Bariatric surgery before and after the SARS-CoV-2 pandemic: a comparative study of cases before the onset of the pandemic in a high volume academic center

Abstract

Introduction: At the beginning of the pandemic, studies showed a higher risk of severe surgical complications and mortality among patients with perioperative SARS-CoV-2 infection, which led to the suspension of elective surgery. Confinement and lockdown measures were shown to be associated with weight gain and less access to medical and surgical care in patients with obesity, with negative health consequences. To evaluate the safety of Bariatric Surgery during the pandemic, we compared 30-day complications between patients who underwent Bariatric Surgery immediately before with those who underwent bariatric surgery during the opening phase of the pandemic. Methods: Observational analytical study of a non-concurrent cohort of patients who underwent Bariatric Surgery in 2 periods: pre-pandemic March 1 to December 31, 2019, and pandemic March 1 to December 31, 2020. Surgical complications were defined using the Clavien-Dindo classification. Results: Pre-pandemic and pandemic groups included 256 and 202 patients who underwent primary Bariatric Surgery, respectively. The mean age were 37.6 + 10.3 years. The overall complication rate during the first 30 days of discharge was 7.42%. No differences between groups were observed in severe complications (pre-pandemic 1.56% vs. pandemic 1.98%, p: 0.58). No mortality was reported. Overall 30-day readmission was 3.28% with no differences between groups. Conclusion: The findings of this study suggest that bariatric surgery can be successfully conducted during the pandemic, enabling patients with obesity to obtain a treatment that was delayed at the beginning of the pandemic due to safety concerns.