Reentry to Metabolic and Bariatric Surgery During the COVID19 Pandemic
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Reentry to Metabolic and Bariatric Surgery During the COVID19 Pandemic Abdelrahman A. Nimeri 1,2
&
Brent D. Matthews 3
Received: 15 May 2020 / Revised: 19 May 2020 / Accepted: 21 May 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Patients with obesity and diabetes have higher risk for severe complications and mortality from COVID19 infection. In addition, unexpected mortalities were reported in a small series of asymptomatic COVID19-positive patients undergoing metabolic and bariatric surgery (MBS). Several organization including IFSO and the American College of Surgeons (ACS) endorsed recommendations to suspend elective nonessential surgery including MBS during the peak period of COVID19. However, both recommendations have no clear guidelines on how to prioritize MBS patients after the peak of COVID19 cases has passed, but there remain patients with asymptomatic COVID19 in the community. We present a tiered approach to restart MBS during the COVID19 pandemic once the peak of new cases has passed or the curve of new COVID19 cases has flattened. Keywords Re-entry to metabolic and bariatric surgery . COVID19 pandemic
Patients with obesity and diabetes have higher risk for severe complications and mortality from COVID19 infection [1, 2]. In addition, unexpected mortalities were reported in a small series of asymptomatic COVID19-positive patients undergoing metabolic and bariatric surgery (MBS) [3, 4]. Several organization including the International Federation for Surgery of Obesity (IFSO) and the American College of Surgeons (ACS) endorsed recommendations to suspend elective nonessential surgery including MBS during the peak period of COVID19 when the number of cases is high [5, 6]. However, both recommendations have no clear guidelines on how to prioritize patients for MBS after the peak of COVID19 cases has passed, but there remain patients with asymptomatic COVID19 in the community.
* Abdelrahman A. Nimeri [email protected] 1
Atrium Health Weight Management, Section of Bariatric & Metabolic Surgery, Charlotte, NC, USA
2
Bariatric and Metabolic Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC 28204, USA
3
Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
Based on the recommendation of the ACS, our healthcare system recommended to stop all nonessential elective surgery including MBS as of March 18, 2020, based on the curve of COVID19 cases in our state and region. On May 11, 2020, based on data showing flattening of the curve of new COVID19 cases in the last 14 days within our healthcare system recommended restarting nonessential elective surgery including MBS. Our weight management program includes two separate Metabolic and Bariatric Surgery Quality Improvement Program (MBSQIP) centers of excellence, and we have developed a tiered approach to restart MBS during the COVID19 pandemic once the peak of new cases has passed or the curve of new COVID19 cases has flattened. This tiered ap
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