COVID-19 will be with us for long time, says WHO

Washington, Apr 24: The number of coronavirus cases in the US has surpassed 850,000, Johns Hopkins University Coronavirus Resource Center data revealed on Thursday (local time).
The country now has registered 8,56,209 cases overall, according to the data, including 47,272 deaths.

The US currently leads the world in the number of reported COVID-19 deaths and confirmed cases.

There are more than 2.6 million COVID-19 cases around the world and more than 1,85,000 deaths, according to the data.

Moscow, Jul 13: Russia has become the first nation to complete clinical trials of a COVID-19 vaccine on humans. Chief researcher Elena Smolyarchuk, who heads the Center for Clinical Research on Medications at Sechenov University, told Russian news agency TASS on Sunday that the human trials for the vaccine have been completed at the university and the volunteers will be discharged soon.

"The research has been completed and it proved that the vaccine is safe. The volunteers will be discharged on July 15 and July 20," Smolyarchuk was quoted as saying in the report.

Though the results have been favourable with respect to the medication’s effectiveness, no further information was provided on when this vaccine would enter commercial production stage.

Russia had allowed clinical trials of two forms of a potential COVID-19 vaccine developed by the Gamaleya National Research Center for Epidemiology and Microbiology on June 18.

The first vaccine, in the form of a solution for intramuscular administration, was carried out at the Burdenko Military Hospital.

Another vaccine, in the form of a powder for the preparation of a solution for intramuscular administration, was carried out at Sechenov First Moscow State Medical University.

The first stage of research on the vaccine at Sechenov University involved a group of 18 volunteers and the second group involved 20 volunteers.

After vaccination, all volunteers were expected to remain in isolation in a hospital for 28 days.

Earlier, results of the COVID-19 vaccine tests performed on a group of volunteers in Russia showed that they were developing immunity to the coronavirus.

"The data obtained by the Gamalei National Research Center for Epidemiology and Microbiology, proves that volunteers of the first and second groups are forming an immune response after injections of the vaccine against the coronavirus," according to an earlier statement from the Russian Defense Ministry.

Russia has reported 719,449 cases and 11,188 deaths to date.

There are at least 21 vaccines currently under key trials, according to the World Health Organisation (WHO).

The overall number of global COVID-19 cases crossed 12.9 million, while the deaths have increased to more than 5,69,000, according to Johns Hopkins University in the US.

As of Monday morning, the total number of cases stood at 1,29,10,357, while the fatalities rose to 5,69,128.

The US accounted for the world's highest number of infections at over 33 lakh. Brazil came in the second place with over 18 lakh infections. India is third worst affected with over 8.7 lakh people reported to have COVID-19.

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."