Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic
Authors: Singhal Rishi , Omar Islam , Madhok Brijesh , Rajeev Yashasvi , Graham Yitka , Tahrani Abd A. , Ludwig Christian , Wiggins Tom , Mahawar Kamal ,   On behalf of the GENEVA Collaborators, Pędziwiatr Michał , Major Piotr , Zarzycki Piotr , Pantelis Athanasios , Lapatsanis Dimitris P. , Stravodimos Georgios , Matthys Chris , Focquet Marc , Vleeschouwers Wouter , Spaventa Antonio G. , Zerrweck Carlos , Vitiello Antonio , Berardi Giovanna , Musella Mario , Sanchez-Meza Alberto , Cantu Felipe J. , Mora Fernando , Cantu Marco A. , Katakwar Abhishek , Reddy D. Nageshwar , Elmaleh Haitham , Hassan Mohammad , Elghandour Abdelrahman , Elbanna Mohey , Osman Ahmed , Khan Athar , Layani Laurent , Kiran Nalini , Velikorechin Andrey , Solovyeva Maria , Melali Hamid , Shahabi Shahab , Agrawal Ashish , Shrivastava Apoorv , Sharma Ankur , Narwaria Bhavya , Narwaria Mahendra , Raziel Asnat , Sakran Nasser , Susmallian Sergio , Karagöz Levent , Akbaba Murat , Pişkin Salih Zeki , Balta Ahmet Ziya , Senol Zafer , Manno Emilio , Iovino Michele Giuseppe , Osman Ahmed , Qassem Mohamed , Arana-Garza Sebastián , Povoas Heitor P. , Vilas-Boas Marcos Leão , Li Alan , Ammori Basil J. , Balamoun Hany , Salman Mohammed , Nasta Amrit Manik , Goel Ramen , Sánchez-Aguilar Hugo , Herrera Miguel F. , Abou-Mrad Adel , Cloix Lucie , Mazzini Guilherme Silva , Kristem Leonardo , Lazaro Andre , Campos Jose , Bernardo Joaquín , González Jesús , Trindade Carlos , Viveiros Octávio , Ribeiro Rui , Goitein David , Hazzan David , Segev Lior , Beck Tamar , Reyes Hernán , Monterrubio Jerónimo , García Paulina , Benois Marine , Kassir Radwan , Contine Alessandro , Elshafei Moustafa , Aktas Sueleyman , Weiner Sylvia , Heidsieck Till , Level Luis , Pinango Silvia , Ortega Patricia Martinez , Moncada Rafael , Valenti Victor , Vlahović Ivan , Boras Zdenko , Liagre Arnaud , Martini Francesco , Juglard Gildas , Motwani Manish , Saggu Sukhvinder Singh , Al Momani Hazem , López Luis Adolfo Aceves , Cortez María Angelina Contreras , Zavala Rodrigo Aceves , D’Haese Christine , Kempeneers Ivo , Himpens Jacques , Lazzati Andrea , Paolino Luca , Bathaei Sarah , Bedirli Abdulkadir , Yavuz Aydın , Büyükkasap Çağrı , Özaydın Safa , Kwiatkowski Andrzej , Bartosiak Katarzyna , Walędziak Maciej , Santonicola Antonella , Angrisani Luigi , Iovino Paola , Palma Rossella , Iossa Angelo , Boru Cristian Eugeniu , De Angelis Francesco , Silecchia Gianfranco , Hussain Abdulzahra , Balchandra Srivinasan , Coltell Izaskun Balciscueta , Pérez Javier Lorenzo , Bohra Ashok , Awan Altaf K. , Madhok Brijesh , Leeder Paul C. , Awad Sherif , Al-Khyatt Waleed , Shoma Ashraf , Elghadban Hosam , Ghareeb Sameh , Mathews Bryan , Kurian Marina , Larentzakis Andreas , Vrakopoulou Gavriella Zoi , Albanopoulos Konstantinos , Bozdag Ahemt , Lale Azmi , Kirkil Cuneyt , Dincer Mursid , Bashir Ahmad , Haddad Ashraf , Hijleh Leen Abu , Zilberstein Bruno , de Marchi Danilo Dallago , Souza Willy