30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries.

Journal: Obesity Surgery
Published:
Abstract

Background: There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates.

Methods: We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020.

Results: Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country.

Conclusions: BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak.

Authors
Rishi Singhal, Christian Ludwig, Gavin Rudge, Georgios Gkoutos, Abd Tahrani, Kamal Mahawar, Piotr Major, Piotr Zarzycki, Athanasios Pantelis, Dimitris Lapatsanis, Georgios Stravodimos, Chris Matthys, Marc Focquet, Wouter Vleeschouwers, Antonio Spaventa, Carlos Zerrweck, Antonio Vitiello, Giovanna Berardi, Mario Musella, Alberto Sanchez Meza, Felipe Cantu, Fernando Mora, Marco Cantu, Abhishek Katakwar, D Reddy, Haitham Elmaleh, Mohammad Hassan, Abdelrahman Elghandour, Mohey Elbanna, Ahmed Osman, Athar Khan, Laurent Layani, Nalini Kiran, Andrey Velikorechin, Maria Solovyeva, Hamid Melali, Shahab Shahabi, Ashish Agrawal, Apoorv Shrivastava, Ankur Sharma, Bhavya Narwaria, Mahendra Narwaria, Asnat Raziel, Nasser Sakran, Sergio Susmallian, Levent Karagöz, Murat Akbaba, Salih Pişkin, Ahmet Balta, Zafer Senol, Emilio Manno, Michele Iovino, Mohamed Qassem, Sebastián Arana Garza, Heitor Povoas, Marcos Vilas Boas, David Naumann, Jonathan Super, Alan Li, Basil Ammori, Hany Balamoun, Mohammed Salman, Amrit Nasta, Ramen Goel, Hugo Sánchez Aguilar, Miguel Herrera, Adel Abou Mrad, Lucie Cloix, Guilherme Mazzini, Leonardo Kristem, Andre Lazaro, Jose Campos, Joaquín Bernardo, Jesús González, Carlos Trindade, Octávio Viveiros, Rui Ribeiro, David Goitein, David Hazzan, Lior Segev, Tamar Beck, Hernán Reyes, Jerónimo Monterrubio, Paulina García, Marine Benois, Radwan Kassir, Alessandro Contine, Moustafa Elshafei, Sueleyman Aktas, Sylvia Weiner, Till Heidsieck, Luis Level, Silvia Pinango, Patricia Ortega, Rafael Moncada, Victor Valenti, Ivan Vlahović, Zdenko Boras, Arnaud Liagre, Francesco Martini, Gildas Juglard, Manish Motwani, Sukhvinder Saggu, Hazem Al Moman, Luis Adolfo López, María Angelina Cortez, Rodrigo Zavala, Christine D'haese, Ivo Kempeneers, Jacques Himpens, Andrea Lazzati, Luca Paolino, Sarah Bathaei, Abdulkadir Bedirli, Aydın Yavuz, Çağrı Büyükkasap, Safa Özaydın, Andrzej Kwiatkowski, Katarzyna Bartosiak, Maciej Walędziak, Antonella Santonicola, Luigi Angrisani, Paola Iovino, Rossella Palma, Angelo Iossa, Cristian Boru, Francesco De Angelis, Gianfranco Silecchia, Abdulzahra Hussain, Srivinasan Balchandra, Izaskun Coltell, Javier Pérez, Ashok Bohra, Altaf Awan, Brijesh Madhok, Paul Leeder, Sherif Awad, Waleed Al Khyatt, Ashraf Shoma, Hosam Elghadban, Sameh Ghareeb, Bryan Mathews, Marina Kurian, Andreas Larentzakis, Gavriella Vrakopoulou, Konstantinos Albanopoulos, Ahemt Bozdag, Azmi Lale, Cuneyt Kirkil, Mursid Dincer, Ahmad Bashir, Ashraf Haddad, Leen Hijleh, Bruno Zilberstein, Danilo De Marchi, Willy Souza, Carl Brodén, Hjörtur Gislason, Kamran Shah, Antonio Ambrosi, Giovanna Pavone, Nicola Tartaglia, S Lakshmi Kona, K Kalyan, Cesar Ernesto Perez, Miguel Alberto Botero, Adrian Covic, Daniel Timofte, Madalina Maxim, Dashti Faraj, Larissa Tseng, Ronald Liem, Gürdal Ören, Evren Dilektasli, Ilker Yalcin, Hudhaifa Almukhtar, Mohammed Al Hadad, Rasmi Mohan, Naresh Arora, Digvijaysingh Bedi, Claire Rives Lange, Jean-marc Chevallier, Tigran Poghosyan, Hugues Sebbag, Lamia Zinaï, Saadi Khaldi, Charles Mauchien, Davide Mazza, Georgiana Dinescu, Bernardo Rea, Fernando Pérez Galaz, Luis Zavala, Anais Besa, Anna Curell, Jose Balibrea, Carlos Vaz, Luis Galindo, Nelson Silva, José Luis Caballero, Sergio Sebastian, João Caetano Marchesini, Ricardo Da Fonseca