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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, Apr 2: The total US death toll from the coronavirus pandemic topped 4,000 early Wednesday, more than double the number from three days earlier, according to a tally by Johns Hopkins University.

The number of deaths was 4,076 -- more than twice the 2,010 recorded late Saturday.

More than 40 percent of recorded deaths nationally were in New York state, the Johns Hopkins data showed.

On Tuesday the United States exceeded the number of deaths in China, where the pandemic emerged in December before spreading worldwide.

The number of confirmed US cases has reached 189,510, the most in the world, though Italy and Spain have recorded more fatalities.

After initially downplaying the threat from new coronavirus in the early stages of the US outbreak, President Donald Trump warned of "a very, very painful two weeks" to come for the country on Tuesday.

Wuhan, Feb 23: Ninety-seven more people died in China due to coronavirus, taking the death toll to 2,442, officials said on Sunday, as a team of WHO experts visited the worst-affected Wuhan city in Hubei province.

By the end of Saturday, a total of 2,442 people had died of the disease and 76,936 confirmed cases of novel coronavirus infection had been reported in 31 provincial-level regions, China's National Health Commission (NHC) said in its daily update on Sunday.

Ninety-six deaths were reported from Hubei province and one from Guangdong province on Saturday besides 648 new confirmed cases of coronavirus infections, it said.

Hubei province, where the virus first emerged in December last, reported 630 new confirmed cases, taking the total confirmed cases in the hard-hit province to 64,084, state-run Xinhua news agency reported.

The NHC also said China's daily number of newly cured and discharged novel coronavirus patients has surpassed that of new confirmed infections for the fifth consecutive day, indicating that cases of infections are coming down.

Saturday saw 2,230 people walk out of hospital after recovery, much higher than the number of the same day's new confirmed infections, which was 648, Xinhua reported.

A total of 22,888 patients infected with the novel coronavirus had been discharged from hospital after recovery by the end of Saturday, NHC said.

Meanwhile, a team of public health experts from the World Health Organisation (WHO) visited Wuhan on Saturday to conduct a detailed probe about the virus which reportedly originated from a seafood market in the city in December last year.

The NHC said WHO experts along with their Chinese counterparts who formed a joint investigation team have held talks with the local health authority in Wuhan and visited relevant healthcare institutions.

The UN team comprises specialists from the United States, Germany, Japan, Nigeria, Russia, Singapore and South Korea, Hong-Kong based South China Morning Post reported.

The 12-member team, which arrived in China on Monday, was initially designated to visit only Beijing, Guangdong and Sichuan provinces, while the worst-affected Hubei province and its capital Wuhan were missing from the list.

However, the team was finally given permission to visit Wuhan by the Chinese government.

Besides controlling the spread of the virus, a major task for the WHO team along with their Chinese counterparts was to come up with standard medicine to cure the disease.

The NHC said on Saturday that the team had met top Chinese respiratory disease expert Zhong Nanshan in Guangdong, and visited the centre for disease control and prevention in Guangdong and the city of Shenzhen, and Sichuan.

The specialists also discussed quarantine measures, the wild animal trade and community prevention measures with their Chinese counterparts, it said.