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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."

London, Apr 27: British Prime Minister Boris Johnson returns to work on Monday more than three weeks after being hospitalised for the coronavirus and spending three days in intensive care.

Johnson, one of the highest-profile people to have contracted the virus, returned to 10 Downing Street on Sunday evening and will chair a meeting on Monday morning of the coronavirus "war cabinet", his colleagues confirmed.

Dominic Raab, the foreign secretary who has deputised in Johnson's absence, told the BBC on Sunday that his return would be a "boost for the government and a boost for the country".

Raab also claimed the prime minister was "raring to go".

Johnson, 55, was admitted to hospital on April 5 suffering from "persistent symptoms" of the deadly disease.

His condition worsened and he later admitted after being put in intensive care that "things could have gone either way".

He was discharged on April 12 and has been recuperating at his official residence, west of London.

In a video message after leaving hospital, Johnson thanked "Jenny from New Zealand and Luis from Portugal" for helping him recover.

On medical advice, he has not been doing official government work during his convalescence but has spoken to Queen Elizabeth and US President Donald Trump on the phone.

The British leader was diagnosed with the virus late last month but initially stayed at Downing Street and was filmed taking part in a round of applause for health workers in the days before he went to hospital.

Washington, Jun 1: Police fired tear gas outside the White House late Sunday as major US cities were put under curfew to suppress rioting as anti-racism protestors again took to the streets to voice fury at police brutality.

With the Trump administration branding instigators of six nights of rioting as domestic terrorists, there were more confrontations between protestors and police and fresh outbreaks of looting.

Violent clashes erupted repeatedly in a small park next to the White House, with authorities using tear gas, pepper spray and flash bang grenades to disperse crowds who lit several large fires and damaged property.

Local US leaders appealed to citizens to give constructive outlet to their rage over the death of an unarmed black man in Minneapolis, while night-time curfews were imposed in cities including Washington, Los Angeles and Houston.

One closely watched protest was outside the state capitol in Minneapolis' twin city of St. Paul, where several thousand people gathered before marching down a highway.

"We have black sons, black brothers, black friends, we don't want them to die. We are tired of this happening, this generation is not having it, we are tired of oppression," said Muna Abdi, a 31-year-old black woman who joined the protest.

"I want to make sure he stays alive," she added in reference to her son, aged three.

Hundreds of police and National Guard troops were deployed ahead of the protest.

At one point, some of the protestors who had reached a bridge were forced to scramble for cover when a truck drove at speed after having apparently breached a barricade.

The driver was later taken to hospital after the protestors hauled him from the vehicle, although there were no immediate reports of other casualties.

There were other large-scale protests in cities including New York and Miami.

Washington's mayor ordered a curfew from 11:00 pm until 6:00 am, as a report in the New York Times said that President Donald Trump had been rushed by Secret Service agents into an underground bunker at the White House on Friday night during an earlier protest.

Stores ransacked

Large-scale violence has rocked many US cities in recent days, and looters ransacked stores in a neighborhood of Philadelphia on Sunday.

In the Los Angeles suburb of Santa Monica, looting was reported at stores in a popular beachside shopping center.

Officials in LA -- a city scarred by the 1992 riots over the police beating of Rodney King, an African-American man -- imposed a curfew from 4:00 pm Sunday until dawn.

"Please, use your discretion and go early, go home, stay home and help us make sure that those who want to change this conversation from being about racial justice to be about burning things and looting things, don't win the day," the city's mayor Eric Garcetti said on CNN.

The shocking videotaped death last Monday of an unarmed black man, George Floyd, at the hands of police in Minneapolis ignited the nationwide wave of outrage over law enforcement's repeated use of lethal force against unarmed African Americans.

Floyd stopped breathing after Minneapolis police officer Derek Chauvin knelt on his neck for nearly nine minutes.

Chauvin has been charged with third-degree murder and is due to make his first appearance in court on Monday. Three other officers with him have been fired but for now face no charges.

Governor Tim Walz has mobilized all of Minnesota's National Guard troops  -- the state guard's biggest mobilization ever -- to help restore order.

Police fired tear gas and stun grenades to clear streets of curfew violators Saturday night in Minneapolis.

Walz extended a curfew for a third night Sunday and praised police and guardsmen for holding down violence. "They did so in a professional manner. They did so without a single loss of life and minimal property damage," he said.

"Congratulations to our National Guard for the great job they did immediately upon arriving in Minneapolis, Minnesota, last night," President Donald Trump tweeted, adding that they "should be used in other States before it is too late!"

The Department of Defense said that around 5,000 National Guard troops had been mobilized in 15 states as well as the capital Washington, with another 2,000 on standby.

The widespread resort to uniformed National Guards units is rare, and it evoked disturbing memories of the rioting in US cities in 1967 and 1968 in a turbulent time of protest over racial and economic disparities.

Trump blamed the extreme left for the violence, saying he planned to designate a group known as Antifa as a terrorist organization.

"The violence instigated and carried out by Antifa and other similar groups in connection with the rioting is domestic terrorism and will be treated accordingly," added Attorney General Bill Barr.

'A nation in pain'

Atlanta Mayor Keisha Lance Bottoms said Trump, who has often urged police to use tough tactics, was not helping matters.

"We are beyond a tipping point in this country, and his rhetoric only enflames that," she said on CBS.

Joe Biden, Trump's likely Democratic opponent in November's presidential election, visited the scene of one anti-racism protest.

"We are a nation in pain right now, but we must not allow this pain to destroy us," Biden tweeted, posting a picture of him speaking with an African-American family at the site where protesters had gathered in Delaware late Saturday.

Floyd's death has triggered protests beyond the United States, with hundreds rallying outside the US embassy in London in solidarity.

"I'm here because I'm tired, I'm fed up with it. When does this stop?" Doreen Pierre told AFP at the protest.

In Germany, England football international Jadon Sancho marked one of his three goals for Borussia Dortmund against Paderborn by lifting his jersey to reveal a T-shirt bearing the words "Justice for George Floyd".