Impact of Prior Dengue or Chikungunya Infection on Bariatric Surgery Outcomes: An Observational Prospective Study.

Abstract

Background: The chronic inflammatory state associated with obesity, when coupled with microcirculatory alterations caused by dengue virus (DENV) or chikungunya virus (CHIKV) infections, may be associated with adverse events in this population, including cellular aging, accelerated atherosclerosis, and metabolic dysfunction. Purpose: This study aimed to explore whether prior DENV or CHIKV infection is associated with differences in bariatric operation outcomes. Methods: This prospective study took place from February 2020 to November 2021 at a specialized center in Brazil. Data were analyzed during July 2024. It included bariatric operation candidates with reactive IgG serology for DENV or CHIKV, indicating previous infection without active disease. Patients were followed to determine the impact of these arboviruses on the post-operative follow-up of bariatric surgical procedure. Over a 36-month follow-up period after operation, weight loss and metabolic and biochemical profiles of these patients were assessed, comparing them to a comparison group with no history of infection (non-reactive IgG serology). Patients were categorized into four groups: non-reactive IgG (Group 1, n = 37), DENV_IgG+ (Group 2, n = 135), CHIKV_IgG+ (Group 3, n = 22), and IgG+ for both DENV and CHIKV (Group 4, n = 20). Results: A total of 172 patients were included, with a majority being female (75.3%) and an average age ranging from 36.3 years to 41.1 years. The mean body mass index (BMI) across groups ranged from 38.5 kg/m² to 39.4 kg/m², with no significant differences. The prevalence of reactive IgG for DENV was 78.4%, and for CHIKV, it was 12.7%, with an overlap of 11.6% between groups. No significant differences were observed in post-operative BMI or glycemic profile. However, mean low-density lipoprotein cholesterol was substantially greater in groups 3 (103.6 vs. 129.5 mg/dL, p < 0.001) and 4 (103.6 vs. 128.7 mg/dL, p < 0.001). Conclusion: Previous DENV or CHIKV infection was not associated with differences in the outcomes of bariatric operation after a 36-month follow-up.