Modeling the Impact of Delaying Bariatric Surgery due to COVID-19: a Decision Analysis

Obes Surg. 2021 Mar;31(3):1387-1391. doi: 10.1007/s11695-020-05054-6. Epub 2020 Oct 26.


We developed a decision analysis model to evaluate risks and benefits of delaying scheduled bariatric surgery during the novel coronavirus disease (COVID-19) pandemic. Our base case was a 45-year-old female with diabetes and a body mass index of 45 kg/m2. We compared immediate with delayed surgery after 6 months to allow for COVID-19 prevalence to decrease. We found that immediate and delayed bariatric surgeries after 6 months resulted in similar 20-year overall survival. When the probability of COVID-19 infection exceeded 4%, then delayed surgery improved survival. If future COVID-19 infection rates were at least half those in the immediate scenario, then immediate surgery was favored and local infection rates had to exceed 9% before surgical delay improved survival. Surgeons should consider local disease prevalence and patient comorbidities associated with increased mortality before resuming bariatric surgery programs.

Keywords: Bariatric surgery; COVID-19; Coronavirus; Decision analysis; Risk modeling; Sleeve gastrectomy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Bariatric Surgery*
  • Body Mass Index
  • COVID-19 / epidemiology*
  • Clinical Decision-Making
  • Comorbidity
  • Databases, Factual
  • Decision Support Techniques
  • Diabetes Complications
  • Diabetes Mellitus
  • Female
  • Humans
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Prevalence
  • SARS-CoV-2