The change in the frequency of community acquired acute respiratory tract infections in weight loss period after bariatric surgery: An observational case-crossover study. Are those who have had bariatric surgery at risk?

Serdar Coşkun; Cüneyt Kırkıl; Gamze Kirkil

doi:10.25000/acem.938844

Research Article

The change in the frequency of community acquired acute respiratory tract infections in weight loss period after bariatric surgery: An observational case-crossover study. Are those who have had bariatric surgery at risk?

Year 2021, Volume: 6 Issue: 2, 50 - 55, 02.08.2021

Serdar Coşkun Cüneyt Kırkıl , Gamze Kirkil

https://doi.org/10.25000/acem.938844

Abstract

Aim: It is unknown whether there is an increase in the frequency of acquired respiratory tract infections (ARTIs) while the weight loss process continues after bariatric surgery (BS).
Methods: An observational case-crossover study of 366 patients underwent BS between September 2018 and September 2019 was performed. Prospectively recorded data of ARTI events in the first pre- and post-operative ARTI seasons were compared.
Results: Mean age was 36.4 ± 10.9 years and mean body mass index (BMI) was 44.1 ± 6.2 kg/m2. Mean change in BMI in an ARTI season was 13.2 ± 6.1 kg/m2. Among 366 patients, 180 (49.2%) were diagnosed with ARTI and the average numbers of ARTIs was 0.69 ± 0.85 in preoperative season. During the postoperative season, 134 (36.6%) patients were diagnosed with ARTI and the average numbers of ARTIs was 0.49 ± 0.76. Both period prevalence and average number of ARTIs in preoperative ARTI season was significantly higher than postoperative season (P = 0.001 for both). The change in BMI in an ARTI season was correlated with the postoperative period prevalence of ARTIs (r = 0.119, P = 0.022).
Conclusion: These findings showed that the period prevalence and incidence of ARTIs reduced after BS. However, the frequency of ARTIs was higher in patients with greater weight loss.

