Handling of the Covid-19 Pandemic and Its Effects on Bariatric Surgical Practice: Analysis of GENEVA Study Database
Authors: Singhal Rishi , Wiggins Tom , Pouwels Sjaak , Rajeev Yashasvi , Madhok Brijesh , Hanif Wasim , Tahrani Abd A. , Graham Yitka , Ludwig Christian , Mahawar Kamal ,   On behalf of the GENEVA Collaborators, Lamota Miguel , Raslan Salah M. , Sumer Aziz , Ugale Surendra , Kassir Radwan , Balta Ahmet Z. , Yarlagadda Krishnamohan , Fage Marcelo L. , Espinosa Francisco Aguilar , Mukherjee Aloy J. , Martinez Duartez Pedro R. , Bedi Digvijaysingh , Ozmen Mahir M. , Kermansaravi Mohammad , Baldini Edoardo , Narwaria Mahendra , Murshid Osama Mohammed , Adel Abou-Mrad , Parikh Chirag , Ramirez-Serrano Christian O. , Martini Francesco , Wadhawan Randeep , Vargas Ronnal P. , Pizza Francesco , Carandina Sergio , Kizilkaya Mehmet Celal , Ilić Miroslav , Lamoza Patricio A. , Bilecik Tuna , Torres Marcelo C. , Guevara Cesar , Garcia-Flores Jose Eduardo , Sakran Nasser , Arana-Garza Sebastian , Khaitan Manish , Karateke Faruk , Valenti Victor , Tartaglia Nicola , Dukkipati Nandakishore , Chiappetta Sonja , Musella Mario , Carvalho Manuel G. , Pinotti Enrico , Prasad Arun , Shah Kamran , Baili Efstratia , Abbas Syed Imran , Nagliati Carlo , Viveiros Octávio , Ribeiro Rui J. S. , Angrisani Luigi , Soriano Ian S. , Abbadi Ahmed Chakib , Kawahara Nilton T. , Praveen Raj P. , Siddiq Ghulam , Balamoun Hany A. , Vaz Carlos , Bhasker Aparna Govil , Himpens Jacques , Techagumpuch Ajjana , Shrivastava Apoorv , Valeti Mahidhar , Bokobza Bernard , Bashir Ahmad , Avallone Salvatore , Sebbag Hugues , Escarti Uso Miguel Angel , Rodriguez Agustin E. , Awruch Diego , Ortiz Silva Camilo , De Gordejuela Amador Garcia Ruiz , Huang Chih-Kun , Manno Emilio , Ruiz-Ucar Elena , Balibrea Jose M. , Marcoen Steven Paul , Kirkil Cuneyt , Maleckas Almantas , Pham Dang Tuan , Hazebroek Eric J. , Al-Khyatt Waleed , Poghosyan Tigran , Mall Julian W. , Goel Rajat , Noel Patrick , Bindal Vivek , Prasad Gaurav , Gomez Davila Oscar M. , Kow Lilian , Focquet Marc , Omerov Taryel , Pantelis Athanasios , Cunha Hércio Azevedo De Vasconcelos , Zerrweck Carlos , Dejeu Viore , Taha Safwan A. , Dominguez Yannko G. , Copaescu Catalin , Pflug Adriano Ribeiro Meyer , Martinez-Ubieto Fernando J. , Usai Antonella , Juneja Girish Kumar , Basho Mahmoud Moustafa , Beglaibter Nahum , Pintar Tadeja , Ağbaba Neslihan , Anselmino Marco , Thorell Anders , Şen Ozan , Wiggins Tom , Trelles Nelson F. , Oren Gurdal , Robertson Andrew G. N. , Chousleb Mizrahi Elias , Sevá-Pereira Gustavo , Carvalho Fabio A. , Salman Ahmed Khalil , Dapri Giovanni , Salvi Prashant H. , Uston Murat , Davarpana ah Jazi Amir Hosein , Zandi Abdollah , Allouch Mustafa I. , Boza Camilo , Esquivel Carlos , Carbajo Miguel A. , Hassan Maaz Ul , Graniel Diaz Adrian Augusto , Elfawal Mohamad Hayssam , Ferrer Jose Vicente , Mazza Davide , Olmi Stefano , Soni Vandana , Uccelli Matteo , Jones Gregory E. , Kona Lakshmi S. , Cottam Daniel , Khatsiev Bekkhan B. , Zuluaga Zuluaga Mauricio , Gawdat Khaled , Povoas Heitor P. , Major Piotr , Al-Momani Hazem , Kurian Marina , Campanile Fabio Cesare , Hazzan David , Alhallak Antone Muneer , Kowalski Grzegorz Józef , Kaseja Krzysztof , Daskalakis Markos , Raziel Asnat , Albanopoulos Konstantinos , Charalabopoulos Alexandros , Jutten Guido , Patel Parag G. , Ahuja Anmol , Mittal Tarun , Shabbir Asim , Mehrotra Magan , Facchiano Enrico , Morrell Andre , Torres Antonio J. , Liem Ronald , Simpson Terry L. , Ramos Almino C. , Takieddine Mazen , Aggarwal Sandeep , Chowbey Pradeep , Piazza Luigi , Pajtak Alen , Shuhaili Mohamad Aznan , Boras Zdenko , Azagra Juan S. , Qassem Mohamed Gamal , Elbanna Mohey R. , Ali Abdulmajid , Franken Rutger , Pournaras Dimitri , Mansour Sami , Apáez Araujo Nestor , Krikhely Abraham , Parmar Chetan , Lo Marcelo , Ajami Hqbib , Yarram Rajanikanth , Kais Hasan , Al-Taan Omer , Hii Michael W. , Barrera Rodriguez Francisco J. , Elghadban Hosam M. , Pérez Cruz Jorge Jpc , Ramirez Salvador , Lázaro André , Riera Manel , Awad Sherif , Neto Guilhermino N. S. , Valencia A Mauricio E. , Olivares Juan C. , Altuve Juan A. , Parmar Jitesh , Cohen Ricardo V. , Verboonen Sergio , De Luca Maurizio , Antoine Heath J. , Núñez Santana Yangel , Carrasco Flores Jhon C. , Tamez Ricardo Cuellar , Ungson Gilberto , Salminen Paulina , Dilektasli Evren , Antozzi Luciano , Adi Hussam Z. , Leyva-Alvizo Adolfo , Andino Sandra Viviana , Romero Rey J. , Nizami Nasir , Proczko-Stepaniak Monika , Romeijn Marleen , Abreu Isaac Walker , Peter Mark , Ward Salena M. , Nassar Ricardo , Aboshanab Hany Mohamed Abdulrahman , Ortega Puy Juan F. , Mirza Gari Mohammed Khalid , Yang Wah , Favretti Franco , Kristinsson Jon A. , Bashah Moataz M. , De Mesquita Luis Flávio Vilela , Cantu Felipe J. , Taskin Halit Eren , Gonzalez Jesus , Lamb Peter , Boru Cristian E. , Hussain Abdulzahra , Alkhaffaf Bilal , Jambulingam P. S. , Tog Chek H. , Picardo Jorge D. , Neimark Aleksandr , Ammori Basil J. , Dong Zhiyong , Garcia Trujillo Ubaldo H. , Layani Laurent Abram , Salsano Vincenzo , Tank Avinash , Zilberstein Bruno , Pajecki Denis , Saha Arin K. , Al Shaban Talat , Topal Ersun , Van Der Fraenen Donald , Jimenez Amin Manuel Enrique , Galaz Fernando P. , Abdo Nael Z. , Mohamed Abbas Abdel Rahman , Poggi Luis , Çiyiltepe Hüseyin , Wietzycoski Cacio Ricardo , Scalera Giuseppe G. S. , Goel Ramen , Santos Newton Teixeira , Inam Aatif , Mans Esther , Altarawni Mohammad , Al Hadad Mohammed , Mejdane Abdelhadi , Mhanna Abdul Aziz Saleh , Martin Santiago , Akbaba Murat , Shah Shahzad Alam , Birk Dieter , Adil Md Tanveer , Torres Máximo Max , Elmaleh Haitham Mostafa , Miller Karl , Malapan Kirubakaran , Matar Hikmat , Mamidanna Ravikrishna , Gudal Ahmad A. , Aljohani Emad A. , Estrada Jose Luis , Fiolo Felipe E. , Md Hashim Mohd Nizam , Prieto-Aldape Manuel-Rodrigo , Niazi Mourad , Cuellar Tamez Ricardo X. , Dargent Jerome , Alharbi Obaid M. , Katakwar Abhishek , Dalati Feras , Sharma Sharad , Samarkandy Tarig A. , Farina Del Rio Miguel Angel M. F. , Dawani Surrendar , Van Der Merwe Maria-Teresa , Vilas-Boas Marcos Leão P. , Moustafa Alaa Abbass , Dukhno Oleg , Ahmed Ahmed , Eghbali Foolad , Bandyopadhyay Samik K. , Khan Amir Ul Haq , Li Alan GK , Fehervari Matyas , Silva Eduardo , Kostalas Marcos , Salih Tamir , Hamed Hosam , Bolckmans Roel , Amr Bassem , Welbourn Richard , Cervantes Jose Arturo Meneses , Menon Vinod , Marzano Bernardo , Garcia Garza Manuel , Talwar Sumit , Jimenez Jose Alfredo , Ramos-Kelly Jaime R. , Lutfi Rami , Husain Farah A. , Heneghan Helen M. , Patel Kirtik , Junior Maurílio Ribeiro , Viegas Fabio , Avalos-Avalos Manuel , Nor Hanipah Zubaidah , Snoekx Rob , Diaz Rincon Camilo A. , Aceves Rodrigo , Fadhel Muayad , Cahalan Steven A. , Jasim Dhafer M. , Al-Hamadani Mohammed Salim , Albermani