Pereira, Wagner Sobottka, Felipe Fiolo, Matias Turchi, Antonio Claudio Coelho, Andre Zacaron, André Barbosa, Reynaldo Quinino, Gabriel Menaldi, Nicolás Paleari, Pedro Martinez Duartez, Gabriel De Aragon Ramírez De Esparza, Valentin Esteban, Antonio Torres, Jose Garcia Galocha, Miguel Josa, Jose Pacheco Garcia, Maria Mayo Ossorio, Pradeep Chowbey, Vandana Soni, Hercio De Vasconcelos Cunha, Michel Castilho, Rafael Meneguzzi Ferreira, Thiago Barreiro, Alexandros Charalabopoulos, Elias Sdralis, Spyridon Davakis, Benoit Bomans, Giovanni Dapri, Koenraad Van Belle, Mazen Takieddine, Pol Vaneukem, Esma Seda Karaca, Fatih Karaca, Aziz Sumer, Caghan Peksen, Osman Savas, Elias Chousleb, Fahad Elmokayed, Islam Fakhereldin, Hany Aboshanab, Talal Swelium, Ahmad Gudal, Lamees Gamloo, Ayushka Ugale, Surendra Ugale, Clara Boeker, Christian Reetz, Ibrahim Hakami, Julian Mall, Andreas Alexandrou, Efstratia Baili, Zsolt Bodnar, Almantas Maleckas, Rita Gudaityte, Cem Guldogan, Emre Gundogdu, Mehmet Ozmen, Deepti Thakkar, Nandakishore Dukkipati, Poonam Shah, Shashank Shah, Simran Shah, Md Adil, Periyathambi Jambulingam, Ravikrishna Mamidanna, Douglas Whitelaw, Vigyan Jain, Deepa Veetil, Randeep Wadhawan, Max Torres, Tabata Tinoco, Wouter Leclercq, Marleen Romeijn, Kelly Van De Pas, Ali Alkhazraji, Safwan Taha, Murat Ustun, Taner Yigit, Aatif Inam, Muhammad Burhanulhaq, Abdolreza Pazouki, Foolad Eghbali, Mohammad Kermansaravi, Amir Hosein Jazi, Mohsen Mahmoudieh, Neda Mogharehabed, Gregory Tsiotos, Konstantinos Stamou, Francisco Barrera Rodriguez, Marco Rojas Navarro, Omar Torres, Sergio Martinez, Elda Rocio Tamez, Gustavo Millan Cornejo, Jose Eduardo Flores, Diya Mohammed, Mohamad Elfawal, Asim Shabbir, Kim Guowei, Jimmy So, Elif Kaplan, Mehmet Kaplan, Tuğba Kaplan, Dangtuan Pham, Gurteshwar Rana, Mojdeh Kappus, Riddish Gadani, Manish Kahitan, Koshish Pokharel, Alan Osborne, Dimitri Pournaras, James Hewes, Errichetta Napolitano, Sonja Chiappetta, Vincenzo Bottino, Evelyn Dorado, Axel Schoettler, Daniel Gaertner, Katharina Fedtke, Francisco Aguilar Espinosa, Saul Aceves Lozano, Alessandro Balani, Carlo Nagliati, Damiano Pennisi, Andrea Rizzi, Francesco Frattini, Diego Foschi, Laura Benuzzi, Chirag Parikh, Harshil Shah, Enrico Pinotti, Mauro Montuori, Vincenzo Borrelli, Jerome Dargent, Catalin Copaescu, Ionut Hutopila, Bogdan Smeu, Bart Witteman, Eric Hazebroek, Laura Deden, Laura Heusschen, Sietske Okkema, Theo Aufenacker, Willem Den Hengst, Wouter Vening, Yonta Van Der Burgh, Ahmad Ghazal, Hamza Ibrahim, Mourad Niazi, Bilal Alkhaffaf, Mohammad Altarawni, Giovanni Cesana, Marco Anselmino, Matteo Uccelli, Stefano Olmi, Christine Stier, Tahsin Akmanlar, Thomas Sonnenberg, Uwe Schieferbein, Alejandro Marcolini, Diego Awruch, Marco Vicentin, Eduardo De Souza Bastos, Samuel Gregorio, Anmol Ahuja, Tarun Mittal, Roel Bolckmans, Tom Wiggins, Clément Baratte, Judith Wisnewsky, Laurent Genser, Lynn Chong, Salena Ward, Lillian Taylor, Michael Hi, Helen Heneghan, Andreas Plamper, Karl Rheinwalt, Justin Geoghegan, Kin Ng, Naomi Fearon, Krzysztof Kaseja, Maciej Kotowski, Tarig Samarkandy, Adolfo Leyva Alvizo, Lourdes Corzo Culebro, Cunchuan Wang, Wah Yang, Zhiyong Dong, Manel Riera, Rajesh Jain, Hosam Hamed, Mohammed Said, Katia Zarzar, Manuel Garcia, Ahmet Türkçapar, Ozan Şen, Edoardo Baldini, Luigi Conti, Cacio Wietzycoski, Eduardo Lopes, Tadeja Pintar, Jure Salobir, Cengiz Aydin, Semra Atici, Anıl Ergin, Huseyin Ciyiltepe, Mehmet Bozkurt, Mehmet Kizilkaya, Nezihe Berrin Onalan, Mariana Nabila Binti Zuber, Wei Wong, Amador Garcia, Laura Vidal, Marc Beisani, Jorge Pasquier, Ramon Vilallonga, Sharad Sharma, Chetan Parmar, Lyndcie Lee, Pratik Sufi, Hüseyin Sinan, Mehmet Saydam