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People with Ity Obesity who have lost weight as a result of bariatric surgery և later become infected with COVID-19 are less likely to be hospitalized with COVID և և the disease is more severe than those of obese COVID patients who have not had surgery , shows a new retrospective analysis.
The study was published recently Gery obesity և surgery for related diseases.
Because obesity is a known risk factor for COVID-19 poor post-traumatic stress disorder, Ali Aminyan, Physician, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, գործընկեր and colleagues decided to investigate whether weight loss surgery affects patient outcomes. on: COVID-19.
They matched 33 COVID-19 patients who underwent metabolic surgery, as well as 330 obese patients who became infected with the virus during the first wave of the epidemic.
Surgery was associated with a 69% reduction in the risk of COVID-19 hospitalization. No surgery patients required intensive care, mechanical ventilation or dialysis, and no one died.
“After bariatric surgery, patients become significantly healthier and can fight the virus better,” Aminyan said in a statement.
“If confirmed by future studies, it could add to the long list of health benefits of bariatric surgery,” he added.
COVID-19 is a warning sign of obesity
Aminyan told Medscape Medical News “COVID-19 is a ‘wake-up call’ to show the public, health professionals, that obesity is a major health problem, it has many health consequences.”
More than 300 articles in the literature show that obesity is a major risk factor for poor outcomes after COVID-19 infection. Aminyan said the epidemic “has improved public awareness of the consequences of obesity.”
“At his facility, the admission of new patients” who would like to join the surgery program or have some tools to help them lose weight is almost double, “he said.
In addition, referrals from primary care physicians, such as endocrinologists and cardiologists, for bariatric surgery in recent months.
Despite the fact that in April, due to COVID-19, the unit had to stop all bariatric surgeries, this year it performed the same number of procedures as in 2019 և 2018.
Due to the recent increase in COVID cases in Ohio, bariatric procedures are being stopped again. “Optional procedures requiring hospital beds after surgery have been discontinued to provide beds for patients with COVID-19,” he explained.
Small sample size, study should be repeated
For their study, Aminyan and colleagues reviewed records from 4,365 patients at the Cleveland Clinic Health System who tested positive for the virus between March 8 and July 22, 2020.
1003 of them had a body mass index (BMI) of ≥35 mg / kg2:; The BMI of 482 was ≥40 kg / m2:. The team identified 33 patients who had previously undergone metabolic surgery, including a 20-year gastrectomy և 13 Roux-en-Y gastric bypass.
Surgical patients tended to have a 1:10 ratio ների BMI ≥ 40 kg / m with non-surgical control patients.2:. Patients were adjusted for age, gender, ethnicity, location, smoking status, and history of chronic obstructive pulmonary disease.
The average BMI of surgical patients was 49.1 kg / m2: before their procedure. It fell to 37.2 kg / m2: when their COVID-19 tests were positive. This compares to an average of 46.7 kg / m2: At that time, they were positively infected with the virus in the control group.
The team found that 18.2% of metabolic surgery patients were admitted to hospital and 42.1% of controlled patients (Q: = .013):
Moreover, patients with metabolic surgery did not require admission to the intensive care unit, nor did mechanical ventilation or dialysis, and no one died. This is compared to 13.0% (Q: = .021), 6.7% (Q: = .24), 1.5% և 2.4%, respectively, in the control group of patients.
The multivariate analysis showed that previous metabolic surgery was associated with a lower hospital admission rate of 0.31 (Q: = .028), compared with obese patients.
Acknowledging the limited size of their study sample, the team writes:
Earn as many aspects of obesity management as possible during an epidemic
Aminyan stressed that the message from his study is that health professionals should “ideally” pursue all aspects of obesity management during an epidemic, including “medical management, behavioral therapy, lifestyle changes, and access to bariatric surgery.” “
This is despite the fact that bariatric surgery insurance “has always been a challenge for many patients because many insurance programs do not cover bariatric procedures,” he said.
In July, the American Society for Metabolic Surgery issued a statement saying that obesity surgery should not be considered an optional procedure and should be resumed as long as it is safe to do so during any recurrence of COVID-19.
Surg Obes Relat Dis. Published online: November 23, 2020. Full text:
The authors did not disclose the relevant financial relationship.
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