Mohannad Kamel , Ali Hussein Saleh , Altaee Wissam Jaafar , Almussawi Hamid Dawood , Silva Antonio S.B. , Atra Ammar A. , Majeed Abdulaziz Abood , Al-Turfi Ahmed Nasser , Alomar Omar Salem , Kalogeropoulos George , Tzvetkov Ivaylo Georgiev , Rajneesh Rana Manindra , Khwaja Haris , Foschi Diego , Al Hajj Georges Nabih , Assalia Ahmad , Khaleal Fadil , Solovyeva Maria , Salem Abdou Abdalla Ali , Takla Hany , Alshurafa Haider A. , Alrifai Nazim , Muñoz-Mora Andres , Martinez De Aragon Gabriel , Diaconu Victor V. , Alenazi Naif A. , Kaplan Mehmet , Grippa Paulo C. , Nottle Peter D. , Fonseca Luis Antonio C. , Luciani Roger C. , Talbot Michael L. , Park Yun Chan , Nacur Silva Eduardo , Merola Giovanni , Sharma Vikrant , Elghandour Abdelrahman M. , Behrens Estuardo J. , Sharples Alistair , Pestana Jose M. , Monterrubio Jeronimo , Bastos Eduardo Lemos De Souza , Alalwani Naser Saleh , Mohammed Diya Aldeen , Kathrein Heidi Louise , Schutte Francois N. , Sava Adrian , Mayo-Ossorio Mª De Los Angeles , Manrique Dick A. , Shahabi Shahab , Guldogan Cem EMIR , Gärtner Daniel , Ksantini Rachid KSAN , Boutry Etienne , Mazzini Guilherme S. , Rheinwalt Karl P. , Pagan Alberto , Ospanov Oral , Saggu Sukhvinder Singh , Alsubaie Saud AES. , Walędziak Maciej , Fallatah Basmah , Edenberg Andreas , Abdullah Mohammed , Floch Neil R. , Stewart Johnny , Timofte Daniel V. , Jawed Aram E. , Bhambri Amit , Hany Mohamed , Jain Sapan A. , Terzis Ioannis , Level Luis , Al Sayyad Mohamad Abdulkader , Ahmed Hassan , Devadas Michael , Coelho Antonio Cláudio Jamel , Shah Shashank S. , Anacona C. Rodrigo J. , Palacios Alexander B. , Ismael Diyaree Nihad , Iqbal Usama , Herrera Héctor R. , Goitein David , Quinino Reynaldo M. , Spiliopoulos Georgios , Zambrana Pablo Pjz , Villagran Rodrigo , Ghazal Ahmad , Frattini Francesco , Battistoni Marco , Stamou Konstantinos , Bodnar Zsolt , Sinan Hüseyin , Nirujogi Vijaya L. , Taha Osama , Hu Songhao , Mahfouz Mohammad Eid M. , Biter L. Ulas , Ibrahim Hamza , Jordan Lynz , Hill January , Mohammed Mohammed Mustafa Hassan , Armijos Luis X. , Vilallonga Ramon , Zabala Salazar Luis Alberto , Schrapps Jerome F. , Al Amri Khalid , Muzio Guillermo J. , Abualsel Abdulmenem Yahya , Kurian Marina , Szczerbinski Lukasz , Trindade Carlos M. , Forieg Ahmed , Schwoch Fallon , Genser Laurent , Osman Ahmed , Menezes Mariano De Almeida , Özgüç Halil , Cunha Hercio A. V. , Sbaï Idrissi Mohamed Saïd , Gülcü Barış , Contine Alessandro , Rossi Lucas Felix , Isik Arda , Khan Omar A. , De Oliveira E. Silva Luiz Gustavo , Bartın Mehmet Kadir , Yardımcı Samet , Yardimci Erkan , Pinto E. Paulo , Hassan Ibrahim Abdelhamid , Yeap Chee Loong , Arias Rafael , Hamouda Ahmed H. , Dorado Evelyn A. , Simoneti Celso , Vasas Peter , Paolino Luca , De Ajuria Roberto Cisneros , Borrelli Vincenzo , Shamim Adeel A. , Herrera Miguel F. , Galindo Alvarez Julio , Wong Wei Jin , Prasad Shalvin R. , Aly Sherif , Karaca Fatih Can , Weiner Sylvia , Kazak Mehmet Altug , Motwani Manish , Büyükkasap Çağrı , Rizzi Andrea , Niazi Samiullah Khan , Alatrakhiam Madhi Hashim , Pararas Nikolaos , Ibrahim Aini F. , Youssef Dali , Marchesini Joao Caetano , Correia-Neves Jose-Maria V. , Shreekumar Aditi , Elwardany Ibrahim , Demirli Atici Semra , Lorenzo Pérez Javier , Ng Kin Cheung , Stier Christine , Hany Ashour Mohammed , Elmaleh Haitham M. , Madalosso Carlos A. S. , Vasas Peter , Raslan Salah 
Published: October 2022

