Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut Du Thorax, Nantes, France.
Chirurgie Cancérologique Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), Centre Hospitalo-universitaire de Nantes (CHU) Hôtel-Dieu, Nantes, France.
Obesity (Silver Spring). 2022 Mar;30(3):599-605. doi: 10.1002/oby.23314. Epub 2022 Feb 9.
This study assessed the impact of a history of metabolic and bariatric surgery (MBS) on the clinical outcomes in patients with type 2 diabetes (T2D) and severe obesity hospitalized for COVID-19.
In this post hoc analysis from the nationwide observational CORONADO (Coronavirus SARS-CoV2 and Diabetes Outcomes) study, patients with T2D and a history of MBS were matched with patients without MBS for age, sex, and BMI either at the time of MBS or on admission for COVID-19. The composite primary outcome (CPO) combined invasive mechanical ventilation and/or death within 7 and 28 days following admission.
Out of 2,398 CORONADO participants, 20 had a history of MBS. When matching for BMI at the time of MBS and after adjustment for diabetes duration, the CPO occurred less frequently within 7 days (3 vs. 17 events, OR: 0.15 [0.01 to 0.94], p = 0.03) and 28 days (3 vs. 19 events, OR: 0.11 [0.01 to 0.71], p = 0.02) in patients with MBS (n = 16) vs. controls (n = 44). There was no difference in CPO rate between patients with MBS and controls when matching for BMI on admission.
These data are reassuring regarding COVID-19 prognosis in patients with diabetes and a history of MBS compared with those without MBS.
本研究评估了代谢和减重手术(MBS)史对因 COVID-19 住院的 2 型糖尿病(T2D)和重度肥胖患者临床结局的影响。
本研究为全国性观察性 CORONADO(冠状病毒 SARS-CoV2 和糖尿病结局)研究的事后分析,将 MBS 史患者与无 MBS 史患者按 MBS 时或 COVID-19 住院时的年龄、性别和 BMI 进行匹配。复合主要结局(CPO)为住院后 7 天和 28 天内需要有创机械通气和/或死亡。
在 2398 名 CORONADO 参与者中,有 20 人有 MBS 史。当按 MBS 时和调整糖尿病病程后的 BMI 进行匹配时,MBS 组(n=16)7 天内(3 例 vs. 17 例事件,OR:0.15[0.01 至 0.94],p=0.03)和 28 天内(3 例 vs. 19 例事件,OR:0.11[0.01 至 0.71],p=0.02)CPO 发生率低于对照组(n=44)。当按住院时 BMI 进行匹配时,MBS 组和对照组的 CPO 发生率无差异。
与无 MBS 史患者相比,这些数据令人安心,表明 MBS 史患者的 COVID-19 预后较好。