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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.

Washington, May 19: As the scientists across the world are struggling to develop a vaccine for combating coronavirus, US drugmaker Moderna announced on Monday (local time) that the phase I trial of its Covid-19 vaccine has shown positive early results.

The company is hopeful that it's vaccine could be available to the public as early as January next year. Several firms across the world are in the race to develop a vaccine for the deadly virus which has claimed over 3 lakh lives worldwide.

CNN citing Dr. Tal Zaks, Moderna's chief medical officer reported that "if future studies go well, the company's vaccine could be available to the public as early as January".

"This is absolutely good news and news that we think many have been waiting for for quite some time," Zaks was quoted as saying.

Moderna, based in Cambridge, Massachusetts announced that the vaccine developed neutralising antibodies to the virus at levels reaching or exceeding the levels seen in people who have naturally recovered from Covid-19, reported CNN.

These will be followed by phase 2 trials and phase 3 trials, which Moderna plans to start in July.

President Donald Trump had on Friday said that that the United States will be able to deliver a few hundred million doses of COVID-19 vaccine, under 'Operation Warp Speed', by the end of this year.

"I have very recently seen early data from a clinical trial with a coronavirus vaccine and this data made me feel even more confident that we'll be able to deliver a few hundred million doses of vaccine by the end of 2020 and we will do the best we can," Trump had said at a press conference at the White House on Friday.

New Delhi, Mar 16: Due to the coronavirus pandemic, most airlines in the world will be bankrupt by the end of May and only a coordinated government and industry action right now can avoid the catastrophe, said global aviation consultancy firm CAPA in a note on Monday.

"As the impact of the coronavirus and multiple government travel reactions sweep through our world, many airlines have probably already been driven into technical bankruptcy, or are at least substantially in breach of debt covenants," it stated.

Across the world, airlines have announced drastic reduction in their operations in the wake of the coronavirus outbreak. For example, Atlanta-based Delta Air Lines stated on Sunday that it would be grounding 300 aircraft in its fleet and reduce flights by 40 per cent.

The US has suspended all tourist visas for people belonging to the European Union, the UK and Ireland. Similarly, the Indian government has suspended all tourist visas and e-visas granted on or before March 11.

CAPA, in its note on Monday, said, "By the end of May-2020, most airlines in the world will be bankrupt. Coordinated government and industry action is needed - now - if catastrophe is to be avoided."

Cash reserves are running down quickly as fleets are grounded and "what flights there are operate much less than half full", it added.

"Forward bookings are far outweighed by cancellations and each time there is a new government recommendation it is to discourage flying. Demand is drying up in ways that are completely unprecedented. Normality is not yet on the horizon," it said.

India's largest airline IndiGo -- which has around 260 planes in its fleet -- said on Thursday that it has seen a decline of 15-20 per cent in daily bookings in the last few days.

The low-cost carrier had stated that it expects its quarterly earnings to be materially impacted due to such decline.

CAPA said the failure to coordinate the future will result in protectionism and much less competition.

"The alternative does not bear thinking about. An unstructured and nationalistic outcome will not be survival of the fittest.

"It will mostly consist of airlines that are the biggest and the best-supported by their governments. The system will reek of nationalism. And it will not serve the needs of the 21st century world. That is not a prospect that any responsible government should be prepared to contemplate," the consultancy firm said.