Cirugía bariátrica y evolución de COVID 19
Resumen
INTRODUCCIÓN. La obesidad es reconocida como un factor de riesgo para desarrollar la enfermedad por el nuevo coronavirus grave. La cirugía bariátrica previa a la infección pudiera comportarse como un factor protector frente a infecciones graves y muerte. OBJETIVO. Describir el impacto de la cirugía bariátrica en la gravedad y mortalidad de los pacientes con obesidad y enfermedad por el nuevo coronavirus; mediante una revisión sistemática y metaanálisis de la literatura especializada desde 2020-2022. METODOLOGÍA. Se tomaron publicaciones indexadas en bases de datos como Pubmed, Tripdatabase, y Google scholar, sobre el impacto de la cirugía bariátrica previa en la evolución y el pronóstico de los pacientes con enfermedad
por el nuevo coronavirus. Se utilizó la escala de Newcastle-Ottawa para evaluar la calidad y riesgo de sesgo. Para el análisis estadístico se utilizó el programa RevMan 5.0. RESULTADOS. Se incluyeron 8 estudios de cohortes, con una población de 137 620 sujetos adultos con obesidad y enfermedad por el nuevo coronavirus; de los cuales, 5638 (4,09%) tenían antecedentes de cirugía bariátrica. En el meta análisis
se determinó que, en sujetos con obesidad y enfermedad por el nuevo coronavirus, el antecedente de cirugía bariátrica tuvo un efecto protector frente al uso de ventilación mecánica [OR: 0,68; IC 95%: 0,62-0,75]; (p<0,001) y la mortalidad [OR: 0,57; IC 95%: 0,50-0,65]; (p<0,01). CONCLUSIONES. El antecedente de cirugía bariátrica en sujetos con obesidad parece tener un efecto protector frente a la gravedad definida
por el uso de ventilacion mecanica de los pacientes con obesidad y mortalidad por enfermedad por el nuevo coronvirus, por lo que, la reanudación de la actividad quirúrgica bariátrica, a los niveles previos a la pandemia, pudiera representar un beneficio adicional para los sujetos candidatos.
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Eastin C, Eastin T. Clinical Characteristics of Coronavirus Disease 2019 in China. J Emerg Med [Internet]. 2020 Apr [cited 2022 Apr 5];58(4):711–2. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266766/
Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A, et al. High Prevalence of Obesity
in Severe Acute Respiratory Syndrome Coronavirus‐2 (SARS‐CoV‐2) Requiring Invasive Mechanical Ventilation.
Obesity [Internet]. 2020 Jul 10 [cited 2022 Apr 5];28(7):1195–9. Available from:
https://pubmed.ncbi.nlm.nih.gov/32271993/
Dietz W, Santos-Burgoa C. Obesity and its Implications for COVID-19 Mortality. Obesity (Silver Spring) [Internet]. 2020 Jun 1 [cited 2022 Jun 22];28(6):1005. Available from:
https://pubmed.ncbi.nlm.nih.gov/32237206/
Sattar N, McInnes IB, McMurray JJV. Obesity Is a Risk Factor for Severe COVID-19 Infection. Circulation [Internet]. 2020 Jul 7;142(1):4–6. Available from:
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.047659
Bel Lassen P, Poitou C, Genser L, Marchelli F, Aron‐Wisnewsky J, Ciangura C, et al. COVID‐19 and its Severity
in Bariatric Surgery‐Operated Patients. Obesity [Internet]. 2021 Jan 3;29(1):24–8. Available from:
https://pubmed.ncbi.nlm.nih.gov/32875723/
Bhasker AG, Prasad A, Raj PP, Wadhawan R, Khaitan M, Agarwal AJ, et al. OSSI (Obesity and Metabolic
Surgery Society of India) Guidelines for Patient and Procedure Selection for Bariatric and Metabolic Surgery.
