China wishes to work with PM Modi again, after victory in polls

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."

Geneva, Jun 22: The global count of coronavirus cases has surpassed 8.7 million, with 183,020 new cases recorded on Sunday, the World Health Organisation said in its daily situation report.

Over the last 24 hours, 4,743 people died from COVID-19 worldwide, taking the death toll to 461,715 fatalities, according to the report.

The cumulative global toll of confirmed cases has now reached 8,708,008, as stated in the report.

The WHO Regional Director for Europe, Dr Hans Henri P. Kluge, shared that Europe accounts for 31 per cent of COVID-19 cases and 43 per cent of COVID-19 deaths globally.

Dr Kluge highlighted that several countries continue to face increasing disease incidence and that "preparing for the autumn is a priority now at the WHO Regional Office for Europe"

The United States continues to be worst affected by the contagion with the highest count of cases and fatalities -- 2.2 million and 118,895, respectively.

The novel coronavirus was declared a pandemic by WHO on March 11.

Islamabad, May 24: Pakistan recorded 32 coronavirus-related deaths during the last 24 hours, taking the total number of fatalities in the country to 1,133, the health ministry said on Sunday.

The total number of COVID-19 patients in Pakistan also jumped to 54,601, it said.

Read: Coronavirus India update: State-wise total number of confirmed cases, deaths

Sindh reported the maximum number of 21,645 coronavirus cases, followed by Punjab at 19,557, Khyber-Pakhtukhwa at 7,685, Balochistan at 3,306, Islamabad at 1,592, Gilgit-Baltistan at 619 and Pakistan-occupied Kashmir (PoK) at 197.

According to the health ministry, 17,198 coronavirus patients have recovered and 473,607 tests, including 12,915 in the last 24 hours, have been conducted so far.

The government also issued strict instructions to observe social distancing while offering Eid prayer and asked people to avoid visiting relatives and hosting parties.

Eid congregations were held at open places, mosques and Eidgahs in all major cities and towns while following strict standard operating procedures (SOPs) of social distancing and other precautionary measures.

Pakistan Prime Minister's Special Assistant on Health Zafar Mirza on Friday said the deadly infection would continue to multiply if precautions are not taken.

Earlier this month, the government had announced the lifting of the countrywide lockdown imposed to curb the spread of the virus in phases, even as infections continued to rise in the country.

Prime Minister Imran Khan had cited the economic havoc the virus restrictions had wreaked on citizens as the reason behind the decision.

The prime minister on Saturday urged Pakistanis to forgo traditional Eid festivity in view of the hundreds of fatalities caused by the coronavirus and the lives lost in Friday's plane crash in Karachi.

Ninety-seven people, including nine children, were killed and two passengers miraculously survived a fiery crash when a Pakistan International Airlines plane with 99 travellers on board plunged into a densely populated residential area near the Jinnah International Airport in Karachi. Most of the victims were travelling home to celebrate Eid.