Influência da cirurgia bariátrica na redução da morbimortalidade da COVID-19

Abstract

Objective: To evaluate whether bariatric surgery reduces mortality levels from Covid-19 and prevents serious manifestations of the disease. Methods: Cross-sectional study, developed with patients treated at an Advanced Medical Center, located in the interior of the state of São Paulo, from January 1, 2018 to December 31, 2019, with obesity (n=751). The sample included patients with a Body Mass Index of 32 kg/m2 and who contracted Covid-19 before the first dose of the vaccine (n=60). Patients who died before 2019, who underwent consultation seeking revision surgery or who underwent surgery by another medical team were excluded. The patients were separated into two groups: Group 1, composed of patients who underwent consultation and subsequently bariatric surgery (n=36); Group 2, consisting of patients who underwent consultation, but were not operated on (n=24). A questionnaire was applied that assessed the presence of comorbidities related to obesity and the worsening of Covid-19, in addition to data on the clinical evolution of the disease. Information collection was carried out through medical record data, direct contact with patients via WhatsApp, and telephone calls. Online questionnaire, search for active health plan contracts and consultation of the Brazilian National Registry of Deceased Persons. Statistical analysis was performed using SPSS (Statistical Package for the Social Science) software. Categorical variables were analyzed using the Chi-square test and Fisher's Exact Test, and qualitative variables were analyzed using the Mann-Whitney Test. A significance level of 5% was considered in all tests. Results: A significant reduction in Body Mass Index was identified in patients in Group 1 (p<0.001). The most prevalent obesity-related complications in both groups were systemic arterial hypertension, dyslipidemia and diabetes mellitus. Three patients from Group 1 and one patient from Group 2 required hospital admission due to complications from Covid-19, however only one patient from Group 1 and one patient from Group 2 required intensive care. No patient underwent orotracheal intubation. Conclusion: Bariatric surgery was effective in reducing BMI and obesity-related complications, but no evidence was found of the influence of bariatric surgery on mortality and clinical conditions of Covid-19. However, it is plausible to conjecture that bariatric surgery may have an indirect effect on the clinical conditions of Covid-19 by reducing obesity-related complications. This study highlights bariatric surgery and its effect on mitigating obesity-related comorbidities and, consequently, mitigating Covid-19 complications.