Hasnain Nimra, Moeed Abdul, Waqar Eisha, Farhan Syed Ali, Amreek Fnu
Department of Surgery, Ruth Pfau. Civil Hospital Karachi, Pakistan.
Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Surg Pract Sci. 2022 Dec;11:100140. doi: 10.1016/j.sipas.2022.100140. Epub 2022 Oct 28.
Obesity is linked with poor outcomes in patients with SARS-CoV-2 infection. In patients with BMI > 35 kg/m, increased rates of hospital and subsequently ICU admissions have been noted. Bariatric surgery resulting in sustained weight loss is hypothesized to decrease the morbid outcomes associated with COVID. In this review, we update the evidence on the topic.
An extensive literature search was conducted of electronic databases. Screening of the articles based on the eligibility criteria was followed by relevant data extraction. In addition to articles used in a previous meta-analysis, relevant databases were searched to filter for any new articles. Initially, two independent reviewers screened Pubmed and the Cochrane database followed by a thorough search of additional databases such as Google scholar and Medrxiv. Articles were first screened using title and abstract, followed by a full text read. Duplicates, meta-analysis, letter to the editors, and commentaries were excluded. No language restrictions were applied.
A total of nine articles with a population of 1,130,341 were entered into RevMan. Patients with bariatric surgery displayed significantly decreased hospitalization (OR: 0.52, 95% CI [0.45, 0.61]), were less likely to be admitted to the ICU (OR: 0.44, 95% CI [0.29, 0.67]), and had reduced overall mortality (OR: 0.42, 95% CI [0.25, 0.70]).
Surgically induced weight loss is beneficial in reducing morbidity and mortality of COVID-19.
肥胖与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染患者的不良预后相关。在体重指数(BMI)>35kg/m的患者中,已注意到住院率以及随后入住重症监护病房(ICU)的比例增加。据推测,导致持续体重减轻的减肥手术可降低与新型冠状病毒肺炎(COVID)相关的不良后果。在本综述中,我们更新了该主题的证据。
对电子数据库进行了广泛的文献检索。根据纳入标准筛选文章,随后进行相关数据提取。除了先前荟萃分析中使用的文章外,还搜索了相关数据库以筛选任何新文章。最初,两名独立评审员筛选了PubMed和Cochrane数据库,随后对谷歌学术和Medrxiv等其他数据库进行了全面搜索。文章首先通过标题和摘要进行筛选,随后进行全文阅读。排除重复项、荟萃分析、给编辑的信和评论。不设语言限制。
共有9篇文章纳入RevMan,涉及1,130,341名患者。接受减肥手术的患者住院率显著降低(比值比:0.52,95%置信区间[0.45,0.61]),入住ICU的可能性较小(比值比:0.44,95%置信区间[0.29,0.67]),总体死亡率降低(比值比:0.42,95%置信区间[0.25,0.70])。
手术诱导的体重减轻有助于降低新型冠状病毒肺炎(COVID-19)的发病率和死亡率。