Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality ). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

Recent literature on knowledge spillovers argues that diversified economic structures are more conducive to knowledge spillovers than specialized structures: a concept that is generally known as Jacobian Externalities. It further argues that diversification can be further decomposed into two forms, that is, related variety (RV) and unrelated variety (UV). RV is the diversification of production in related or similar products, whereas UV is the diversification of production in unrelated or dissimilar products. Most of the existing research on RV and UV is on advanced economies, and research on developing countries, particularly in the South Asian region that mostly produces agricultural and textile products, is scarce. Therefore, this study examines the relationship between RV and UV with economic growth in six South Asian countries using secondary data from 1995 to 2019. Since products at two-digit Standard International Trade Classification are unrelated to each other, UV is calculated at the two-digit level and RV is calculated at the five-digit level because of the similarity among sectors. Using fixed-effects regressions on the standard growth model, our findings suggest that related specialization is beneficial for economic growth in South Asian countries, and UV has a positive relationship with growth only when government effectiveness is high. Our results show that South Asian countries should produce selected products under the broad product classification to benefit from economies of scale instead of diversifying their product portfolio by producing similar products.

Fear of CIVID-19 and psychological health issues are most common in general population, health professionals and students after emerging the COVID-19 infection. The literature review elaborated the correlation among fear of COVID-19, stress, depression and anxiety among students at different levels.The current study was conducted with two objectives. First aim was to assess the relationships among fear of COVID-19, stress, anxiety and depression among university students. The second objective was to measure the mediating role of anxiety and stress between the relationship of fear of COVID-19 and depression.Total 500 Government and private university students were selected through convenient sampling technique to obtain the online data. Fear of COVID-19 Scale and Depression, Anxiety & Stress Scale were used as measuring tool to collect data. The results depicted that fear of COVID-19, stress, depression and anxiety had statistically significant positive relationships with each other. Mediation analysis also indicated the anxiety and stress as mediators with significant value (FCV with depression= p≥.05) and direct effect (-, +) in the presence of the mediators (anxiety and stress).The current study indicated the dire need of counseling services for students in order to reduce the fear of COVID-19 and symptoms of psychological disturbance.

Objective: To compare and predict the irrational beliefs and cognitive functioning among depressed and non-depressed adults in Gujrat, Pakistan. Study Design: Comparative cross-sectional study. Place and Duration of Study: Zulfiqar Hospital, Akram Hospital and Aziz Bhatti Hospital, Gujrat and Department of Psychology, the University of Gujrat from Dec 2017 to Mar 2018. Methodology: The data was collected from 200 adults, 100 depressed adults and 100 non-depressed adults using consecutive sampling. The non-depressed adults with no past psychiatric history were recruited from the community. The irrational beliefs were assessed using the Evaluative beliefs scale, and cognitive functioning was measured using the Montreal cognitive assessment scale. Results: The independent sample t-test indicated that there was a statistically significant difference (p<0.001) in the irrational beliefs of depressed and non-depressed adults, and the irrational beliefs of depressed were more (37.83 ± 8.12) than the nondepressed adults (4.33 ± 4.64). The comparison of cognitive functioning of the depressed and non-depressed was also significantly different (p<0.001). The cognitive functioning of depressed adults was poorer (12.44 ± 3.85) than the nondepressed adults (26.92 ± 2.55). Further-more, irrational beliefs predict cognitive functioning [R²=0.729; F (1,198) = 532.763, p<0.001]. Conclusion: The study findings indicated a difference in the irrational beliefs and cognitive functioning of depressed and nondepressed adults. Further, the depressed had more irrational beliefs and worsened cognitive functioning.