Keywords

Bariatric surgery, weight loss, acute respiratory tract infection

References

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2. Torrance HDT, Pearse RM, O’Dwyer MJ. Does major surgery induce immune suppression and increase the risk of postoperative infection? Curr Opin Anaesthesiol. 2016; 29(3): 376– 383.
3. Baigrie RJ, Lamont PM, Kwiatkowski D, Dallman MJ, Morris PJ. Systemic cytokine response after major surgery. Br J Surg. 1992; 79(8): 757– 760.
4. Klava A, Windsor AC, Farmery SM, Woodhouse LF, Reynolds JV et al. Interleukin–10. A role in the development of postoperative immunosuppression. Arch Surg. 1997; 132(4): 425– 429.
5. Mraz M, Haluzik M. The role of adipose tissue immune cells in obesity and low–grade inflammation. J Endocrinol. 2014; 222(3): R113– 127.
6. Poitou C, Dalmas E, Renovato M, Benhamo V, Hajduch F et al. CD14dimCD16+ and CD14+CD16+ monocytes in obesity and during weight loss: relationships with fat mass and subclinical atherosclerosis. Arterioscler Thromb Vasc Biol. 2011; 31(10): 2322– 2330.
7. Mertz D, Kim TH, Johnstone J, Lam P-P, Science M et al. Populations at risk for severe or complicated influenza illness: systematic review and meta–analysis. Br Med J 2013; 347: f5061.
8. Çiçek C, Arslan A, Karakuş HS, Yalaz M, Saz EU, Pullukçu H, Çok G. Akut solunum yolu enfeksiyonu olan hastalarda solunum viruslarının prevalansı ve mevsimsel dağılımı, 2002-2014 [Prevalence and seasonal distribution of respiratory viruses in patients with acute respiratory tract infections, 2002-2014]. Mikrobiyol Bul. 2015 Apr;49(2):188-200. Turkish. doi: 10.5578/mb.9024. PMID: 26167819.
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13. Tsatsanis C, Margioris AN, Kontoyiannis DP. Association between H1N1 infection severity and obesity–adiponectin as a potential etiologic factor. J Infect Dis. 2010; 202(3): 459– 460.
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15. Huttunen R, Syrjänen J. Obesity and the risk and outcome of infection. Int J Obes. 2013; 37(3): 333– 340.
16. Ferkol T, Schraufnagel D. The Global Burden of Respiratory Disease. Ann Am Thorac Soc. 2014; 11(3): 404– 406.
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19. Gupta R, Ghosh A, Singh AK, Misra A. Clinical considerations for patients with diabetes in times of COVID–19 epidemic. Diabetes Metab Syndr. 2020; 14(3): 211– 212.
20. Rodriguez L, Cervantes E, Ortiz R. Malnutrition and Gastrointestinal and Respiratory Infections in Children: A Public Health Problem. Int J Environ Res Public Health. 2011; 8(4): 1174– 1205.
21. Schaible UE, Kaufman SHE. Malnutrition and infection: complex mechanisms and global impacts. PLoS Med. 2007; 4(5): e115.
22. Sirisinha S. The pleotropic role of vitamin A in regulating mucosal immunity. Asian Pac J Allergy Immunol. 2015; 33(2): 71– 89.
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26. Sethi S. Infection as a comorbidity of COPD. Eur Respir J. 2010; 35(6): 1209–1215.
27. Franssen FM, O'Donnell DE, Goossens GH, Blaak EE, Schols AM. Obesity and the lung: 5. Obesity and COPD. Thorax 2008; 63(12): 1110– 1117.
28. Sutherland ER. Linking obesity and asthma. Ann N Y Acad Sci. 2014; 1311: 31– 41.
29. James KM, Peebles RS Jr, Hartert TV. Response to infections in patients with asthma and atopic disease: an epiphenomenon or reflection of host susceptibility? J Allergy Clin Immunol Pract. 2012; 130(2): 343– 351.
30. Chicaiza-Ayala W, Henríquez-Trujillo AR, Ortiz-Prado E, Douce RW, Coral-Almeida M. The burden of acute respiratory infections in Ecuador 2011-2015. PLoS One. 2018 May 1;13(5):e0196650.
31. https://www.grip.gov.tr/tr/2017-2018-haftalik-influenza-raporlari.html (access date: August 1, 2020).

Bariatrik cerrahi sonrası kilo kaybı döneminde toplum kökenli akut solunum yolu enfeksiyonlarının sıklığındaki değişim: Bir gözlemsel vaka-çapraz çalışma. Bariatrik cerrahi geçirenler risk altında mı?

Year 2021, Volume: 6 Issue: 2, 50 - 55, 02.08.2021

Serdar Coşkun Cüneyt Kırkıl , Gamze Kirkil

https://doi.org/10.25000/acem.938844

Abstract

Amaç: Bariatrik cerrahi (BC) sonrası kilo verme süreci devam ederken, edinilmiş solunum yolu enfeksiyonlarının (ASYE) sıklığında bir artış olup olmadığı bilinmemektedir.
Yöntem: Eylül 2018-Eylül 2019 tarihleri arasında BC uygulanan 366 hastanın gözlemsel vaka-çapraz çalışması yapıldı. Ameliyat öncesi ve sonrası ilk ASYE mevsimlerinde ASYE olaylarının prospektif olarak kaydedilen verileri karşılaştırıldı.
Bulgular: Ortalama yaş 36.4 ± 10.9 yıl, ortalama vücut kitle indeksi (VKİ) 44.1 ± 6.2 kg/m2 idi. Bir ASYE mevsiminde VKİ’ndeki ortalama değişim 13.2 ± 6.1 kg / m2 idi. 366 hasta arasında 180 (%49.2) ASYE tanısı kondu ve preoperatif sezonda ortalama ASYE sayısı 0.69 ± 0.85 idi. Postoperatif dönemde 134 (%36.6) hastaya ASYE tanısı kondu ve ortalama ASYE sayısı 0.49 ± 0.76 idi. Preoperatif ASYE sezonunda hem dönem prevalansı hem de ortalama ASYE sayısı postoperatif sezona göre anlamlı derecede yüksekti (her ikisi için de p = 0.001). Bir ASYE mevsiminde VKİ’deki değişim, ASYE’nun postoperatif dönem prevalansı ile korele idi (r = 0.119, p = 0.022).
Sonuç: Bu bulgular, BC sonrası ASYE prevalansının ve insidansının azaldığını göstermiştir. Bununla birlikte, daha fazla kilo kaybı olan hastalarda ASYE sıklığı daha yüksekti.

