Prior metabolic surgery reduced COVID-19 severity: Systematic analysis from year one of the COVID-19 pandemic.

Background: Obesity is a risk factor for COVID-19 severity. Recent studies suggest that prior metabolic surgery (MS) modifies the risk of COVID-19 severity. Methods: COVID-19 outcomes were compared between patients with MS (n = 287) and a matched cohort of unoperated patients (n = 861). Multiple logistic regression was used to identify predictors of hospitalization. A systematic literature review and pooled analysis was conducted to provide overall evidence of the influence of prior metabolic surgery on COVID-19 outcomes. Results: COVID-19 patients with MS had less hospitalization (9.8% versus 14.3%, p = 0.049). Age 70+, higher BMI, and low weight regain after MS were associated with more hospitalization after COVID-19. A systematic review of 7 studies confirmed that MS reduced the risk of post-COVID-19 hospitalization (OR = 0.71, 95%CI = [0.61-0.83], p < 0.0001) and death (OR = 0.44, 95%CI = [0.30-0.65], p < 0.0001). Conclusion: MS favorably modifies the risks of severe COVID-19 infection. Older age and higher BMI are major risk factors for severity of COVID-19 infection.

Postoperative Urinary Retention in Patients Undergoing Lung Resection: Incidence and Risk Factors.

BACKGROUND: The purpose of this study was to (1) determine the incidence of postoperative urinary retention (POUR) in patients undergoing lung resection at our institution, (2) identify differences in potential risk factors between patients with and without POUR, and (3) describe patient outcomes across POUR status. METHODS: The medical records of 225 patients between 2016 and 2017 were reviewed, and 191 met criteria for inclusion. The institution's catheterization removal protocol was followed in all patients. Recatheterization was defined as requiring in-and-out catheterization or Foley catheter placement. Fisher exact and Wilcoxon tests were used for analysis. RESULTS: POUR developed in 35 patients (18%). Patients with POUR were older (P = .01), had increased baseline creatinine (P = .04), and a higher prevalence of benign prostatic hyperplasia (P = .007). POUR patients were also less likely to get a Foley catheter intraoperatively (P = .0002). Other intraoperative factors, such as surgical approach and extent of resection, were not significantly different between patients with and without POUR. Postoperative factors (epidural use or days with chest tube) were similar. Although patients with POUR were more likely to be discharged with a Foley catheter (13% vs 0%, P = .002), no difference in length of stay, incidences of urinary tract infections, or 30-day readmission were observed. CONCLUSIONS: POUR develops in approximately 1 in 5 patients undergoing lung resection. Patients with POUR were more likely to not have a Foley catheter placed intraoperatively. However, patients who had POUR did not have worsened patient outcomes (urinary tract infections, length of stay, or 30-day readmission).