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The Association of Weight Reduction and Other Variables after Bariatric Surgery with the Likelihood of SARS-CoV-2 Infection

Frish et al., Journal of Clinical Medicine, doi:10.3390/jcm12124054
Jun 2023  
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Case 35% Improvement Relative Risk Vitamin D for COVID-19  Frish et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 3,038 patients in Israel (February - December 2020) Fewer cases with higher vitamin D levels (p=0.0014) c19early.org Frish et al., J. Clinical Medicine, Jun 2023 Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020
 
*, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,800+ studies for 102 treatments. c19early.org
Retrospective 3,038 bariatric surgery patients in Israel, showing higher risk of SARS-CoV-2 infection with vitamin D deficiency, and lower risk with physical activity.
This is the 183rd of 204 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 107,767,362 vigintillion).
Study covers exercise and vitamin D.
risk of case, 35.5% lower, OR 0.65, p = 0.001, cutoff 20ng/mL, adjusted per study, inverted to make OR<1 favor high D levels (≥20ng/mL), multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Frish et al., 15 Jun 2023, retrospective, Israel, peer-reviewed, 7 authors, study period 1 February, 2020 - 31 December, 2020. Contact: emarzon@leumit.co.il (corresponding author), noamfrish12@gmail.com, shaias@ariel.ac.il, aisrael@leumit.co.il, svinker@leumit.co.il, igreen@leumit.co.il, agolanchoen@leumit.co.il.
This PaperVitamin DAll
The Association of Weight Reduction and Other Variables after Bariatric Surgery with the Likelihood of SARS-CoV-2 Infection
Noam Frish, Ariel Israel, Shai Ashkenazi, Shlomo Vinker, Ilan Green, Avivit Golan-Cohen, Eugene Merzon
Journal of Clinical Medicine, doi:10.3390/jcm12124054
Background and aims: Although obesity has been confirmed as a risk factor for SARS-CoV-2 infection and its severity, the role of post-bariatric surgery (BS) variables and the infection is unclear. We, therefore, aimed to study comprehensively the relationship between the extent of weight reduction after surgery and other demographic, clinical, and laboratory variables with the rates of SARS-CoV-2 infection. Methods: A population-based cross-sectional study was performed, utilizing advanced tracking methodologies on the computerized database of a nation-wide health maintenance organization (HMO). The study population included all HMO members aged ≥18 years that had been tested at least once for SARS-CoV-2 during the study period and underwent BS at least one year before their testing. Results: Of the total 3038 individuals who underwent BS, 2697 (88.78%) were positive for SARS-CoV-2 infection and 341 (11.22%) were negative. Multivariate regression analysis demonstrated that the body mass index and the amount of weight reduction after the BS were not related to the likelihood of SARS-CoV-2 infection. Post-operative low socioeconomic status (SES) and vitamin D3 deficiency were associated with significant and independent increased rates of SARS-CoV-2 infection (odds ratio [OR] 1.56, 95% confidence interval [CI], 1.19-2.03, p < 0.001; and OR 1.55, 95% CI, 1.18-2.02, p < 0.001; respectively). Post-operative physical activity > 3 times/week was associated with a significant and independent reduced rate of SARS-CoV-2 infection (OR 0.51, 95% CI, 0.35-0.73, p < 0.001). Conclusion: Post-BS vitamin D3 deficiency, SES, and physical activity, but not the amount of weight reduction, were significantly associated with the rates of SARS-CoV-2 infection. Healthcare workers should be aware of these associations after BS and intervene accordingly.
Conflicts of Interest: The authors declare no conflict of interest.
