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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.

Citing the current dismal aviation scenario, Air India is terminating the services of trainee cabin crew and cabin crew by withdrawing the offer of employment of those who were under training.

As per sources, the new crew and trainee pilots might reduce contracts from five years to one year. Sources said Air India is terminating 1,200 crew and employees who are more than 55-yr-old including 190 trainee pilots.

In a letter reviewed by IANS, Air India has informed an applicant who had been selected as cabin crew in August 2019 subject to successful completion of training.

"On behalf of Air India we would like to thank you for the interest shown by you in joining our organization. However, in view of the current aviation scenario, it would not be possible for Air India to impart any further training to you for engaging your services," the company said.

"In view of the above reasons, which are beyond the control of the company, it has been decided to discontinue your training arrangements and dispense with the offer of engagement with immediate effect. The bank guarantee furnished by you at the time of joining is returned herewith," Air India told the cabin crew.

"Once again on behalf of Air India we thank you for your cooperation and trust that you will appreciate the circumstances under which we are constrained to discontinue the training arrangements," the carrier said.

New Delhi, Mar 7: The Union government has issued a Global Invite for Expression of Interest for disinvestment in Bharat Petroleum Corporation Limited (BPCL) from prospective bidders with a minimum net worth of $10 billion as of Saturday.

The EoI submissions can be made till May 2, whereas investor queries will be entertained till April 4.

Another condition pertains to a maximum of four members are permitted in a consortium, and the lead member must hold 40 per cent in proportion. Other members of the consortium must have a minimum $1 billion net worth.

The EOI allows changes in the consortium within 45 days, though the lead member cannot be changed.

The GoI proposes to disinvest its entire shareholding in BPCL comprising 1,14,91,83,592 equity shares held through the Ministry of Petroleum and Natural Gas, which constitutes 52.98 per cent of BPCL's equity share capital, along with the transfer of management control to the strategic buyer (except BPCL's equity shareholding of 61.65 per cent in Numaligarh Refinery Limited (NRL) and management control thereon).

The shareholding of BPCL in NRL will be transferred to a Central Public Sector Enterprise operating in the oil and gas sector under the Ministry and accordingly is not a part of the proposed transaction.