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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.

Giving each and every app access to personal information stored on Android smartphones such as your contacts, call history, SMS and photos may put you in trouble as bad actors can easily use these access to spy on you, send spam messages and make calls anywhere at your expense or even sign you up for a premium "service", researchers from cybersecurity firm Kaspersky have warned.

But one can restrict access to such information as Android lets you configure app permissions. 

Giving an app any of these permissions generally means that from now on it can obtain information of this type and upload it to the Cloud without asking your explicit consent for whatever it intends to do with your data.

Therefore, security researchers recommend one should think twice before granting permissions to apps, especially if they are not needed for the app to work. 

For example, most games have no need to access your contacts or camera, messengers do not really need to know your location, and some trendy filter for the camera can probably survive without your call history, Kaspersky said. 

While decision to give permission is yours, the fewer access you hand out, the more intact your data will be.

Here's what you should know to protect your data.

SMS: An app with permission to send and receive SMS, MMS, and WAP (Wireless Application Protocol) push messages, as well as view messages in the smartphone memory will be able to read all of your SMS correspondence, including messages with one-time codes for online banking and confirming transactions.

Using this permission, the app can also send spam messages in your name (and at your expense) to all your friends. Or sign you up for a premium "service." You can see and conrol which apps have these rights by going to the settings of your phone.

Calendar: With permission to view, delete, modify, and add events in the calendar, prying eyes can find out what you have done and what you are doing today and in the future. Spyware loves this permission.

Camera: Permission to access the camera is necessary for the app to take photos and record video. But apps with this permission can take a photo or record a video at any moment and without warning. Attackers armed with embarrassing images and other dirt on you can make life a misery, according to Kaspersky.

Contacts: With permission to read, change, and add contacts in your address book, and access the list of accounts registered in the smartphone, an app can send your entire address book to its server. Even legitimate services have been found to abuse this permission, never mind scammers and spammers, for whom it is a windfall.

This permission also grants access to the list of app accounts on the device, including Google, Facebook, and many other services.

Phone: Giving access to your phone means permission to view and modify call history, obtain your phone number, cellular network data, and the status of outgoing calls, add voicemail, access IP telephony services, view numbers being called with the ability to end the call or redirect it to another number and call any number.

This permission basically lets the app do anything it likes with voice communication. It can find out who you called and when or prevent you from making calls (to a particular number or in general) by constantly terminating calls. 

It can eavesdrop on your conversations or, of course, make calls anywhere at your expense, including to pay-through-the-nose numbers, Kaspersky warned.

Amid the rapid spread of the novel coronavirus (COVID-19), which has infected 73 people in India and killed more than 4,500 individuals globally, doctors have advised that in addition to regularly washing hands, one should also disinfect their smartphone every 90 minutes with alcohol-based hand sanitizer.

Ravi Shekhar Jha, Head of Department at Fortis Escorts Hospital in Faridabad said the best method to disinfect your smartphone is to use regular doctor spirit or the alcohol-based hand sanitizer at least every 90 minutes.

"Avoid touching your eyes, mouth, or nose. The best option is to use a phone cover or a Bluetooth device and try to touch your phone as less as possible. We would also recommend cleaning your phone at least twice a day," Jha told IANS.

According to research, published in 2018 by Insurance2Go, a gadget insurance provider, revealed that smartphone screens have three times more germs than a toilet seat.

One in 20 smartphone users was found to clean their phones less than every six months, said the study.

"In the time of fear of coronavirus, smartphones should also be disinfected with alcohol-based sanitizer rub. Pour few drops of sanitizer on a tiny clean cotton pad and rub it safely on your entire phone," said Jyoti Mutta, Senior Consultant, Microbiology, Sri Balaji Action Medical Institute in New Delhi.

"You can repeat this process every evening coming back home after an entire day out at work and once in the morning before going out," Mutta added.

"Maintain basic cleanliness, and try to avoid using other's phones especially if suffering from respiratory illness or flu-like symptoms as there is no other way to disinfect these regular gadgets," she stressed.

Another study from the University of Surrey in the UK, also found that the home button on your smartphone may be harbouring millions of bacteria - some even harmful.

The World Health Organisation (WHO) declared the novel coronavirus as a global pandemic on Wednesday. The death toll of COVID-19 has crossed the 4,500 marks and confirmed cases globally have touched one lakh as per the reports.

According to Suranjeet Chatterjee, Senior Consultant in Internal Medicine Department of Indraprastha Apollo Hospitals in New Delhi, "We should frequently wash our hands, cover our coughs and it is important to adapt to other good hygiene habits that are most important in such a situation."

"Coronavirus and other germs can live on surfaces like glass, metal or plastics and phones are bacteria-ridden. It is necessary that we sanitize our hands frequently and make sure that our hands are clean all the time," Chatterjee told IANS.

"The emphasis should be laid on sanitising our hands rather than sanitizing the phone - once in a while the phone can be sanitized under the guidance of the makers of the phone," Chatterjee stressed.

According to the global health agency, the most effective way to protect yourself against coronavirus is by frequently cleaning of your hands with alcohol-based hand rub or washing them with soap and water.

The WHO's report showed the virus infects people of all ages, among which older people and those with underlying medical conditions are at a higher risk of getting infected.

People should eat only well-cooked food, avoid spitting in public, and avoid close contact, the WHO said, adding that it is important for people to seek medical care at the earliest if they become sick.