Ali Aminian, MD, Director of Bariatric and Metabolic Institute at the Cleveland Clinic talks about how bariatric surgery may reduce the severity of COVID-19 in patients with obesity.
What do scientists know about the association between obesity and COVID-19 outcomes?
Dr. Aminian: In the last 10 months, we learned that obesity could increase the risk of contracting COVID-19 and can worsen the clinical outcomes of COVID-19. Specifically, we learned that in patients with COVD-19, obesity can increase the risk of hospitalization, the risk of being placed in the intensive care unit, the risk of invasive mechanical ventilation, and more importantly, it can increase the risk of death by almost 50 percent.
Do researchers have any indication why patients who are obese have more severe reactions to the virus?
Dr. Aminian: There are some explanations. Obesity can increase the risk of diabetes, high blood pressure, cardiac disease, lung disease, kidney problems, fatty liver disease, and sleep apnea. All these conditions can increase the risk of COVID-19. In addition, obesity and diabetes can impair immunity which can contribute to worse outcomes. Furthermore, obesity is a hypercoagulable state. That means obesity increases the risk of blood clot formation. Obesity also is a hyperinflammatory state. We know that in patients with COVID-19, hyperinflammation and blood clot formation can contribute to morbidity and mortality and individuals with obesity are more prone to develop these problems.
Could you describe the study you and your colleagues conducted?
Dr. Aminian: To study the effect of weight loss and bariatric surgery on the outcomes of COVID-19, we looked at the data of nearly 4,000 patients who tested positive between March and July of 2020 at the Cleveland Clinic. We identified patients who had history of bariatric surgery, and we carefully matched them to patients with severe obesity. In total, we included around 350 patients in this study.
What were the findings?
Dr. Aminian: We found that in patients with severe obesity, 42% required hospital admission after contracting COVID-19. However, in a group of patients who had bariatric surgery before contracting COVID-19, only 18% required hospital admission. In patients with severe obesity, 13% required ICU admission and 7% required mechanical ventilation. However, none of the patients in the bariatric surgery group required ICU admission or mechanical ventilation. More importantly, about 2.5% of patients with severe obesity unfortunately died. But none of the patients who had a history of bariatric surgery died.
What to do those findings suggest?
Dr. Aminian: These findings suggest that if patients can lose weight and keep the weight off for a long period of time, they will become healthier and stronger, and their metabolic profile will significantly improve. And if they contract the virus, they can fight it and their outcome is probably going to be better.
Is there anything else that we did not ask that you wanted to highlight about the research?
Dr. Aminian: COVID-19 has been a wake-up call that shows the health consequences of obesity. This study showed that weight loss, in this study with the help of bariatric surgery, can be a strong tool to keep people healthier to improve their outcomes if they contract this infection.
Interview conducted by Ivanhoe Broadcast News.
END OF INTERVIEW
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