IntroductionPatients infected with novel COVID-19 virus have a spectrum of illnesses ranging from asymptomatic to death . Data has shown that age, gender and obesity are strongly correlated with poor outcomes in COVID-19 positive patients . Bariatric surgery is the only treatment that provides significant, sustained weight loss in the severely obese . We look at whether prior bariatric surgery correlates with increased risk of hospitalization and outcome severity after COVID-19 infection . MethodsA cross-sectional retrospective analysis of a COVID-19 database from a single, NYC-based, academic institution was conducted . A cohort of COVID-19 positive patients with a history of bariatric surgery (n=124) were matched in a 4:1 ratio to a control cohort of COVID-19 positive patients who were eligible for bariatric surgery (BMI [≥] 40 kg/m2 or BMI [≥] 35 kg/m2 with a comorbidity) (n=496). A comparison of outcomes, including mechanical ventilation requirements and deceased at discharge, was done between cohorts using Chi-square test or Fishers exact test . Additionally, overall length of stay and duration of time in ICU were compared using Wilcoxon Rank Sum test . Conditional logistic regression analyses were done to determine both unadjusted (UOR) and adjusted odds ratios (AOR). ResultsA total of 620 COVID-19 positive patients were included in this analysis . The categorization of bariatric surgeries included 36% Roux-en-Y Gastric Bypass (RYGB, n=45), 35% laparoscopic adjustable gastric banding (LAGB, n=44), and 28% laparoscopic sleeve gastrectomy (LSG, n=35). The body mass index (BMI) for the bariatric group was 36.1 kg/m2 (SD=8.3), which was significantly lower than the control group , 41.4 kg/m2 (SD=6.5) (p <0.0001). There was also less burden of diabetes in the bariatric group (32 %) compared to the control group (48 %) (p=0.0019). Patients with a history of bariatric surgery were less likely to be admitted through the emergency room (UOR=0.39, p=0.0001), less likely to have had a ventilator used during the admission (UOR=0.42, p=0.028), had a shorter length of stay in both the ICU (p=0.033) and overall (UOR=0.44, p=0.0002), and were less likely to be deceased at discharge compared to the control group (OR=0.42, p=0.028). ConclusionA history of bariatric surgery significantly decreases the risk of emergency room admission, mechanical ventilation, prolonged ICU stay, and death in patients with COVID-19.