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{ 'indexed': {'date-parts': [[2023, 6, 16]], 'date-time': '2023-06-16T04:12:57Z', 'timestamp': 1686888777651}, 'reference-count': 56, 'publisher': 'MDPI AG', 'issue': '12', 'license': [ { 'start': { 'date-parts': [[2023, 6, 15]], 'date-time': '2023-06-15T00:00:00Z', 'timestamp': 1686787200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>Background and aims: Although obesity has been confirmed as a risk factor for ' 'SARS-CoV-2 infection and its severity, the role of post-bariatric surgery (BS) variables and ' 'the infection is unclear. We, therefore, aimed to study comprehensively the relationship ' 'between the extent of weight reduction after surgery and other demographic, clinical, and ' 'laboratory variables with the rates of SARS-CoV-2 infection. Methods: A population-based ' 'cross-sectional study was performed, utilizing advanced tracking methodologies on the ' 'computerized database of a nation-wide health maintenance organization (HMO). The study ' 'population included all HMO members aged ≥18 years that had been tested at least once for ' 'SARS-CoV-2 during the study period and underwent BS at least one year before their testing. ' 'Results: Of the total 3038 individuals who underwent BS, 2697 (88.78%) were positive for ' 'SARS-CoV-2 infection and 341 (11.22%) were negative. Multivariate regression analysis ' 'demonstrated that the body mass index and the amount of weight reduction after the BS were ' 'not related to the likelihood of SARS-CoV-2 infection. Post-operative low socioeconomic ' 'status (SES) and vitamin D3 deficiency were associated with significant and independent ' 'increased rates of SARS-CoV-2 infection (odds ratio [OR] 1.56, 95% confidence interval [CI], ' '1.19–2.03, p &lt; 0.001; and OR 1.55, 95% CI, 1.18–2.02, p &lt; 0.001; respectively). ' 'Post-operative physical activity &gt; 3 times/week was associated with a significant and ' 'independent reduced rate of SARS-CoV-2 infection (OR 0.51, 95% CI, 0.35–0.73, p &lt; 0.001). ' 'Conclusion: Post-BS vitamin D3 deficiency, SES, and physical activity, but not the amount of ' 'weight reduction, were significantly associated with the rates of SARS-CoV-2 infection. ' 'Healthcare workers should be aware of these associations after BS and intervene ' 'accordingly.</jats:p>', 'DOI': '10.3390/jcm12124054', 'type': 'journal-article', 'created': {'date-parts': [[2023, 6, 15]], 'date-time': '2023-06-15T06:03:19Z', 'timestamp': 1686808999000}, 'page': '4054', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'The Association of Weight Reduction and Other Variables after Bariatric Surgery with the ' 'Likelihood of SARS-CoV-2 Infection', 'prefix': '10.3390', 'volume': '12', 'author': [ { 'given': 'Noam', 'family': 'Frish', 'sequence': 'first', 'affiliation': [ { 'name': 'Adelson School of Medicine, Ariel University, Ariel 40700, ' 'Israel'}]}, { 'ORCID': 'http://orcid.org/0000-0003-4389-8896', 'authenticated-orcid': False, 'given': 'Ariel', 'family': 'Israel', 'sequence': 'additional', 'affiliation': [ {'name': 'Leumit Health Services, Tel Aviv 64738, Israel'}, { 'name': 'Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv ' '69978, Israel'}]}, { 'ORCID': 'http://orcid.org/0000-0001-7244-0679', 'authenticated-orcid': False, 'given': 'Shai', 'family': 'Ashkenazi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Adelson School of Medicine, Ariel University, Ariel 40700, ' 'Israel'}]}, { 'given': 'Shlomo', 'family': 'Vinker', 'sequence': 'additional', 'affiliation': [ {'name': 'Leumit Health Services, Tel Aviv 64738, Israel'}, { 'name': 'Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv ' '69978, Israel'}]}, { 'ORCID': 'http://orcid.org/0000-0002-9435-7152', 'authenticated-orcid': False, 'given': 'Ilan', 'family': 'Green', 'sequence': 'additional', 'affiliation': [ {'name': 'Leumit Health Services, Tel Aviv 64738, Israel'}, { 'name': 'Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv ' '69978, Israel'}]}, { 'given': 'Avivit', 'family': 'Golan-Cohen', 'sequence': 'additional', 'affiliation': [ {'name': 'Leumit Health Services, Tel Aviv 64738, Israel'}, { 'name': 'Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv ' '69978, Israel'}]}, { 'ORCID': 'http://orcid.org/0000-0001-5469-0236', 'authenticated-orcid': False, 'given': 'Eugene', 'family': 'Merzon', 'sequence': 'additional', 'affiliation': [ { 'name': 'Adelson School of Medicine, Ariel University, Ariel 40700, ' 'Israel'}, {'name': 'Leumit Health Services, Tel Aviv 64738, Israel'}]}], 'member': '1968', 'published-online': {'date-parts': [[2023, 6, 15]]}, 'reference': [ { 'key': 'ref_1', 'unstructured': 'World Health Organization (2023, March 03). WHO Coronavirus (COVID-19) ' 'Dashboard. Available online: https://covid19.who.int/.'}, { 'key': 'ref_2', 'doi-asserted-by': 'crossref', 'first-page': '130', 'DOI': '10.1038/s41586-022-05522-2', 'article-title': 'The WHO Estimates of excess mortality associated with the COVID-19 ' 'pandemic', 'volume': '613', 'author': 'Msemburi', 'year': '2023', 'journal-title': 'Nature'}, { 'key': 'ref_3', 'doi-asserted-by': 'crossref', 'first-page': '1088', 'DOI': '10.1111/apa.15270', 'article-title': 'Systematic Review of COVID-19 in Children Shows Milder Cases and a ' 'Better Prognosis than Adults', 'volume': '109', 'author': 'Ludvigsson', 'year': '2020', 'journal-title': 'Acta Paediatr.'}, { 'key': 'ref_4', 'doi-asserted-by': 'crossref', 'first-page': '669', 'DOI': '10.1016/S1473-3099(20)30243-7', 'article-title': 'Estimates of the severity of Coronavirus Disease 2019: A model-based ' 'analysis', 'volume': '20', 'author': 'Verity', 'year': '2020', 'journal-title': 'Lancet Infect. 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