Background

The coronavirus disease 2019 (COVID-19) pandemic led to a worldwide suspension of bariatric and metabolic surgery (BMS) services. The current study analyses data on patterns of service delivery, recovery of practices, and protective measures taken during the COVID-19 pandemic by bariatric teams.

Materials and Methods

The current study is a subset analysis of the GENEVA study which was an international cohort study between 01/05/2020 and 31/10/2020. Data were specifically analysed regarding the timing of BMS suspension, patterns of service recovery, and precautionary measures deployed.

Results

A total of 527 surgeons from 439 hospitals in 64 countries submitted data regarding their practices and handling of the pandemic. Smaller hospitals (with less than 200 beds) were able to restart BMS programmes more rapidly (time to BMS restart 60.8 ± 38.9 days) than larger institutions (over 2000 beds) (81.3 ± 30.5 days) (p = 0.032). There was a significant difference in the time interval between cessation/reduction and restart of bariatric services between government-funded practices (97.1 ± 76.2 days), combination practices (84.4 ± 47.9 days), and private practices (58.5 ± 38.3 days) (p < 0.001).

Precautionary measures adopted included patient segregation, utilisation of personal protective equipment, and preoperative testing. Following service recovery, 40% of the surgeons operated with a reduced capacity. Twenty-two percent gave priority to long waiters, 15.4% gave priority to uncontrolled diabetics, and 7.6% prioritised patients requiring organ transplantation.

Conclusion

This study provides global, real-world data regarding the recovery of BMS services following the COVID-19 pandemic.

Graphical abstract