January 07 2022
2 minutes to read
Source / Disclosures
Disclosures: Aminian reported receiving research support from Medtronic.
The data showed that significant weight loss after bariatric surgery was associated with improved COVID-19 outcomes compared to non-surgical controls, including a 49% lower risk of hospitalization and 60% lower risk of critical illness.
“Many studies show a strong link between obesity and clinical outcomes of COVID-19, and all available studies indicate that obesity is a major risk factor for COVID-19 severity,” Ali Aminian, MD, Professor of surgery and director of the Obesity and Metabolic Institute at the Cleveland Clinic, told Healio. However, there is no study to examine whether obesity is a modifiable risk factor for COVID-19. We designed and conducted this study to assess the effects of a successful weight loss intervention on the risk of developing COVID-19.”
In an identical retrospective study, Aminian and colleagues analyzed data from 5,053 adults with a BMI of at least 35 kg/m.2 Who underwent gastric bypass or sleeve gastrectomy from 2004 to 2017 in the Cleveland Clinic health system (mean age, 46 years; 77.6% of women; median BMI, 45 kg/m2). The researchers compared patients in the 1:3 surgical group with 15,159 obese adults who had not had bariatric surgery, using electronic health record data. Researchers evaluated four COVID-19-related outcomes among patients from March 2020 to March 2021: a positive COVID-19 test result; hospitalization; the need for supplemental oxygen; and severe COVID-19 infection, which is defined as a combination of ICU admission, need for mechanical ventilation or death. The mean total follow-up time was 6.1 years.
The results have been published in Gamma surgery.
Prior to the COVID-19 outbreak, patients in the surgical group lost more weight versus controls, with a 10-year median difference from baseline of 18.6 percentage points (95% CI, 18.4-18.7) as well as a 53% lower 10-year cumulative incidence for all-cause and non-COVID-19 mortality versus controls (4.7% versus 9.4%; P .001).
Within the cohort, 11,809 patients were available on March 1, 2020 to assess outcomes related to COVID-19. The rates of positive SARS-CoV-2 test results were comparable in the surgical (9.1%) and control (8.7%) groups; q = .71). However, undergoing weight-loss surgery was associated with lower risks of hospitalization (adjusted heart rate = 0.51; 95% CI, 0.35-0.76), need for supplemental oxygen (aHR = 0.37; 95% CI, 0.23-0.61) and severe COVID -19 hit (aHR = 0.4; 95% CI, 0.18-0.86).
“The significant magnitude of the effects after weight loss with metabolic surgery was surprising,” Aminian told Helio. If we help patients lose weight, we can reverse many of the health consequences of obesity. This study clearly demonstrated that obesity is a modifiable risk factor for COVID-19. Given the prevalence of obesity worldwide, the findings of this study could have significant public health implications in the current epidemic and future infectious disease outbreaks.
The researchers noted that due to the observational nature of the study and the low number of infections, the results should be considered as hypotheses rather than conclusive.
“Let me be clear about the results of this study,” Eminian told Helio. “Anyone can develop a severe form of COVID-19; however, the risk is greater among obese patients. That is why everyone should follow public health recommendations, such as mask wearing and vaccination. Based on our findings, in patients with Obesity, losing weight can also be beneficial in reducing the severity of COVID-19.”
for more information:
Ali Aminian, MD, She can be reached at firstname.lastname@example.org; Twitter: @Ali_Aminian_MD.