Having undergone bariatric (weight-loss) surgery is linked to a lower risk for severe COVID-19, including a lower rate of hospitalization, according to a new study published in the journal JAMA Surgery.
Bariatric surgery has been linked to many benefits for people with diabetes who undergo the procedure, which is typically reserved for people with obesity who are at higher risk for health problems related to obesity. Not only does it often lead to remission of diabetes, but it also tends to improve quality of life and perception of general health. Research has also shown that it may reduce liver fat, helping people avoid or limiting the progression of nonalcoholic fatty liver disease (NAFLD). Recent studies have also shown that people who experience diabetes remission after bariatric surgery may be at lower risk for cancer.
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Since diabetes and obesity are linked to worse outcomes in people who develop COVID-19 — especially for people with a history of less-than-ideal blood glucose control — it’s not a stretch to wonder if bariatric surgery could help make people less prone to severe COVID-19 if they develop the viral infection. For the latest study, researchers looked at health outcomes in 20,212 people with obesity, with an average age of 46 — including 2,958 who underwent bariatric surgery, and an otherwise similar group of 8,851 who didn’t have the procedure. Before the COVID-19 pandemic began, people in the bariatric surgery group already tended to have better outcomes on many fronts. They lost 19% more weight in the 10 years leading up to the pandemic, resulting in a body weight that was 20 kilograms (44 pounds) lower, on average — although their average body-mass index (BMI, a measure of body weight that takes height into account) was still 38, well into the range of obesity. During those 10 years, members of the bariatric surgery group were 53% less likely to die of all causes than people who didn’t undergo bariatric surgery. They also had an average A1C level (a measure of long-term blood glucose control) of 6.0%, compared with 7.2% for people who didn’t have the surgery.
Bariatric surgery link to reduced risk of severe COVID-19
Once the COVID-19 pandemic began, outcomes related to the viral infection were available for 11,809 of the study participants. Between March 1, 2020, and March 1, 2021, people who underwent bariatric surgery weren’t any more or less likely to develop COVID-19. But among participants who developed COVID-19, those who had undergone bariatric surgery were 49% less likely to need hospitalization for the infection. They were also 63% less likely to require supplemental oxygen, and 60% to have COVID-19 that was deemed severe based on standard diagnostic criteria.
These results show that even if people remain obese following bariatric surgery, undergoing the surgery and experiencing a certain amount of weight loss are linked to lower risks in people who develop COVID-19. “The findings suggest that obesity can be a modifiable risk factor for the severity of COVID-19 infection,” the researchers concluded, although they noted that it’s still unclear exactly what factors in the bariatric surgery group — such as weight loss or a lower A1C level — might have been responsible for the better COVID-19 outcomes seen in this group.
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