Obes Surg [Internet]. 2020 Jun 1 [cited 2022 Aug 19];30(6):2362–8. Available from:
https://pubmed.ncbi.nlm.nih.gov/32125645/
Stenberg E, dos Reis Falcão LF, O’Kane M, Liem R, Pournaras DJ, Salminen P, et al. Guidelines for Perioperative
Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A
Update. World J Surg [Internet]. 2022 Apr 1 [cited 2022 Aug 19];46(4):729–51. Available from:
https://link.springer.com/article/10.1007/s00268-021-06394-9
Ochner CN, Dambkowski CL, Yeomans BL, Teixeira J, Xavier Pi-Sunyer F. Pre-bariatric surgery weight loss requirements and the effect of preoperative weight loss on postoperative outcome. Int J Obes [Internet]. 2012 Nov 17;36(11):1380–7. Available from:
https://www.nature.com/articles/ijo201260
Han Y, Jia Y, Wang H, Cao L, Zhao Y. Comparative analysis of weight loss and resolution of comorbidities between laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass: A systematic review and meta-analysis based on 18 studies. Int J Surg [Internet]. 2020 Apr 1 [cited 2022 Jun 22];76(2):101–10. Available from: https://www.sciencedirect.com/science/article/pii/S1743919120302004?-via%3Dihub
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients
with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet (London, England) [Internet]. 2020 Mar 28
[cited 2022 Jun 22];395(10229):1054–62. Available from:
https://pubmed.ncbi.nlm.nih.gov/32171076/
Luzi L, Radaelli MG. Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic.
Acta Diabetol [Internet]. 2020 Jun 1 [cited 2022 Jun 22];57(6):759–64. Available from:
https://pubmed.ncbi.nlm.nih.gov/32249357/
Romero-Velez G, Pereira X, Skendelas JP, Costinett S, Grosser R, Creange C, et al. Diagnosis of COVID-19
and the bariatric surgery population: a single center experience. Surg Endosc [Internet]. 2022 Jan 1 [cited 2022 Jun 22];36(1):149–54. Available from:
https://pubmed.ncbi.nlm.nih.gov/33492513/
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement:
an updated guideline for reporting systematic reviews. BMJ [Internet]. 2021 Mar 29;372(6):n71. Available from: https://www.bmj.com/content/372/bmj.n71
Wells G, Shea B, O¨Conell D, Peterson J, Welch V. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. Available from:
https://www.ohri.ca//programs/clinical_epidemiology/oxford.asp
Aminian A, Fathalizadeh A, Tu C, Butsch WS, Pantalone KM, Griebeler ML, et al. Association of prior metabolic and bariatric surgery with severity of coronavirus disease 2019 (COVID-19) in patients with obesity. Surg Obes Relat Dis [Internet]. 2021 Jan;17(1):208–14. Available from:
https://www.soard.org/article/S1550-7289(20)30619-5/fulltext
Hadi YB, Mann R, Sohail AH, Graves M, Szoka N, Abunnaja S, et al. Prior Bariatric Surgery is Associated with a
Reduced Risk of Poor Outcomes in COVID-19: Propensity Matched Analysis of a Large Multi-institutional Research
Network. Obes Surg [Internet]. 2022 Feb 23;32(2):237–44.
Available from: https://link.springer.com/10.1007/s11695-021-05803-1
Jenkins M, Maranga G, Wood GC, Petrilli CM, Fielding G, Ren-Fielding C. Prior bariatric surgery in COVID-19–
positive patients may be protective. Surg Obes Relat Dis [Internet]. 2021 Nov;17(11):1840–5.
Available from:
https://www.soard.org/article/S1550-7289(21)00387-7/fulltex
Purdy AC, Hohmann SF, Nguyen NT. Outcomes of obese patients hospitalized with COVID-19: the impact of prior bariatric surgery. Surg Obes Relat Dis [Internet]. 2022 Jan;18(1):35–40. Available from: https://www.soard.org/article/S1550-7289(21)00469-X/fulltext
Blanchard C, Perennec T, Smati S, Tramunt B, Guyomarch B, Bigot‐Corbel E, et al. History of bariatric surgery
and COVID‐19 outcomes in patients with type 2 diabetes: Results from the CORONADO study. Obesity [Internet].
