Abstract

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.