Impacto del aislamiento durante la pandemia COVID-19 en los pacientes intervenidos de cirugía bariátrica

Abstract

Introduction: Bariatric surgery is the most effective treatment for morbid obesity. Obesity is increasing all over the world, and it has been related with comorbidities such as hypertension, diabetes, sleep obstructive apnea and dyslipidemia. Although weight loss is achieved after bariatric surgery in all patients, differences between them have been found. Factors involved in different outcomes after bariatric surgery has still to be determined. On March 2020, the COVID-19 pandemic was declared, the Spanish government established a lockdown from March 15th to June 21st. During this period, changes in lifestyle affected the population. We aimed to investigate the impact of COVID-19 lockdown on short-term weight loss 1 year after Bariatric Surgery. Also, we analyzed the differences in food intake, physical activity, and anxiety between those patients operated during and before the lockdown. Methods: We performed a retrospective analysis of a prospective maintained database; for the COVID-group (study group) we selected all patients undergoing a primary bariatric procedure, within six months from the lockdown declaration. The PRECOVID group (control group) comprised patients completing one year of follow up after bariatric surgery before March 2020. Validated questionnaires were used to measure: 1) food intake, Food Frequency Questionnaire (FFQ); 2) physical activity, Global Physical Activity Questionnaire (GPAQ); 3) anxiety, Hamilton Anxiety Scale (HAM-A). Results: We included 37 patients in each group, 22 laparoscopic sleeve gastrectomy (LSG), and 15 Roux-Y laparoscopic gastric bypass (RYLGB). Mean % excess weight loss (EWL) at 1 year follow up was similar between the COVID and control groups COVID group 78,77% (+/-23,39%) vs PRECOVID group 72,66% (+/- 26,6%) (p=0.828) and the mean % of total weight loss (TWL) at 1 year follow up was also similar. A similar result was found for TWL, but a difference between the PRECOVID and COVID group was found in those patients submitted to LSG, showing a higher TWL in the COVID period after 2 years follow up. Based on what patients reported on the questionnaires no differences were found in PA or anxiety between groups. Oral intake did not differ except for complex carbohydrates (CCH) with a lower consumption in the COVID SG subgroup. Conclusion: Our study shows that the lockdown during the COVID-19 pandemic did not affect shortterm weight loss after BS. We did not find any significant differences in food intake, PA or anxiety between groups using validated questionnaires.