Mar 9;30(3):599–605. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8661775/
Iannelli A, Bouam S, Schneck A-S, Frey S, Zarca K, Gugenheim J, et al. The Impact of Previous History of Bariatric Surgery on Outcome of COVID-19. A Nationwide Medico-Administrative French Study. Obes Surg [Internet]. 2021 Apr 18;31(4):1455–63. Available from:
https://link.springer.com/article/10.1007/s11695-020-05120-z
Marchesi F, Valente M, Riccò M, Rottoli M, Baldini E, Mecheri F, et al. Effects of Bariatric Surgery on COVID-
: a Multicentric Study from a High Incidence Area. Obes Surg [Internet]. 2021 Jun 8;31(6):2477–88. Available
from:
https://link.springer.com/article/10.1007/s11695-020-05193-w
Santa-Cruz F, Siqueira LT, Coutinho LR, Leão LHA, Almeida ACA, Kreimer F, et al. Is COVID-19 Severity Impacted by Bariatric Surgery in the Early Postoperative Period? Obes Surg [Internet]. 2022 Apr 26; 32(4):1178–83. Available from:
https://link.springer.com/article/10.1007/s11695-022-05915-2
Frühbeck G, Baker JL, Busetto L, Dicker D, Goossens GH, Halford JCG, et al. European Association for the Study
of Obesity Position Statement on the Global COVID-19 Pandemic. Obes Facts [Internet]. 2020 May 1 [cited 2022
Aug 18];13(2):292–6. Available from:
https://pubmed.ncbi.nlm.nih.gov/32340020/
Frydrych LM, Bian G, O’Lone DE, Ward PA, Delano MJ. Obesity and type 2 diabetes mellitus drive immune
dysfunction, infection development, and sepsis mortality. J Leukoc Biol [Internet]. 2018 Sep 1 [cited 2022 Aug
;104(3):525–34. Available from:
https://pubmed.ncbi.nlm.nih.gov/30066958/
Zhou Y, Chi J, Lv W, Wang Y. Obesity and diabetes as high-risk factors for severe coronavirus disease 2019 (Covid-19). Diabetes Metab Res Rev [Internet]. 2021 Feb 1 [cited 2022 Aug 19];37(2). Available from: https://pubmed.ncbi.nlm.nih.gov/32588943/
Kwok S, Adam S, Ho JH, Iqbal Z, Turkington P, Razvi S, et al. Obesity: A critical risk factor in the COVID-19
pandemic. Clin Obes [Internet]. 2020 Dec [cited 2022 Aug 19];10(6). Available from:
https://pubmed.ncbi.nlm.nih.gov/32857454/
Uccelli M, Cesana GC, De Carli SM, Ciccarese F, Oldani A, Zanoni AAG, et al. COVID-19 and Obesity: Is Bariatric
Surgery Protective? Retrospective Analysis on 2145 Patients Undergone Bariatric-Metabolic Surgery from High
Volume Center in Italy (Lombardy). Obes Surg [Internet]. 2021 Mar 1 [cited 2022 Aug 19];31(3):942–8. Available
from:
https://pubmed.ncbi.nlm.nih.gov/33128218/
Aminian A, Tu C. Association of Bariatric Surgery with Clinical Outcomes of SARS-CoV-2 Infection: a Systematic
Review and Meta-analysis in the Initial Phase of COVID-19 Pandemic. Obes Surg [Internet]. 2021 Jun
;31(6):2419–25.
Available from: https://link.springer.com/article/10.1007/s11695-020-05213-9
Castillo-de la Cruz A, Carrión-Arias A, Hilario-Vargas J. Cirugía bariátrica en la morbimortalidad de la infección por SARS-CoV-2. Rev del Cuerpo Médico Hosp Nac Almanzor Aguinaga Asenjo [Internet]. 2021 Dec 21;14(3):367–74. Available from:
http://cmhnaaa.org.pe/ojs/index.php/rcmhnaaa/article/view/1277
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