Successful Weight-Loss Surgery Reduces Risk of Severe COVID-19

Previous research has shown obesity is closely correlated with severe COVID-19 illness.

Patients who lost weight due to bariatric surgery prior to COVID-19 infection were less likely to experience drastic outcomes than patients with obesity, a Cleveland Clinic study found.

The observational study, published today in JAMA Surgery, examined whether formerly obese patients who underwent successful weight-loss intervention subsequently had less severe COVID-19 illness. It included 20212 adults with obesity, classified by a body mass index (BMI) of at least 35.

Patients (n=5053) who underwent weight-loss surgery from 2004-2017 were matched 1:3 to patients with obesity who did not have the surgery (n=15159). Prior to Cleveland’s COVID-19 outbreak on March 1, 2020, patients who had bariatric surgery saw a comparative 19% reduce in weight.

Investigators examined rate of contracting COVID-19, hospitalization, need for supplemental oxygen, and severe disease. “Severe disease” was defined as intensive care unit (ICU) admission, mechanical ventilation need, or death.

Both groups had similar rates of COVID-19 infection; 9.1% in the group that had surgery and 8.7% in the group that did not. However, participants who underwent weight-loss surgery had significantly better outcomes.

Patients with prior bariatric surgery who contracted COVID-19 were had a 49% lower risk of hospitalization, 63% reduced need for supplemental oxygen, and 60% risk reduction in developing severe COVID-19.

The study’s lead author, Ali Aminian, MD, said, “Patients with obesity who achieved substantial and sustained weight loss with bariatric surgery prior to a COVID-19 infection reduced their risk of developing severe illness by 60 percent.” Aminian noted that the patients who underwent weight-loss surgery were healthier at the time they contracted COVID-19, leading to better outcomes.

Aminian, also the director of Cleveland Clinic’s Bariatric and Metabolic Institute, added, “Our study provides strong evidence that obesity is a modifiable risk factor for COVID-19 that can be improved through a successful weight-loss intervention.”