History of Bariatric Surgery Improves COVID-19 Outcomes in Patients with Obesity

October 7, 2021
Connor Iapoce

Connor Iapoce is an assistant editor for HCPLive and joined the MJH Life Sciences team in April 2021. He graduated from The College of New Jersey with a degree in Journalism and Professional Writing. He enjoys listening to records, going to concerts, and playing with his cat Squish. You can reach him at ciapoce@mjhlifesciences.com.

Data show 5 of 20 patients with history of MBS in the study experienced the primary composite outcome of IMV and/or death by day 7.

Obesity is shown to increase the risk of severe forms of COVID-19, making obesity management a priority in order to reduce the severity of the virus.

Due to this, a post-hoc analysis was performed on patient data from the CORONADO (Coronavirus SARS-CoV2 and Diabetes Outcomes) regarding history of metabolic and bariatric surgery (MBS) in patients with type 2 diabetes and severe obesity who were hospitalized for COVID-19.

The team of investigators, led by Bertrand Cariou, Department of Endocrinology, Diabetology and Nutrition, l’institut du Thorax, observed a previous history of MBS in obese patients with T2D and hospitalized for COVID-19 might have associations with a better prognosis in comparison to those without MBS.

Methods

The CORONADO study was a retrospective study designed to describe phenotypic characteristics and prognosis of patients with diabetes admitted for COVID-19 to 68 French hospitals. It occurred between March - April 2020.

Investigators included any patient with personal history of MBS in the exposed group and matched them 3:1 with other CORONADO patients without a history of MBS. They were matched according to sex, age (± 3 years) and body mass index (±3 kg/m2) measured before surgery or at the time of hospital admission. The control group was matched using BMI on admission.

Composite primary outcomes were considered a combination of invasive mechanical ventilation (IMV) and/or death by day 7. Then, a secondary time point was considered by day 28 for all patients alive and not discharged by day 7.

What were the findings?

Out of a total of 2398 patients with type 2 diabetes in CORONADO, 20 (0.83%) had a previous history of MBS, at a median of 8.5 years before admission to the hospital.

This patient population with a history of MBS consisted of mostly female patients (60%) with a mean age of 59.0 ± 10.8 years.

Data show at day 7, a total of 5 out of 20 patients with MBS (25%) experienced the primary composite outcome. Investigators noted that these outcomes were mainly invasive mechanical ventilation (n = 4), rather than death (n = 1).

As a result, data show the rate of CPO was not statistically different between patients with or without MBS by day 7 (25.0% versus 28.7%; OR, 0.83, 0.30 - 2.29, P = .72) or day 28 (25.0% versus 35.4%; OR, 0.61, 0.22 - 1.68, P = .34).

Then, when the team matched BMI at the time of MBS following adjustment on diabetes duration, they found the primary outcome occurred less frequently within 7 days (3 versus 17 events, OR: 0.15, 0.01 - 0.94, P = .03).

It remained the same within 28 days (3 versus 19 events, OR: 0.11, 0.01 - 0.71, P = .02) in patients with MBS (n = 16) versus control (n = 44).

What did they say?

“Prospective studies are needed to confirm these results in larger populations in order to further promote efficient weight loss interventions as therapeutic strategy to improve COVID-19 prognosis in patients with severe obesity,” investigators wrote.

The study, “History of bariatric surgery and COVID 19 outcomes in patients with type 2 diabetes: results from the CORONADO study,” was published in Obesity: A Research Journal.


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