In a new study, researchers found that among patients who have obesity and who tested positive for COVID-19, a past history of bariatric surgery was strongly linked to a lower risk of hospital and intensive care unit admission.
The research was conducted by a team at Cleveland Clinic.
In the past months, researchers worldwide have identified obesity as a risk factor for developing a severe form of COVID-19, which may require hospital admission, need for intensive care and the use of ventilator support.
The Centers for Disease Control and Prevention reported that more than 70 % of U.S. adults are overweight or have obesity, which may increase the risk of severe illness from the coronavirus.
Obesity is a complex disease caused by multiple factors that weaken the immune system.
Obesity creates a chronic inflammatory state that causes excessive production of cytokines, which are small proteins involved in the immune response.
Infection with the coronavirus also triggers the immune system to release cytokines, which may lead to excessive cytokine production that damages organs.
That may partly explain the severity of infection in patients with obesity.
In addition, obesity increases the risk for heart disease, high blood pressure, diabetes, kidney disease, and blood clot formation.
Those conditions can lead to poor outcomes after infection with SARS-CoV-2, which is the virus that causes COVID-19. Obesity may also affect the respiratory system.
Many patients with obesity have underlying lung conditions, such as sleep apnea and obesity hypoventilation syndrome, that can worsen the outcomes of COVID-19 pneumonia.
In the study, the team examined 4,365 patients who tested positive for SARS-CoV-2 between March 8, 2020, and July 22, 2020.
They identified 33 patients who had a prior history of weight-loss surgery (20 patients had a sleeve gastrectomy and 13 patients had a Roux-en-Y gastric bypass).
The researchers found that sustained weight loss and improvement of diabetes and high blood pressure in the bariatric surgical group prior to contracting COVID-19 was linked to a much lower rate of hospital and ICU admission.
18% of patients in the weight-loss surgery group and 42 % of patients in the control group required hospitalization after contracting COVID-19.
In addition, 13 % of patients in the control group required ICU admission, 7 % required mechanical ventilation, and 2.4 % died.
None of these occurred in the weight loss surgical group.
The study provides further evidence of the important link between obesity and poor outcomes from coronavirus infection.
The study shows for the first time that substantial weight loss via bariatric surgery may actually reduce the risk from a severe illness in these patients.
Another Cleveland Clinic study showed that weight-loss surgery was linked to a 40 % reduction in risk of death and heart complications in patients with diabetes and obesity.
One author of the study is Ali Aminian, M.D., Director of the Bariatric & Metabolic Institute at Cleveland Clinic.
The study is published in the journal of Surgery for Obesity and Related Diseases.
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