Safety of Bariatric Surgery During the Opening Phase After the First Wave of the COVID-19 Pandemic: Experience at an Academic Center

Abstract
Introduction Increased morbimortality in patients with COVID-19 infection who had undergone surgery has raised concerns about bariatric surgery safety during the current COVID-19 pandemic. Currently, there is scarce literature on safety outcomes after bariatric surgery during the COVID-19 pandemic.
Objectives To determine the risk of symptomatic COVID-19 infection and associated complications during the first 30 days after bariatric surgery.
Materials and Methods Prospective observational cohort study including all patients who consecutively underwent primary bariatric surgery between August and December 2020.
Results A total of 189 patients were included. Median age and BMI were 36 (17-70) years and 38 (35-41) kg/m(2), respectively. Forty percent of patients were women (n = 76), 59.3% (n = 112) underwent sleeve gastrectomy ( SG), and 40.7% (n = 77) underwent Roux-en-Y gastric bypass (RYGB). All surgeries were performed laparoscopically. The median length of postoperative stay was 2 (0-5) days. Postoperative COVID-19 infection was detected in two patients (1.1%): one patient was readmitted without the need of intermediate or ICU care, and the other was managed as an outpatient. Major complications occurred in three patients (1.6%); none of them was COVID-19 related. Two patients required an unplanned reoperation. No patient required intermediate or ICU care, no severe COVID-19 complications were observed, and no mortality was reported.
Conclusion Bariatric surgery can be safely performed during the ongoing pandemic, albeit a low risk of COVID- 19 symptomatic infection. Rigorous perioperative COVID-19 institutional protocols are required to perform bariatric surgery safely during the current pandemic.
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Keywords
COVID-19, Bariatric surgery, Roux-en-Y gastric bypass, Sleeve gastrectomy
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