Petrini , Brodén Carl Magnus , Gislason Hjörtur , Shah Kamran , Ambrosi Antonio , Pavone Giovanna , Tartaglia Nicola , Kona S. Lakshmi Kumari , Kalyan K. , Perez Cesar Ernesto Guevara , Botero Miguel Alberto Forero , Covic Adrian , Timofte Daniel , Maxim Madalina , Faraj Dashti , Tseng Larissa , Liem Ronald , Ören Gürdal , Dilektasli Evren , Yalcin Ilker , AlMukhtar Hudhaifa , Al Hadad Mohammed , Mohan Rasmi , Arora Naresh , Bedi Digvijaysingh , Rives-Lange Claire , Chevallier Jean-Marc , Poghosyan Tigran , Sebbag Hugues , Zinaï Lamia , Khaldi Saadi , Mauchien Charles , Mazza Davide , Dinescu Georgiana , Rea Bernardo , Pérez-Galaz Fernando , Zavala Luis , Besa Anais , Curell Anna , Balibrea Jose M. , Vaz Carlos , Galindo Luis , Silva Nelson , Caballero José Luis Estrada , Sebastian Sergio Ortiz , Marchesini João Caetano Dallegrave , da Fonseca Pereira Ricardo Arcanjo , Sobottka Wagner Herbert , Fiolo Felipe Eduardo , Turchi Matias , Coelho Antonio Claudio Jamel , Zacaron Andre Luis , Barbosa André , Quinino Reynaldo , Menaldi Gabriel , Paleari Nicolás , Martinez-Duartez Pedro , de Aragon Ramírez de Esparza Gabriel Martínez , Esteban Valentin Sierra , Torres Antonio , Garcia-Galocha Jose Luis , Josa MIguel , Pacheco-Garcia Jose Manuel , Mayo-Ossorio Maria Angeles , Chowbey Pradeep , Soni Vandana , de Vasconcelos Cunha Hercio Azevedo , Castilho Michel Victor , Ferreira Rafael Meneguzzi Alves , Barreiro Thiago Alvim , Charalabopoulos Alexandros , Sdralis Elias , Davakis Spyridon , Bomans Benoit , Dapri Giovanni , Van Belle Koenraad , MazenTakieddine  , Vaneukem Pol , Karaca Esma Seda Akalın , Karaca Fatih Can , Sumer Aziz , Peksen Caghan , Savas Osman Anil , Chousleb Elias , Elmokayed fahad , Fakhereldin Islam , Aboshanab Hany Mohamed , Swelium Talal , Gudal Ahmad , Gamloo Lamees , Ugale Ayushka , Ugale Surendra , Boeker Clara , Reetz Christian , Hakami Ibrahim Ali , Mall Julian , Alexandrou Andreas , Baili Efstratia , Bodnar Zsolt , Maleckas Almantas , Gudaityte Rita , Guldogan Cem Emir , Gundogdu Emre , Ozmen Mehmet Mahir , Thakkar Deepti , Dukkipati Nandakishore , Shah Poonam Shashank , Shah Shashank Subhashchandra , Shah Simran Shashank , Adil Md Tanveer , Jambulingam Periyathambi , Mamidanna Ravikrishna , Whitelaw Douglas , Adil Md Tanveer , Jain Vigyan , Veetil Deepa Kizhakke , Wadhawan Randeep , Torres Antonio , Torres Max , Tinoco Tabata , Leclercq Wouter , Romeijn Marleen , van de Pas Kelly , Alkhazraji Ali K. , Taha Safwan A. , Ustun Murat , Yigit Taner , Inam Aatif , Burhanulhaq Muhammad , Pazouki Abdolreza , Eghbali Foolad , Kermansaravi Mohammad , Jazi Amir Hosein Davarpanah , Mahmoudieh Mohsen , Mogharehabed Neda , Tsiotos Gregory , Stamou Konstantinos , Barrera Rodriguez Francisco J. , Rojas Navarro Marco A. , Torres Omar MOhamed , Martinez Sergio Lopez , Tamez Elda Rocio Maltos , Millan Cornejo Gustavo A. , Flores Jose Eduardo Garcia , Mohammed Diya Aldeen , Elfawal Mohamad Hayssam , Shabbir Asim , Guowei Kim , So Jimmy By , Kaplan Elif Tuğçe , Kaplan Mehmet , Kaplan Tuğba , Pham DangTuan , Rana Gurteshwar , Kappus Mojdeh , Gadani Riddish , Kahitan Manish , Pokharel Koshish , Osborne Alan , Pournaras Dimitri , Hewes James , Napolitano Errichetta , Chiappetta Sonja , Bottino Vincenzo , Dorado Evelyn , Schoettler Axel , Gaertner Daniel , Fedtke Katharina , Aguilar-Espinosa Francisco , Aceves-Lozano Saul , Balani Alessandro , Nagliati Carlo , Pennisi Damiano , Rizzi Andrea , Frattini Francesco , Foschi Diego , Benuzzi Laura , Parikh Chirag , Shah Harshil , Pinotti Enrico , Montuori Mauro , Borrelli Vincenzo , Dargent Jerome , Copaescu Catalin A , Hutopila Ionut , Smeu Bogdan , Witteman Bart , Hazebroek Eric , Deden Laura , Heusschen Laura , Okkema Sietske , Aufenacker Theo , den Hengst Willem , Vening Wouter , van der Burgh Yonta , Ghazal Ahmad , Ibrahim Hamza , Niazi Mourad , Alkhaffaf Bilal , Altarawni Mohammad , Cesana Giovanni Carlo , Anselmino Marco , Uccelli Matteo , Olmi Stefano , Stier Christine , Akmanlar Tahsin , Sonnenberg Thomas , Schieferbein Uwe , Marcolini Alejandro , Awruch Diego , Vicentin Marco , de Souza Bastos Eduardo Lemos , Gregorio Samuel Azenha , ahuja Anmol , mittal Tarun , Bolckmans Roel , Wiggins Tom , Baratte Clément , Wisnewsky Judith Aron , Genser Laurent , Chong Lynn , Taylor Lillian , Ward Salena , Chong Lynn , Taylor Lillian , Hi Michael W , Heneghan Helen , Fearon Naomi , Plamper Andreas , Rheinwalt Karl , Heneghan Helen , Geoghegan Justin , Ng Kin Cheung , Fearon Naomi , Kaseja Krzysztof , Kotowski Maciej , Samarkandy Tarig A , Leyva-Alvizo Adolfo , Corzo-Culebro Lourdes , Wang Cunchuan , Yang Wah , Dong Zhiyong , Riera Manel , Jain Rajesh , Hamed Hosam , Said Mohammed , Zarzar Katia , Garcia Manuel , Türkçapar Ahmet Gökhan , Şen Ozan , Baldini Edoardo , Conti Luigi , Wietzycoski Cacio , Lopes Eduardo , Pintar Tadeja , Salobir Jure , Aydin Cengiz , Atici Semra Demirli , Ergin Anıl , Ciyiltepe Huseyin , Bozkurt Mehmet Abdussamet , Kizilkaya Mehmet Celal , Onalan Nezihe Berrin Dodur , Zuber Mariana Nabila Binti Ahmad , Wong Wei Jin , Garcia Amador , Vidal Laura , Beisani Marc , Pasquier Jorge , Vilallonga Ramon , Sharma Sharad , Parmar Chetan , Lee Lyndcie , Sufi Pratik , Sinan Hüseyin , Saydam Mehmet 
Published: May 2022

Background

Age ≥ 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort.

Methods

We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups — patients ≥ 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality.

Results

There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 ± 2.5 years, 119.5 ± 24.5 kg, and 43 ± 7 in Group I and 39.8 ± 11.3 years, 117.7±20.4 kg, and 43.7 ± 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p= < 0.001).

The 30-day morbidity was significantly higher in Group I (11.4%) compared to Group II (6.6%) (p= 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups.

Conclusions

Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those ≥ 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups.

Graphical abstract