Keywords

Bariatrik cerrahi, kilo kaybı, akut solunum yolu enfeksiyonu

References

1. English WJ, DeMaria EJ, Hutter MM, Kothari SN, Mattar SG et al. American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States. Surg Obes Relat Dis. 2020; 16(4): 457– 463.
2. Torrance HDT, Pearse RM, O’Dwyer MJ. Does major surgery induce immune suppression and increase the risk of postoperative infection? Curr Opin Anaesthesiol. 2016; 29(3): 376– 383.
3. Baigrie RJ, Lamont PM, Kwiatkowski D, Dallman MJ, Morris PJ. Systemic cytokine response after major surgery. Br J Surg. 1992; 79(8): 757– 760.
4. Klava A, Windsor AC, Farmery SM, Woodhouse LF, Reynolds JV et al. Interleukin–10. A role in the development of postoperative immunosuppression. Arch Surg. 1997; 132(4): 425– 429.
5. Mraz M, Haluzik M. The role of adipose tissue immune cells in obesity and low–grade inflammation. J Endocrinol. 2014; 222(3): R113– 127.
6. Poitou C, Dalmas E, Renovato M, Benhamo V, Hajduch F et al. CD14dimCD16+ and CD14+CD16+ monocytes in obesity and during weight loss: relationships with fat mass and subclinical atherosclerosis. Arterioscler Thromb Vasc Biol. 2011; 31(10): 2322– 2330.
7. Mertz D, Kim TH, Johnstone J, Lam P-P, Science M et al. Populations at risk for severe or complicated influenza illness: systematic review and meta–analysis. Br Med J 2013; 347: f5061.
8. Çiçek C, Arslan A, Karakuş HS, Yalaz M, Saz EU, Pullukçu H, Çok G. Akut solunum yolu enfeksiyonu olan hastalarda solunum viruslarının prevalansı ve mevsimsel dağılımı, 2002-2014 [Prevalence and seasonal distribution of respiratory viruses in patients with acute respiratory tract infections, 2002-2014]. Mikrobiyol Bul. 2015 Apr;49(2):188-200. Turkish. doi: 10.5578/mb.9024. PMID: 26167819.
9. Han YY, Forno E, Gogna M, Celedon JC. Obesity and rhinitis in a nationwide study of children and adults in the United States. J Allergy Clin Immunol Pract. 2016; 137(5): 1460–1465.
10. Cocoros NM, Lash TL, DeMaria A Jr, Klompas M. Obesity as a risk factor for severe influenza–like illness. Influenza Other Respir Viruses. 2014; 8(1): 25– 32.
11. Kaspersen KA, Pedersen OB, Petersen MS, Hjalgrim H, Rostgaard K et al. Obesity and risk of infection: results from the Danish blood donor study. Epidemiology. 2015; 26(4): 580– 589.
12. Harpsoe MC, Nielsen NM, Friis–Moller N, Andersson M, Wohlfahrt J et al. Body mass index and risk of infections among women in the Danish National Birth Cohort. Am J Epidemiol. 2016; 183(11): 1008– 1017.
13. Tsatsanis C, Margioris AN, Kontoyiannis DP. Association between H1N1 infection severity and obesity–adiponectin as a potential etiologic factor. J Infect Dis. 2010; 202(3): 459– 460.
14. Huttunen R, Syrjänen J. Obesity and the outcome of infection. Lancet Infect Dis. 2010; 10(7): 442– 443.
15. Huttunen R, Syrjänen J. Obesity and the risk and outcome of infection. Int J Obes. 2013; 37(3): 333– 340.
16. Ferkol T, Schraufnagel D. The Global Burden of Respiratory Disease. Ann Am Thorac Soc. 2014; 11(3): 404– 406.
