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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.

New Zealand's research institute in Antarctica is scaling back the number of projects planned for the upcoming season, in an effort to keep the continent free of coronavirus, it was reported on Tuesday.

The government agency, Antarctica New Zealand, told the BBC on Tuesday that it was dropping 23 of the 36 research projects.

Only long-term science monitoring, essential operational activity and planned maintenance will go ahead.

The upcoming research season runs from October to March.

"As COVID-19 sweeps the planet, only one continent remains untouched and (we) are focused on keeping it that way," Antarctica New Zealand told the BBC.

The organisation's chief executive Sarah Williamson said the travel limits and a strict managed isolation plan were the key factors for keeping Scott Base - New Zealand's research facility - virus free.

"Antarctica New Zealand is committed to maintaining and enhancing the quality of New Zealand's Antarctic scientific research. However, current circumstances dictate that our ability to support science is extremely limited this season" she said.

Earlier in April, Australia announced that it would scale back its activity in the 2020-21 summer season.

This included decreasing operational capacity and delaying work on some major projects.

New Delhi, Jul 19: Indian equities will be driven by a host of factors like corporate earnings, coronavirus cases trend and geo-political developments this week, according to analysts.

Market participants will also keenly watch the progress of monsoon, with experts saying that the farm sector revival will play a key role in lifting the coronavirus-hit economy.

"With no major event, the ongoing earnings season and global cues will continue to dictate the market trend. Besides, the progress of monsoon will also be closely watched," Ajit Mishra, VP - Research, Religare Broking, said.

Globally, the rising coronavirus infections and geo-political tensions have created uncertainty on the economic recovery front.

With India's COVID-19 cases fast approaching the 11 lakh mark, the third-highest behind the US and Brazil, and the death toll nearing 27,000, participants are expected to tread cautiously going forward.

At global level, confirmed COVID-19 cases have crossed 1.4 crore and deaths totalled about 6 lakh.

Markets globally will closely follow developments on the trade and political level between the US and China, according to analysts.

"We would continue witnessing stock-specific action as the earnings season unfold. Though the near-term momentum looks positive, we would advise traders to be cautious, given flaring US-China trade relations, persistent rise in virus cases and implementation of fresh lockdowns in parts of the country," said Siddhartha Khemka, Head - Retail Research, Motilal Oswal Financial Services Ltd.

HDFC Bank will remain in focus on Monday after having announced its June quarter earnings on Saturday.

The lender reported 19.6 per cent rise in its standalone net profit at Rs 6,658.62 crore for April-June 2020; while its income rose to Rs 34,453.28 crore during the quarter.

Other major companies to announce their quarterly results this week are Axis Bank, Bajaj Finance, Hindustan Unilever Limited, Bajaj Auto and ITC.

"Going ahead market participants will closely track the development related to covid vaccine, the rising infection of coronavirus, development on economic activities, corporate earnings and US-China relationship," said Sumeet Bagadia, Executive Director, Choice Broking.

On weekly basis, the Sensex gathered 425.81 points or 1.16 per cent, and the Nifty gained 133.65 points or 1.24 per cent.