The SARS-CoV-2 virus outbreak commenced in late 2019, leading to WHO declaring COVID-19 a global pandemic on the 11th of March 2020. Obesity, diabetes and advanced age are significant risk factors that have been shown to confer poorer prognosis in COVID infected patients. Even though bariatric surgery can cause initial infection vulnerability through a period of brief immunoparesis in the post-operative recovery phase, the associated medium to long term protective benefits needs to be highlighted and discussed.
An extensive literature review along with expert panel recommendations have been summarised.
The COVID-19 pandemic does not seem to slow down and at the same time, an effective vaccination is still far from being available. We must adjust to this reality and allow our health systems to prioritise healthcare accordingly. Diabetes and obesity have been shown to be the two most significant risk factors for severe COVID infection in patients under the age of 60. Bariatric surgery can offer 15% total body weight loss within 3-4 months after surgery along with immediate remission from diabetes. Even though laparoscopic bariatric surgery carries a degree of immunoparesis immediately following surgery, these effects have been shown to improve significantly within the first 1-2 months. In addition, there is a potential advantage in reducing transmission by decreasing viral shedding, viral charge in breath and viral variability (might need to reword this).
In the current COVID crisis, we need to maintain our advocacy for the health of severely obese patients. Beyond the initial recovery phase, bariatric surgery can be protective in minimising morbidty and mortality in obese patients who have contracted COVID. When considering bariatric surgery, we need to take a holistic approach by reviewing each patient’s COVID risk profile, while balancing peri-operative risk with the long-term benefits.