术（BS）对整体肺功能及肥胖相关并发症的有利影响，可能在抵御SARS-CoV-2感染方面发挥作用。本研究通过比较意大利春季疫情期间接受减重手术的患者队列与肥胖候选者队列的COVID-19发病率和临床病程，对此进行了探究。

材料与方法：2020年4月至8月，来自艾米利亚-罗马涅地区6个主要减重中心的594名患者接受了包含87项问题的电话问卷调查。比较了患者的基线资料、COVID-19发病率、疑似症状及接受减重手术的患者和候选者的临床结局参数。对有症状的COVID-19发病率进行了评估，包括根据世界卫生组织标准确定的可能病例的临床定义。

结果：最终纳入统计分析的有353名接受手术的患者（Op）和169名减重手术候选者（C）。尽管实验室检测确认的COVID-19发病率在两组中相似（5.7% vs 5.9%），但Op患者中大多数COVID-19相关症状的发生率较低，如嗅觉丧失（p：0.046）、味觉异常（p：0.049）、发热迅速发作（p：0.046），导致可能病例的比率较低（14.4% vs 23.7%；p：0.009）。C患者住院率更高（2.4% vs 0.3%，p：0.02）。每组报告了一例死亡（0.3% vs 0.6%）。单因素和多因素分析显示，既往肺炎和恶性肿瘤与有症状的COVID-19相关。

结论：接受减重手术的患者似乎比肥胖个体发展出的SARS-CoV-2感染更为轻微。