既往代谢手术降低了新冠病毒疾病的严重程度：来自新冠病毒疾病大流行第一年的系统分析
Prior metabolic surgery reduced COVID-19 severity: Systematic analysis from year one of the COVID-19 pandemic.
作者信息
Wood G Craig, Benotti Peter N, Fano Rodrigo M, Dove James T, Rolston David Dk, Petrick Anthony T, Still Christopher D
机构信息
Obesity Institute, Geisinger, Danville, PA, USA.
Geisinger Commonwealth School of Medicine, Geisinger, Scranton, PA, USA.
出版信息
Heliyon. 2023 May;9(5):e15824. doi: 10.1016/j.heliyon.2023.e15824. Epub 2023 Apr 26.
BACKGROUND
Obesity is a risk factor for COVID-19 severity. Recent studies suggest that prior metabolic surgery (MS) modifies the risk of COVID-19 severity.
METHODS
COVID-19 outcomes were compared between patients with MS (n = 287) and a matched cohort of unoperated patients (n = 861). Multiple logistic regression was used to identify predictors of hospitalization. A systematic literature review and pooled analysis was conducted to provide overall evidence of the influence of prior metabolic surgery on COVID-19 outcomes.
RESULTS
COVID-19 patients with MS had less hospitalization (9.8% versus 14.3%, p = 0.049). Age 70+, higher BMI, and low weight regain after MS were associated with more hospitalization after COVID-19. A systematic review of 7 studies confirmed that MS reduced the risk of post-COVID-19 hospitalization (OR = 0.71, 95%CI = [0.61-0.83], p < 0.0001) and death (OR = 0.44, 95%CI = [0.30-0.65], p < 0.0001).
CONCLUSION
MS favorably modifies the risks of severe COVID-19 infection. Older age and higher BMI are major risk factors for severity of COVID-19 infection.
背景
肥胖是新冠病毒病（COVID-19）严重程度的一个风险因素。近期研究表明，既往代谢手术（MS）可改变COVID-19严重程度的风险。
方法
比较了代谢手术患者（n = 287）与未接受手术的匹配队列患者（n = 861）的COVID-19结局。采用多因素logistic回归分析确定住院的预测因素。进行了一项系统文献综述和汇总分析，以提供既往代谢手术对COVID-19结局影响的总体证据。
结果
接受代谢手术的COVID-19患者住院率较低（9.8%对14.3%，p = 0.049）。70岁及以上、较高的体重指数（BMI）以及代谢手术后体重恢复不佳与COVID-19后住院率较高相关。对7项研究的系统评价证实，代谢手术降低了COVID-19后住院风险（比值比[OR]=0.71，95%置信区间[CI]=[0.61-0.83]，p<0.0001）和死亡风险（OR = 0.44，95%CI = [0.30-0.65]，p<0.0001）。
结论
代谢手术可有效改善严重COVID-19感染的风险。高龄和较高的BMI是COVID-19感染严重程度的主要风险因素。
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