Bangla to stakes in Dhaka Stock Exchange to China; rejects India's offer

Washington, Apr 28: After nearly three weeks in an intensive care unit in Los Angeles, doctors treating 41-year-old Broadway actor Nick Cordero for COVID-19 were forced to amputate his right leg.

The flow of blood had been impeded by a blood clot: yet another dangerous complication of the disease that has been bubbling up in frontline reports from China, Europe and the United States.

To be sure, so-called "thrombotic events" occur for a variety of reasons among intensive care patients, but the rates among COVID-19 patients are far higher than would be otherwise expected.

"I have had 40-year-olds in my ICU who have clots in their fingers that look like they'll lose the finger, but there's no other reason to lose the finger than the virus," Shari Brosnahan, a critical care doctor at NYU Langone said.

One of these patients is suffering from a lack of blood flow to both feet and both hands, and she predicts an amputation may be necessary, or the blood vessels may get so damaged that an extremity could drop off by itself.

Blood clots aren't just dangerous for our limbs, but can make their way to the lungs, heart or brain, where they may cause lethal pulmonary embolisms, heart attacks, and strokes.

A recent paper from the Netherlands in the journal Thrombosis Research found that 31 percent of 184 patients suffered thrombotic complications, a figure that the researchers called "remarkably high" -- even if extreme consequences like amputation are rare.

Behnood Bikdeli, a doctor at New York-Presbyterian Hospital, assembled an international consortium of experts to study the issue. Their findings were published in the Journal of The American College of Cardiology.

The experts found the risks were so great that COVID-19 patients "may need to receive blood thinners, preventively, prophylactically," even before imaging tests are ordered, said Bikdeli.

What exactly is causing it? The reasons aren't fully understood, but he offered several possible explanations.

People with severe forms of COVID-19 often have underlying medical conditions like heart or lung disease -- which are themselves linked to higher rates of clotting.

Next, being in intensive care makes a person likelier to develop a clot because they are staying still for so long. That's why for example people are encouraged to stretch and move around on long haul flights.

It's also now clear the COVID-19 illness is associated with an abnormal immune reaction called "cytokine storm" -- and some research has indicated this too is linked to higher rates of clotting.

There could also be something about the virus itself that is causing coagulation, which has some precedent in other viral illnesses.

A paper in the journal The Lancet last week showed that the virus can infect the inner cell layer of organs and of blood vessels, called the endothelium. This, in theory, could interfere with the clotting process.

According to Brosnahan, while thinners like Heparin are effective in some patients, they don't work for all patients because the clots are at times too small.

"There are too many microclots," she said. "We're not sure exactly where they are."

Autopsies have in fact shown some people's lungs filled with hundreds of microclots.

The arrival of a new mystery however helps solve a slightly older one.

Cecilia Mirant-Borde, an intensive care doctor at a military veterans hospital in Manhattan, told AFP that lungs filled with microclots helped explain why ventilators work poorly for patients with low blood oxygen.

Earlier in the pandemic doctors were treating these patients according to protocols developed for acute respiratory distress syndrome, sometimes known as "wet lung."

But in some cases, "it's not because the lungs are occupied with water" -- rather, it's that the microclotting is blocking circulation and blood is leaving the lungs with less oxygen than it should.

It has just been a little under five months since the virus emerged in Wuhan, China, and researchers are learning more about its impact every day.

"While we react surprised, we shouldn't be as surprised as we were. Viruses tend to do weird things," said Brosnahan.

While the dizzying array of complications may seem daunting, "it's possible there'll be one or a couple of unifying mechanisms that describe how this damage happens," she said.

"It's possible it's all the same thing, and that there'll be the same solution."

Paris, Mar 2: A global agency says the spreading new virus could make the world economy shrink this quarter, for the first time since the international financial crisis more than a decade ago.

The Organization for Economic Cooperation and Development says Monday in a special report on the impact of the virus that the world economy is still expected to grow overall this year and rebound next year.

But it lowered its forecasts for global growth in 2020 by half a percentage point, to 2.4 per cent, and said the figure could go as low as 1.5 per cent if the virus lasts long and spreads widely.

The last time world GDP shrank on a quarter-on-quarter basis was at the end of 2008, during the depths of the financial crisis. On a full-year basis, it last shrank in 2009.

The OECD said China's reduced production is hitting Asia particularly hard but also companies around the world that depend on its goods.

It urged governments to act fast to prevent contagion and restore consumer confidence.

The Paris-based OECD, which advises developed economies on policy, said the impact of this virus is much higher than past outbreaks because "the global economy has become substantially more interconnected, and China plays a far greater role in global output, trade, tourism and commodity markets."

New Delhi, Jan 22: Defence Minister Rajnath Singh on Wednesday said Indian values consider all religions equal, and that is why the country is secular and never became a theocratic state like Pakistan.

Speaking at the NCC Republic Day Camp in Delhi, Singh said: "We (India) said we would not discriminate among religions. Why did we do that? Our neighbouring country has declared that their state has a religion. They have declared themselves a theocratic state. We didn't declare so."

"Even America is a theocratic country. India is not a theocratic country. Why? Because our saints and seers did not just consider the people living within our borders as part of the family, but called everyone living in the world as one family," the minister said.

Singh underlined that India had never declared its religion would be Hindu, Sikh or Buddhist and people of all religions could live here.

"They gave the slogan of 'Vasudev Kutumbakam' -- the whole world is one family. This message has gone to the whole world from here only," he added.