17. Arcavi L, Benowitz NL. Cigarette smoking and infection. AMA Arch Intern Med. 2004; 164(20): 2206– 2216.
18. Huttunen R, Heikkinen T, Syrjanen J. Smoking and the outcome of infection. J Intern Med. 2011; 269(3): 258– 269.
19. Gupta R, Ghosh A, Singh AK, Misra A. Clinical considerations for patients with diabetes in times of COVID–19 epidemic. Diabetes Metab Syndr. 2020; 14(3): 211– 212.
20. Rodriguez L, Cervantes E, Ortiz R. Malnutrition and Gastrointestinal and Respiratory Infections in Children: A Public Health Problem. Int J Environ Res Public Health. 2011; 8(4): 1174– 1205.
21. Schaible UE, Kaufman SHE. Malnutrition and infection: complex mechanisms and global impacts. PLoS Med. 2007; 4(5): e115.
22. Sirisinha S. The pleotropic role of vitamin A in regulating mucosal immunity. Asian Pac J Allergy Immunol. 2015; 33(2): 71– 89.
23. Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB et al. Epidemic influenza and vitamin D. Epidemiol Infect. 2006; 134(6): 1129– 1140.
24. Johnston CS, Barkyoumb GM, Schumacher SS. Vitamin C supplementation slightly improves physical activity levels and reduces cold incidence in men with marginal vitamin C status: a randomized controlled trial. Nutrients 2014; 6(7): 2572– 2583.
25. Jafarinejad H, Moghoofei M, Mostafaei S, Salimian J, Jamalkandi SA, Ahmadi A. Worldwide prevalence of viral infection in AECOPD patients: A metaanalysis. Microb Pathog. 2017; 113: 190– 196.
26. Sethi S. Infection as a comorbidity of COPD. Eur Respir J. 2010; 35(6): 1209–1215.
27. Franssen FM, O'Donnell DE, Goossens GH, Blaak EE, Schols AM. Obesity and the lung: 5. Obesity and COPD. Thorax 2008; 63(12): 1110– 1117.
28. Sutherland ER. Linking obesity and asthma. Ann N Y Acad Sci. 2014; 1311: 31– 41.
29. James KM, Peebles RS Jr, Hartert TV. Response to infections in patients with asthma and atopic disease: an epiphenomenon or reflection of host susceptibility? J Allergy Clin Immunol Pract. 2012; 130(2): 343– 351.
30. Chicaiza-Ayala W, Henríquez-Trujillo AR, Ortiz-Prado E, Douce RW, Coral-Almeida M. The burden of acute respiratory infections in Ecuador 2011-2015. PLoS One. 2018 May 1;13(5):e0196650.
31. https://www.grip.gov.tr/tr/2017-2018-haftalik-influenza-raporlari.html (access date: August 1, 2020).

There are 31 citations in total.

Details

Primary Language	English
Subjects	Surgery
Journal Section	Original Research
Authors	Serdar Coşkun This is me 0000-0002-7238-6032 Cüneyt Kırkıl 0000-0001-8756-4850 Gamze Kirkil 0000-0003-4799-5589
Publication Date	August 2, 2021
Published in Issue	Year 2021 Volume: 6 Issue: 2

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Vancouver	Coşkun S, Kırkıl C, Kirkil G. The change in the frequency of community acquired acute respiratory tract infections in weight loss period after bariatric surgery: An observational case-crossover study. Are those who have had bariatric surgery at risk?. Arch Clin Exp Med. 2021;6(2):50-5.

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