Background

Obesity is a risk factor for poor clinical outcomes in patients with COVID-19. We explored the effect of bariatric surgery on the severity of COVID-19 infection among persons with obesity.

Methods

A retrospective review of our electronic medical record identified 161 metabolic and bariatric surgery (MBS) and 5879 non-surgical (NSurg) patients with BMI>=35 who had tested positive for SARS-CoV-2 between 3/1/2020 and 12/31/2020 (before the vaccine rollout) within a single healthcare system. MBS patients were included if COVID-19 occurred >6 months post-bariatric surgery. The highest historical BMI (HHBMI) within five years prior to infection was extracted as a 'pre-surgery' weight. The analytic study sample included all the surgery cases and a random sample of non-surgery patients stratified to achieve a subset not different from MBS based on gender, age, obesity class, and HHBMI.

Results

The proportion of MBS patients hospitalized in our healthcare system for COVID-19 was lower than NSurg (8.7% vs.11.9%, p=0.247). No MBS patient required mechanical ventilation compared to 2.2% of NSurg (p=0.058). Need for ICU care (2.5% vs. 3%, p=1.000) and mortality (0.6% vs. 1.2%, p=1.000) were also lower for MBS compared to NSurg.

Conclusions

Although differences did not reach statistical difference, COVID-19 related outcomes, including mortality, inpatient hospitalization, need for ICU care and mechanical ventilation, were favorable for the patients with a history of bariatric surgery compared to patients with a similar degree of obesity and no history of bariatric surgery. Larger studies are required to confirm these findings.