Bariatric surgery in patients with previous COVID-19 infection

INTRODUCTION Reintroducing bariatric surgery to our communities in a COVID-19 environment was particular to each country. Furthermore, no clear recommendation was made for patients with previous COVID-19 infection and favorable outcome seeking for bariatric surgery. OBJECTIVE The purpose of the current manuscript is to analyze the risk of specific complications for patients with previous COVID-19 infection who were admitted for bariatric surgery. SETTINGS 8 high volume private centers from 5 countries METHODS All patients with morbid obesity disease and previous COVID-19 infection admitted for bariatric surgery were included in the current study. Patients were enrolled from 8 centers and 5 countries and their electronic health data were reviewed retrospectively. The primary outcome was to identify early ( RESULTS Thirty-five patients with a mean age of 40 years (range 21 – 68) and mean BMI of 44.3 kg/m2 (± 7.4 kg/m2) with previous COVID-19 infection underwent different bariatric procedures: 23 cases of sleeve (65.7 %), 7 cases of bypass, and 5 other cases. The symptomatology of the previous COVID-19 infection varied: no symptoms (15 patients), fever and respiratory signs (12 patients), only fever (5 patients), digestive symptoms (2 patients), and isolated respiratory signs (one patient). Only 5 patients (14.2 %) were hospitalized for COVID-19 infection for a mean period of 8.8 days (range 6-15 days). One patient was admitted in intensive care unit and needed invasive mechanical ventilation. The mean interval time from COVID infection to the bariatric surgery was of 11.3 weeks (3 - 34 weeks). Hospital stay was 1.7 days (± 1) and all patients were clinically evaluated one month following the bariatric procedure. There were 2 readmissions and one case of complication: one case of gastric leak treated with laparoscopic drainage and repeated pigtail drain with favorable outcome. No case of other specific complications or mortality were recorded. CONCLUSION Minor and moderate COVID-19 infections, especially the forms not complicated with invasive mechanical ventilation should not preclude the indication for bariatric surgery. In our experience, the previous COVID-19 infection has not induced additional specific complications following bariatric surgery.