Bariatric Surgery and COVID-19: a Change of Perspective in a New Phase of the Pandemic

Purpose The protective role of bariatric surgery (BS) against COVID-19 has been reported by several studies, showing, in the first pandemic waves, better outcome of the infection in patients that had undergone BS. With the virus progressive endemicity, BS benefits on COVID-19 clinical course could appear less evident, while COVID-19 effects on BS outcomes must be investigated. In this national multicentric cross-sectional study, we compared COVID-19 incidence and clinical course between a cohort of patients that had undergone BS (OP) and a cohort of candidates to BS (WS); moreover, we analyzed BS outcomes based on SARS-CoV-2 positivity/negativity. Methods From June to December 2021, 522 patients from five Italian referral centers were administered an 87-item telephonic questionnaire completing the analysis of electronic medical records. Demographics, COVID-19 “tested” incidence, suggestive symptoms and clinical outcome parameters of OP and WS were compared. BS outcomes parameters were compared between OP that developed the disease or not. Results COVID-19 incidence was the same in OP and WS, while symptoms and clinical course seemed milder in OP, with no data individually reaching statistical significance. OP who developed SARS-CoV-2 infection had higher excess weight loss than negative OP (66.8% ± 22.1 vs. 57.7% ± 22.8, p = 0.029). Positive OP had had gastric-bypass (RYGB/OAGB) more frequently than negative ones (38.4% vs. 18.2%, p = 0.025). Conclusion With the disease becoming endemic, BS protective role against COVID-19 seems clinically less relevant. BS outcomes can be affected by COVID-19, thus imposing careful follow-up for positive patients, especially if undergoing gastric-bypass. Graphical Abstract