Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA.
Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA.
Obes Surg. 2022 Nov;32(11):3807-3810. doi: 10.1007/s11695-022-06281-9. Epub 2022 Sep 27.
Less is known whether bariatric surgery (BS) is associated with improved outcomes of COVID-19 complications among patients with class III obesity. Using data from the Florida's state inpatient database (SID) in 2020, we performed multivariable logistic regressions to investigate the impact of prior BS on three separate events, including admission due to COVID-19 among patients eligible for BS (non-BS) and those with prior BS, ventilator usage, and all-cause mortality among those admitted due to COVID-19. Of 409,665 patients included in this study, 25,116 (6.1%) had a history of BS. Results from adjusted logistic regression showed that prior BS was associated with decreased risk of admission due to COVID-19 than that in non-BS group. The risk reduction was smaller among those with class III obesity (adjusted odds ratio [aOR]: 0.58; 95% CI: 0.51-0.66; p < 0.001) than those without (aOR: 0.32; 95% CI: 0.28-0.38; p < 0.001). Compared with the non-BS group, aOR of ventilator use and all-cause mortality for patients without class III obesity decreased by 58% and 78% (p < 0.05), respectively. However, these significances disappeared among patients with continued class III obesity after BS. Our findings suggest that patients with continued class III obesity after BS were still at higher risk of severe COVID-19 outcomes than those without.
肥胖症患者接受减重手术(BS)是否能改善 COVID-19 并发症的预后,目前尚不清楚。本研究利用 2020 年佛罗里达州住院患者数据库(SID)的数据,通过多变量逻辑回归分析,探讨了既往 BS 对三个不同事件的影响,包括符合 BS 条件的患者(非 BS 组)和既往接受过 BS 治疗的患者因 COVID-19 入院、使用呼吸机和因 COVID-19 入院患者的全因死亡率。本研究共纳入 409665 例患者,其中 25116 例(6.1%)有 BS 病史。调整后的逻辑回归结果显示,与非 BS 组相比,既往 BS 与 COVID-19 入院风险降低相关。在 BMI 为 III 级肥胖的患者中,风险降低幅度较小(调整比值比[aOR]:0.58;95%置信区间[CI]:0.51-0.66;p < 0.001),而 BMI 正常的患者风险降低幅度较大(aOR:0.32;95% CI:0.28-0.38;p < 0.001)。与非 BS 组相比,无 III 级肥胖的患者使用呼吸机和全因死亡率的 aOR 分别降低了 58%(p < 0.05)和 78%(p < 0.05)。然而,在接受 BS 治疗后仍存在 III 级肥胖的患者中,这些差异不再具有统计学意义。我们的研究结果表明,接受 BS 治疗后仍持续存在 III 级肥胖的患者,其 COVID-19 严重结局的风险仍高于无 III 级肥胖的患者。