Mysterious blood clots are COVID-19's latest lethal surprise

News Network
April 28, 2020

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."

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Agecnies
July 13,2020

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.

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News Network
February 3,2020

Beijing, Feb 3: The first batch of patients arrived on Monday at a specialised hospital built in just 10 days as part of China's intensive efforts to fight a new virus.

Huoshenshan Hospital and a second facility with 1,500 beds that's due to open this week were built by construction crews who are working around the clock in Wuhan, the city in central China where the outbreak was first detected in December.

The Wuhan treatment centres mark the second time Chinese leaders have responded to a new disease by building specialised hospitals almost overnight. As severe acute respiratory syndrome, or SARS, spread in 2003, a facility in Beijing for patients with that viral disease was constructed in a week.

The first batch of patients arrived at the Huoshenshan Hospital at 10 am on Monday, according to state media. The reports gave no details of the patients' identities or conditions.

The ruling Communist Party's military wing, the People's Liberation Army, sent 1,400 doctors, nurses and other personnel to staff the Wuhan hospital, the official Xinhua News Agency said. The government said earlier some have experience fighting SARS and other outbreaks.

Authorities have cut most road, rail and air access to Wuhan and surrounding cities, isolating some 50 million people, in efforts to contain the viral outbreak that has sickened more than 17,000 and killed more than 360 people.

The Huoshenshan Hospital was built by a 7,000-member crew of carpenters, plumbers, electricians and other specialists, according to the Xinhua News Agency.               Photos in state media showed workers in winter clothing, safety helmets and the surgical-style masks worn by millions of Chinese in an attempt to avoid contracting the virus.

About half of the two-storey, 600,000-square-foot building is isolation wards, according to the government newspaper Yangtze Daily. It has 30 intensive care units.

Doctors can talk with outside experts over a video system that links them to Beijing's PLA General Hospital, according to the Yangtze Daily. It said the system was installed in less than 12 hours by a 20-member "commando team" from Wuhan Telecom Ltd.

The building has specialised ventilation systems and double-sided cabinets that connect patient rooms to hallways and allow hospital staff to deliver supplies without entering the rooms.

The hospital received a donation of "medical robots" from a Chinese company for use in delivering medicines and carrying test samples, according to the Shanghai newspaper The Paper.

In other cities, the government has designated hospitals to handle cases of the new virus.

In Beijing, the Xiaotangshan Hospital built in 2003 for SARS is being renovated by construction workers. The government has yet to say whether it might be used for patients with the new disease.

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News Network
June 17,2020

Beijing, Jun 17: Beijing's airports cancelled more than 1,200 flights and schools in the Chinese capital were closed again on Wednesday as authorities rushed to contain a new coronavirus outbreak linked to a wholesale food market.

The city reported 31 new cases on Wednesday while officials urged residents not to leave Beijing, with fears growing about a second wave of infections in China, which had largely brought its outbreak under control.

Tens of thousands of people linked to the new Beijing virus cluster -- believed to have started in the sprawling Xinfadi wholesale food market -- are being tested, with almost 30 residential compounds in the city now under lockdown.

At least 1,255 scheduled flights were cancelled Wednesday morning, state-run People's Daily reported, nearly 70 percent of all trips to and from Beijing's main airports.

The outbreak had already forced authorities to announce a travel ban for residents of "medium- or high-risk" areas of the city, while requiring other residents to take nucleic acid tests in order to leave Beijing.

Meanwhile, several provinces were quarantining travellers from Beijing, where all schools -- which had mostly reopened -- have been ordered to close again and return to online classes.

"The epidemic situation in the capital is extremely severe," Beijing city spokesman Xu Hejian warned Tuesday.

Mass testing under way

Officials have closed 11 markets and disinfected thousands of food and beverage businesses in Beijing after the outbreak was detected.

The city has now reported 137 infections over the last six days, with six new asymptomatic cases and three suspected cases on Wednesday, according to the municipal health commission.

An additional two domestic cases, one in neighbouring Hebei province and another in Zhejiang, were reported by national authorities on Wednesday, while there were 11 imported cases.

Authorities have so far banned group sports, ordered people to wear masks in crowded enclosed spaces, and suspended inter-provincial group tours in response to the outbreak.

Officials said that since May 30, more than 200,000 people had visited Xinfadi market, which supplies more than 70 percent of Beijing's fruit and vegetables.

More than 8,000 workers there were tested and quarantined.

Until the new outbreak, most of China's recent cases were nationals returning from abroad as COVID-19 spread globally, and the government had all but declared victory against the disease.

China's Center for Disease Control and Prevention said Monday that the virus type found in the Beijing outbreak was a "major epidemic strain" in Europe.

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