COVID-19 patients undergo surgery at increased death risk: Lancet study

News Network
May 30, 2020

May 30: Patients undergoing surgery after contracting the novel coronavirus are at an increased risk of postoperative death, according to a new study published in The Lancet journal which may lead to better treatment guidelines for COVID-19.

In the study, the scientists, including those from the University of Birmingham in the UK, examined data from 1,128 patients from 235 hospitals from a total of 24 countries.

Among COVID-19 patients who underwent surgery, they said the death rates approach those of the sickest patients admitted to intensive care after contracting the virus.

The scientists noted that SARS-CoV-2 infected patients who undergo surgery, experience substantially worse postoperative outcomes than would be expected for similar patients who do not have the infection.

According to the study, the 30-day mortality among these patients was nearly 24 per cent.

The researchers noted that mortality was disproportionately high across all subgroups, including those who underwent elective surgery (18.9 per cent), and emergency surgery (25.6 per cent).

Those who underwent minor surgery, such as appendicectomy or hernia repair (16.3 per cent), and major surgery such as hip surgery or for colon cancer also had higher mortality rates (26.9 per cent), the study said.

According to the study, the mortality rates were higher in men versus women, and in patients aged 70 years or over versus those aged under 70 years.

The scientists said in addition to age and sex, risk factors for postoperative death also included having severe pre-existing medical problems, undergoing cancer surgery, undergoing major procedures, and undergoing emergency surgery.

"We would normally expect mortality for patients having minor or elective surgery to be under 1 per cent, but our study suggests that in SARS-CoV-2 patients these mortality rates are much higher in both minor surgery (16.3%) and elective surgery (18.9%)," said study co-author Aneel Bhangu from the University of Birmingham.

Bhangu said these mortality rates are greater than those reported for even the highest-risk patients before the pandemic.

Citing an example from the 2019 UK National Emergency Laparotomy Audit report, he said the 30-day mortality was 16.9 per cent in the highest-risk patients.

Based on an earlier study across 58 countries, Bhangu said the 30-day mortality was 14.9 per cent in patients undergoing high-risk emergency surgery.

"We recommend that thresholds for surgery during the SARS-CoV-2 pandemic should be raised compared to normal practice," he said.

"For example, men aged 70 years and over undergoing emergency surgery are at particularly high risk of mortality, so these patients may benefit from their procedures being postponed," Bhangu added.

The study also noted that patients undergoing surgery are a vulnerable group at risk of SARS-CoV-2 exposure in hospital.

It noted that the patients may also be particularly susceptible to subsequent pulmonary complications, due to inflammatory and immunosuppressive responses to surgery and mechanical ventilation.

The scientists found that overall in the 30 days following surgery 51 per cent of patients developed a pneumonia, acute respiratory distress syndrome, or required unexpected ventilation.

Nearly 82 per cent of the patients who died had experienced pulmonary complications, the researchers said.

"Worldwide an estimated 28.4 million elective operations were cancelled due to disruption caused by COVID-19," said co-author Dmitri Nepogodiev from the University of Birmingham.

"Our data suggests that it was the right decision to postpone operations at a time when patients were at risk of being infected with SARS-CoV-2 in hospital," Nepogodiev said.

According to the researchers, there's now an urgent need for investment by governments and health providers in to measures which ensure that as surgery restarts patient safety is prioritised.

They said this includes the provision of adequate personal protective equipment (PPE), establishment of pathways for rapid preoperative SARS-CoV-2 testing, and consideration of the role of dedicated 'cold' surgical centres.

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Agencies
January 20,2020

Washington D.C., Jan 20: An American bride asked for money from her invitees so that they can be on the 'exclusive guest list'.

Weddings can be surely expensive. But is it feasible for one to charge the guests to make up for the expenses?

According to Fox News, that is exactly what happened in a recent American wedding. A 19-year-old shared on Reddit that her cousin was getting married on Sunday and announced that she would charge 50 dollars to those who wanted to attend her wedding.

"She said that they can Venmo her money so there won't be no [sic] problems and everyone who paid will be added onto the 'exclusive guest list' which basically means you won't have to wait in line while other guests pay," wrote the user named DaintySheep.

While she refused to pay for entry into her cousin's wedding the bride-to-be contacted the elders in the family which ended up in an embarrassing situation.

"She wanted to get the money she spent on her special day back. I told her I wouldn't be able to come because this was outrageous and that I wish her well on her special day. She contacted my aunt and my aunt called me cheap and rude. My parents offered to pay for my entry, but I refused," continued the disheartened girl.

While in almost every nook and cranny of the world gifting the bride-groom with money is a tradition, asking for money from friends and family to replenish the money spent on a wedding is can be said to be a rare scenario.

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Agencies
June 26,2020

Facebook will introduce a new notification screen on its platform that will warn users if the article they are about to share is over 90 days old, the company announced on Thursday.

“We’re starting to globally roll out a notification screen that will let people know when news articles they are about to share are more than 90 days old,” Facebook wrote in a blog post.

The social media platform had previously introduced a context button in 2018 that provides information about the sources of articles in the News Feed. Building upon that, the new feature will inform users about the timeliness of the article.

“To ensure people have the context they need to make informed decisions about what to share on Facebook, the notification screen will appear when people click the share button on articles older than 90 days, but will allow people to continue sharing if they decide an article is still relevant,” Facebook said.

The social media giant stated that timeliness is important in understanding the context of an article and curbing the spread of misinformation on the platform.

“News publishers, in particular, have expressed concerns about older stories being shared on social media as current news, which can misconstrue the state of current events. Some news publishers have already taken steps to address this on their own websites by prominently labelling older articles to prevent outdated news from being used in misleading ways,” Facebook added.

Apart from this, the platform will also be testing a similar notification screen for information related to the global Covid-19 pandemic. The notification screen will provide information about the source of the link shared in a post if the link is related to information on Covid-19. It will also direct people to its previously introduced Covid-19 information centre for “authoritative” health information, it said.

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News Network
February 21,2020

London, Feb 21: Scientists have discovered a new species of land snail, and have named it Craspedotropis Greta Thunberg in honour of the Swedish activist Greta Thunberg for her efforts to raise awareness about climate change.

According to the study, published in the Biodiversity Data Journal, the newly discovered species belongs to the so-called caenogastropods -- a group of land snails known to be sensitive to drought, temperature extremes, and forest degradation.

The scientists, including evolutionary ecologist Menno Schilthuizen from Naturalis Biodiversity Center in the Netherlands, said the snails were found very close to the research field station at Kuala Belalong Field Studies Centre in Brunei.

They added that the snails were discovered at the foot of a steep hill-slope, next to a river bank, foraging at night on the green leaves of understorey plants.

The effort aided by amateur scientist J.P. Lim, who found the first individual of the snail said, "Naming this snail after Greta Thunberg is our way of acknowledging that her generation will be responsible for fixing problems that they did not create."

"And it's a promise that people from all generations will join her to help," Lim said.

The researchers said they approached Thunberg who said that she would be "delighted" to have this species named after her.

The study work including, fieldwork, morphological study, and classification of identified specimen was carried out in a field centre with basic equipment and no internet access, the scientists said.

According to the study, the work was done by untrained ‘citizen scientists’ guided by experts, on a 10-day taxon expedition.

"While we are aware that this way of working has its limitations in terms of the quality of the output (for example, we were unable to perform dissections or to do extensive literature searches), the benefits include rapid species discovery and on-site processing of materials," the researchers wrote in the study.

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