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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."

Washington, Feb 19: Sri Srinivasan, a prominent Indian-American judge, has created history by becoming the first person of South Asian descent to lead a powerful federal circuit court considered next only to the US Supreme Court.

Srinivasan, 52, became the Chief Judge of the United States Court of Appeals for the DC Circuit.

An Obama appointee who has already been considered for a Supreme Court seat twice, donned the mantle of the chief judge of the DC federal court circuit on February 12.

Srinivasan succeeded Judge Merrick Garland, who has been a member of the DC Circuit since 1997 and Chief Judge since 2013. He will remain on the bench, a press release said.

Notably, Garland's nomination to the Supreme Court by the then president Barack Obama was blocked by Senate Republicans in 2016.

Srinivasan, was appointed to the US Court of Appeals for the District of Columbia Circuit in May 2013.

He was the first ever Indian-American to be appointed to the second most powerful court of the US.

Neomi Rao, nominated by President Donald Trump, is the second Indian American on this powerful judiciary bench.

History being made on the DC Court of Appeals. Congratulations, Judge Srinivasan! Senator Mark Warner said.

Congratulations to Judge Sri Srinivasan on becoming the Chief Judge of the U.S. Court of Appeals for the D.C. Circuit! A milestone for the Indian-American/Kansan community (and yet another piece of evidence my family can use that I'm underachieving), US Federal Communications Commission Chair Ajit Pai said.

According to The Washington Post, Srinivasan spoke recently about his path to the bench at an event celebrating women in the law, a field where men still dominate leadership positions.

"Everybody doubts their belonging and worthiness in some measure. I definitely did and still do. This is just going to be a part of the thing when you're looking out in the world in which everyone isn't like you. It's natural to doubt whether you belong and whether you're worthy, he said, "but you do belong and you are worthy.

Born in Chandigarh, and raised in Lawrence, Kansas, he received a B.A. from Stanford University, a J.D. from Stanford Law School, and an M.B.A. from the Stanford Graduate School of Business.

Following graduation, he served as a law clerk to Judge J. Harvie Wilkinson III of the US Court of Appeals for the Fourth Circuit, as a Bristow Fellow in the Office of the US Solicitor General, and as a law clerk to US Supreme Court Justice Sandra Day O'Connor.

From 2011 until his appointment to the US Court of Appeals, Judge Srinivasan served as the Principal Deputy Solicitor General of the United States.

He has argued 25 cases before the US Supreme Court. He has also taught appellate advocacy at Harvard Law School as well as a seminar on civil rights statutes and the Supreme Court at Georgetown University Law Center.

Islamabad, May 13 : The number of confirmed COVID-19 cases in Pakistan rose to 34,370 on Wednesday after new infections were confirmed in the country.

As per province-wise breakup of the total tally cited by Radio Pakistan, so far 13,225 cases have been registered in Punjab, 12,610 in Sindh, 5,021 in Khyber Pakhtunkhwa, 2,158 in Balochistan, 759 in Islamabad, 475 in Gilgit Baltistan and 88 in Pakistan-occupied Kashmir.

As many as 2,255 cases positive were confirmed, while 31 deaths reported during the last 24 hours.

At least 737 patients have died so far while 8,812 stand recovered, the media reported further.