Missing US woman found after 10 years

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."

Paris, Apr 24: The worldwide death toll from the coronavirus pandemic crossed 190,000 on Friday, with nearly two-thirds of the fatalities in Europe, according to an AFP tally compiled from official sources at 0740 GMT.

A total of 190,089 people have died and 2,698,733 been infected since the virus emerged in China in December. The hardest hit continent is Europe, with 116,221 deaths and 1,296,248 cases.

The country with the most deaths is the United States with 49,963, followed by Italy with 25,549, Spain with 22,157, France with 21,856 and Britain 18,738.

Beijing, Jan 24: As China stepped up measures to control the spread of coronavirus, locking down Wuhan and Huanggang cities in the Hubei province where several Indians live, the Indian Embassy here has set up hotlines for their assistance.

Chinese officials assured all assistance, including food supply, to the Indians who stayed put in the province, the Indian Embassy here said in a press release on Thursday.

Wuhan and its surrounding area became the epicentre of the coronavirus outbreak as the confirmed cases climbed to over 600 mostly from the city and the province with 17 deaths so far.

China has virtually sealed Wuhan and Huanggang cities, halting all public transport, including flight services, and advised people to stay at home and follow the precautions. The two cities put together have a population of over 17 million people.

Chinese officials said the measures have been taken to prevent the spread of the virus to other cities and the world.

Concerns arose for India too as about 700 Indian students, mostly studying medicine in different Chinese universities, resided in Wuhan and its neighbouring areas.

While many of them were believed to have left home for the Chinese New Year holidays, others remained in the city to complete their academic work. However, the exact number is not yet known.

“The Embassy of India has been receiving queries from Indians in Hubei province as well as their relatives in India in connection with the evolving situation of coronavirus infection in China,” the embassy press release said.

The embassy is in touch with relevant Chinese authorities in Beijing and Wuhan as well as Indians in Hubei Province, especially in Wuhan, it said.

“We are closely monitoring the evolving situation in China, including the advisories issued by the World Health Organisation (WHO),” the embassy said.

According to the embassy, Chinese authorities have assured all assistance to residents of Wuhan, including food supply.

“At present, it is reported that supermarkets (particularly those that are government-run) and e-commerce services, including food delivery, continue to remain operational in Wuhan,” it said.

The embassy has started two hotlines for those who wish to get in touch with the Mission in this regard in the following phone numbers:              +8618612083629 and +8618612083617.

“All are advised to also keep track of the embassy's social media accounts (Twitter:@EoIBeijing; Facebook: India in China) for updates on this evolving situation,” the release said.

Meanwhile, the Chinese Foreign ministry said all assistance would be provided to consular officials of the foreign missions to ensure the safety of the foreigners in the country.

Asked whether China would consider any request from the respective countries to move their citizens out of Wuhan, Chinese Foreign Ministry spokesman Geng Shuang said, “We always help foreign consular officials in China in their official jobs, we offer them all the assistance and convenience necessary and we work to guarantee foreign citizens' legitimate rights and interest in China.”

He said while specific detailed would be provided by local officials, China in principle, has always handled issues according to domestic laws, international laws and bilateral consular agreements.