A Cleveland Clinic study shows that among patients with obesity, prior
weight loss achieved with bariatric surgery was associated with a 60% lower
risk of developing severe complications from COVID-19 infection. The
research was published in the journal JAMA Surgery.
Numerous studies have established obesity as a major risk factor for
developing serious illness from an infection of SARS-CoV-2, the virus that
causes COVID-19. Obesity weakens the immune system, creates a chronic
inflammatory state, and increases risk for cardiovascular disease, blood
clots, and lung conditions. All of these conditions can complicate COVID-19.
The aim of this study was to examine whether a successful weight-loss
intervention in patients with obesity prior to contracting COVID-19 could
reduce the risk of developing a severe form of this disease.
“The research findings show that patients with obesity who achieved
substantial and sustained weight loss with bariatric surgery prior to a
COVID-19 infection reduced their risk of developing severe illness by 60
percent,” said Ali Aminian, M.D., lead author of the study and director of
Cleveland Clinic’s Bariatric & Metabolic Institute. “Our study provides
strong evidence that obesity is a modifiable risk factor for COVID-19 that
can be improved through a successful weight-loss intervention.”
A total of 20,212 adult patients with obesity were included in this
observational study. A group of 5,053 patients with a body mass index (BMI)
of 35 or greater who had weight-loss surgery between 2004 and 2017 were
carefully matched 1:3 to non-surgical patients, resulting in 15,159 control
patients. Compared with those in the non-surgical group, patients who had
bariatric surgery lost 19% more body weight prior to March 1, 2020 (the
beginning of the COVID-19 outbreak in Cleveland).
After the COVID-19 outbreak, researchers looked at four COVID-19-related
outcomes: rate of contracting SARS-CoV-2 infection, hospitalization, need
for supplemental oxygen, and severe disease (defined as a combination of ICU
admission, need for mechanical ventilation, or death).
Although the rate of contracting SARS-CoV-2 was similar between the groups
(9.1% in the surgical group and 8.7% in the non-surgical group),
participants in the weight-loss surgery group experienced much better
outcomes after contracting COVID-19 compared with those in the non-surgical
group. Researchers found that patients with prior weight loss surgery had a
49% lower risk of hospitalization, 63% lower risk of need for supplemental
oxygen, and 60% lower risk of developing severe COVID-19.
Although the exact underlying mechanisms are not known, these data suggest
that patients who underwent weight-loss surgery were healthier at the time
of contracting a SARS-CoV-2 infection, which resulted in better clinical
outcomes.
“Striking findings from the current study support the reversibility of the
health consequences of obesity in the patients with COVID-19,” said the
study’s senior author, Steven Nissen, M.D., Chief Academic Officer of the
Heart, Vascular and Thoracic Institute at Cleveland Clinic. “This study
suggests that an emphasis on weight loss as a public health strategy can
improve outcomes during the COVID-19 pandemic and future outbreaks or
related infectious diseases. That is a very important finding considering
that 40% of Americans have obesity.”
Reference:
Association of Weight Loss Achieved Through Metabolic Surgery With Risk and
Severity of COVID-19 Infection” 29 December 2021, JAMA Surgery.
DOI: 10.1001/jamasurg.2021.6496