Obesity has been linked to immunosuppressive effects and increased susceptibility to respiratory infections, including COVID-19. Bariatric surgery (BS) has demonstrated promising results in enhancing a variety of clinical outcomes in obese patients. The purpose of this meta-analysis is to evaluate the effect of BS on COVID-19 outcomes, specifically all-cause mortality. A thorough literature search was conducted in electronic databases to identify pertinent studies through November 2022. Inclusion criteria included retrospective cohort studies that investigated the association between BS and COVID-19 mortality. Data extraction and quality assessment were carried out in accordance with established protocols. A random-effects model was used to calculate the odds ratio (OR) and 95% confidence intervals (CIs). Using I² statistics, heterogeneity was evaluated, and publication bias was assessed using funnel plots. Eight retrospective studies involving a total cohort of 409,665 patients met the quantitative analysis eligibility criteria. In the crude unmatched analysis, the overall mortality rate among patients with prior BS was significantly lower than among those without BS (OR 0.52; 95% CI [0.43, 0.62]; p = 0.03; I² = 53.66%). After adjusting for comorbidities, the matched analysis yielded comparable results (OR 0.42, 95% CI [0.25, 0.72], p = 0.14, I² = 41.88%). Comparing the BS group to the non-BS group, subgroup analyses by country (the USA and Europe) showed that the BS group had a mortality risk that was nearly 50% lower. The funnel plot indicated that there was no publication bias, and the sensitivity analysis revealed balanced results when each study was excluded. This meta-analysis suggests that a history of BS is associated with a decreased risk of deaths from all causes in COVID-19 patients. These results highlight the prospective benefits of BS in mitigating adverse outcomes in obese COVID-19 patients. To investigate the underlying mechanisms and potential confounders of this association, additional research is required.

肥胖与免疫抑制作用以及对呼吸道感染（包括 COVID-19）的易感性增加有关。减肥手术（BS）在改善肥胖患者的各种临床结果方面已显示出有希望的结果。本荟萃分析的目的是评估 BS 对 COVID-19 结果的影响，特别是全因死亡率。在电子数据库中进行了彻底的文献检索，以确定截至 2022 年 11 月的相关研究。纳入标准包括调查 BS 与 COVID-19 死亡率之间关系的回顾性队列研究。数据提取和质量评估是按照既定方案进行的。使用随机效应模型来计算比值比 (OR) 和 95% 置信区间 (CI)。使用I ²统计数据评估异质性，并使用漏斗图评估发表偏倚。涉及 409,665 名患者的八项回顾性研究符合定量分析资格标准。在粗略的未匹配分析中，既往有 BS 的患者的总体死亡率显着低于无 BS 的患者（OR 0.52；95% CI [0.43, 0.62]；p = 0.03；I ² = 53.66%）。调整合并症后，匹配分析产生了可比较的结果（OR 0.42，95% CI [0.25，0.72]，p = 0.14，I ² = 41.88%）。将 BS 组与非 BS 组进行比较，按国家（美国和欧洲）进行的亚组分析表明，BS 组的死亡风险低了近 50%。漏斗图表明不存在发表偏倚，敏感性分析显示排除每项研究后的平衡结果。这项荟萃分析表明，BS 病史与 COVID-19 患者全因死亡风险降低相关。这些结果凸显了 BS 在减轻肥胖 COVID-19 患者不良后果方面的预期益处。为了调查这种关联的潜在机制和潜在的混杂因素，需要进行更多的研究。