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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.

Paris, Jun 16: Increasing numbers of readers are paying for online news around the world even if the level of trust in the media, in general, remains very low, according to a report published Tuesday.

Around 20 percent of Americans questioned said they subscribed to an online news provider (up to four points over the previous year) and 42 percent of Norwegians (up eight points), along with 13 percent of the Dutch (up to three points), compared with 10 percent in France and Germany.

But between a third and a half of all news subscriptions go to just a few major media organisations, such as the New York Times, according to the annual Digital News Report by the Reuters Institute.

Some readers, however, are also beginning to take out more than one subscription, paying for a local or specialist title in addition to a national news source, the study's authors said.

But a large proportion of internet users say nothing could convince them to pay for online news, around 40 percent in the United States and 50 percent in Britain.

YouGov conducted the online surveys of 40 countries for the Reuters Institute in January, with 2,000 respondents in each.

Further surveys were carried out in six countries in April to analyse the initial effects of COVID-19.

The health crisis brought a revival of interest in television news -- with the audience rising five percent on average -- establishing itself as the main source of information along with online media.

Conversely, newspaper circulation was hard-hit by coronavirus lockdown measures.

The survey found trust in the news had fallen to its lowest level since the first report in 2012, with just 38 percent saying they trusted most news most of the time.

However, confidence in the news media varied considerably by country, ranging from 56 percent in Finland and Portugal to 23 percent in France and 21 percent in South Korea.

In Hong Kong, which has been hit by months of sometimes violent street protests against an extradition law, trust in the news fell 16 points to 30 percent over the year.

Chile, which has had regular demonstrations against inequality, saw trust in the media fall 15 percent while in Britain, where society has been polarised by issues such as Brexit, it was down 12 points.

New Delhi, Jun 12: The Supreme Court on Friday asked Solicitor General Tushar Mehta to convene a meeting of the Finance Ministry and RBI officials over the weekend to decide whether interest incurred on EMIs during the moratorium period can be charged by banks.

A bench comprising Justices Ashok Bhushan, Sanjay Kishan Kaul and M.R. Shah queried Mehta as the court was concerned since the Centre has deferred loan for three months.

"Then how can interest of these 3 months be added?" the apex bench asked. Mehta replied: "I need to sit down with the RBI officials and have a meeting."

SBI's counsel, senior advocate Mukul Rohatgi, intervened during the proceedings and said "all banks are of the view that interest cannot be waived for a six month EMI moratorium period".

"We need to discuss it with the RBI," insisted Rohatgi.

Justice Bhushan then asked Mehta to convene a meeting of the RBI and Finance Ministry officials over the weekend, and listed the matter for further hearing on June 17.

The top court, during the hearing, indicated that it was not considering a complete waiver of interest but was only concerned that postponement of interest shouldn't accrue further interest on it.

After the RBI said the waiver of interest charges on EMIs during moratorium will lead to loss of 1 per cent of the nation's GDP, the top court had earlier asked the Finance Ministry to reply, whether the interest could be waived or it would continue during the moratorium period.

The top court said these are not normal times, and it is a serious issue, as on one hand moratorium is granted and then, the interest is charged on loans during this period.

"There are two issues in this (matter). No interest during the moratorium period and no interest on interest," said Justice Bhushan. The observation from the bench came on a petition by Gajendra Sharma, in which he sought a direction to declare portion of the RBI's March 27 notification as ultra vires to the extent it charged interest on the loan amount during the moratorium period.