Impact of prior bariatric surgery on risk and severity of COVID-19 infection: A meta-analysis of observational studies. Issue 6 (November 2022)

• Record Type: Journal Article
• Authors: Hung, Kuo-Chuan; Chen, Hsiao-Tien; Hsing, Chung-Hsi; Jinn-Rung, Kuo; Ho, Chun-Ning; Lin, Yao-Tsung; Chang, Ying-Jen; Chiu, Sheng-Fu; Sun, Cheuk-Kwan
• Is Part Of: Obesity research & clinical practice. Volume 16:Issue 6(2022)
• Page Start: 439
• Page End: 446
• Publication Date: 2022-11
• Subjects: Bariatric surgery -- COVID-19 -- Mortality -- Infection rate; Obesity -- Research -- Periodicals; Obesity -- Treatment -- Periodicals; Obesity -- Periodicals; Obésité -- Recherche -- Périodiques; Obésité -- Traitement -- Périodiques; Obesity -- Research; Obesity -- Treatment; Electronic journals; Periodicals; 616.398
• DOI: 10.1016/j.orcp.2022.10.005
• Languages: English
• ISSNs: 1871-403X

Abstract

Abstract: Background: The association of prior bariatric surgery (BS) with infection rate and prognosis of coronavirus disease 2019 (COVID-19) remains unclear. We conducted a meta-analysis of observational studies to address this issue. Methods: We searched databases including MEDLINE, Embase, and CENTRAL from inception to May, 2022. The primary outcome was risk of mortality, while secondary outcomes included risk of hospital/intensive care unit (ICU) admission, mechanical ventilation, acute kidney injury (AKI), and infection rate. Results: Eleven studies involving 151, 475 patients were analyzed. Meta-analysis showed lower risks of mortality [odd ratio (OR)= 0.42, 95% CI: 0.27–0.65, p < 0.001, I 2 = 67%; nine studies; 151, 113 patients, certainty of evidence (COE):moderate], hospital admission (OR=0.56, 95% CI: 0.36–0.85, p = 0.007, I 2 =74.6%; seven studies; 17, 810 patients; COE:low), ICU admission (OR=0.5, 95% CI: 0.37–0.67, p < 0.001, I 2 =0%; six studies; 17, 496 patients, COE:moderate), mechanical ventilation (OR=0.52, 95% CI: 0.37–0.72, p < 0.001, I 2 =57.1%; seven studies; 137, 992 patients, COE:moderate) in patients with prior BS (BS group) than those with obesity without surgical treatment (non-BS group). There was no difference in risk of AKI (OR=0.74, 95% CI: 0.41–1.32, p = 0.304, I 2 =83.6%; four studies; 129, 562 patients, COE: very low) and infection rate (OR=1.05, 95% CI: 0.89–1.22, p = 0.572, I 2 =0%; four studies; 12, 633 patients, COE:low) between the two groups. Subgroup analysis from matched cohort studies demonstrated associations of prior BS with lower risks of mortality, ICU admission, mechanical ventilation, and AKI. Conclusion: Our results showed a correlation between prior BS and less severe COVID-19, which warrants further investigations to verify. Highlights: Association of bariatric surgery (BS) with severity of COVID-19 remains unclear. BS correlated with lower mortality rate and risks of admission and intensive care. BS had no impact on the risk of acute kidney injury and COVID-19 infection rate. Subgroup analysis of matched cohort studies showed mostly consistent results. This study demonstrated a correlation between prior BS and less severe COVID-19.