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."

Comments

Add new comment

  • Coastaldigest.com reserves the right to delete or block any comments.
  • Coastaldigset.com is not responsible for its readers’ comments.
  • Comments that are abusive, incendiary or irrelevant are strictly prohibited.
  • Please use a genuine email ID and provide your name to avoid reject.
Agencies
June 10,2020

Houston, Jun 10: George Floyd was fondly remembered Tuesday as “Big Floyd” — a father and brother, athlete and neighborhood mentor, and now a catalyst for change — at a funeral for the black man whose death has sparked a global reckoning over police brutality and racial prejudice.

More than 500 mourners wearing masks against the coronavirus packed a Houston church a little more than two weeks after Floyd was pinned to the pavement by a white Minneapolis police officer who put a knee on his neck for what prosecutors said was 8 minutes and 46 seconds.

Cellphone video of the encounter, including Floyd’s pleas of “I can’t breathe,” ignited protests and scattered violence across the U.S. and around the world, turning the 46-year-old Floyd — a man who in life was little known beyond the public housing project where he was raised in Houston’s Third Ward — into a worldwide symbol of injustice.

“Third Ward, Cuney Homes, that’s where he was born at,” Floyd’s brother, Rodney, told mourners at the Fountain of Praise church. “But everybody is going to remember him around the world. He is going to change the world.”

The funeral capped six days of mourning for Floyd in three cities: Raeford, North Carolina, near where he was born; Houston, where he grew up; and Minneapolis, where he died. The memorials have drawn the families of other black victims whose names have become familiar in the debate over race and justice — among them, Eric Garner, Michael Brown, Ahmaud Arbery and Trayvon Martin.

After the service, Floyd’s golden casket was taken by hearse to the cemetery in the Houston suburb of Pearland to be entombed next to his mother, for whom he cried out as he lay dying. A mile from the graveyard, the casket was transferred to a glass-sided carriage drawn by a pair of white horses. A brass band played as his casket was taken inside the mausoleum.

Hundreds of people, some chanting, “Say his name, George Floyd,” gathered along the procession route and outside the cemetery entrance in the mid-90s heat.

“I don’t want to see any black man, any man, but most definitely not a black man sitting on the ground in the hands of bad police,” said Marcus Brooks, 47, who set up a tent with other graduates of Jack Yates High School, Floyd’s alma mater.

In the past two weeks, amid the furor over Floyd’s death, sweeping and previously unthinkable things have taken place: Confederate statues have been toppled, and many cities are debating overhauling, dismantling or cutting funding for police departments. Authorities in some places have barred police from using chokeholds or are otherwise rethinking policies on the use of force.

Dozens of Floyd’s family members, most dressed in white, took part in the four-hour service. Grammy-winning singer Ne-Yo was among those who sang.

The mourners included actors Jamie Foxx and Channing Tatum, J.J. Watt of the NFL’s Houston Texans, rapper Trae tha Truth, Rep. Sheila Jackson Lee, Houston Police Chief Art Acevedo and Houston Mayor Sylvester Turner, who brought the crowd to its feet when he announced he will sign an executive order banning chokeholds in the city.

“I know you have a lot of questions that no child should have to ask, questions that too many black children have had to ask for generations: Why? Why is Daddy gone?” former Vice President Joe Biden, the Democratic presidential candidate, said, addressing Floyd’s 6-year-old daughter in a video eulogy played at the service. “Now is the time for racial justice. That’s the answer we must give to our children when they ask why.”

Biden made no mention of his opponent in November. But other speakers took swipes at President Donald Trump, who has ignored demands to address racial bias and has called on authorities to crack down hard on lawlessness.

“The president talks about bringing in the military, but he did not say one word about 8 minutes and 46 seconds of police murder of George Floyd,” said the Rev. Al Sharpton, the civil rights activist. “He challenged China on human rights. But what about the human right of George Floyd?”

Most of the pews were full, with relatively little space between people.

“So much for social distancing today,” the Rev. Remus Wright told mourners, gently but firmly instructing those attending to wear face masks.

Texas has no limit on how many people can gather in places of worship during the pandemic, though Republican Gov. Greg Abbott has encouraged churches to follow federal health guidelines.

Although the church service was private, at least 50 people gathered outside to pay their respects.

“There’s a real big change going on, and everybody, especially black, right now should be a part of that,” said Kersey Biagase, who traveled more than three hours from Port Barre, Louisiana, with his girlfriend, Brandy Pickney. They wore T-shirts printed with Floyd’s name and “I Can’t Breathe.”

Floyd served nearly five years in prison for robbery with a deadly weapon before becoming a mentor and a church outreach volunteer in Houston. He moved to Minnesota several years ago through a program that tried to change men’s lives by helping them find work in new settings.

At the time of his death, Floyd was out of work as a bouncer at a Minneapolis club that had closed because of the coronavirus outbreak. He was seized by police after being accused of passing a counterfeit $20 bill at a convenience store.

Four Minneapolis officers were arrested in his death: Derek Chauvin, 44, was charged with second-degree murder. J. Alexander Kueng, Thomas Lane and Tou Thao were charged with aiding and abetting. All four could get up to 40 years in prison.

Some of the mostly peaceful demonstrations that erupted after Floyd’s death were marked by bursts of arson, assaults, vandalism and smash-and-grab raids on businesses, with more than 10,000 people arrested. But protests in recent days have been overwhelmingly peaceful.

Comments

Add new comment

  • Coastaldigest.com reserves the right to delete or block any comments.
  • Coastaldigset.com is not responsible for its readers’ comments.
  • Comments that are abusive, incendiary or irrelevant are strictly prohibited.
  • Please use a genuine email ID and provide your name to avoid reject.
Agencies
May 19,2020

Washington DC, May 19: US President Donald Trump has threatened to permanently halt funding for the World Health Organisation (WHO) if it did not commit to improvements within 30 days, and to reconsider the membership of the United States in the global health body.

On Monday, Trump wrote a letter to WHO Director-General Tedros Ghebreyesus that read, "If WHO doesn't commit to major substantive improvements within the next 30 days, I will make my temporary freeze of US funding to WHO permanent and reconsider our membership in the organisation."

Trump had temporarily suspended US' contribution to the WHO last month, accusing it of promoting China's "disinformation" about the coronavirus outbreak, although WHO officials denied the accusation and Beijing said that it was transparent and open.

"The only way forward for the WHO is if it can actually demonstrate independence from China. My administration has already started discussions with you on how to reform the organisation. But action is needed quickly. 

We do not have time to waste," Trump said in the letter.

"I cannot allow American taxpayer dollars to continue to finance an organisation that, in its present state, is so clearly not serving America's interests," he added.

On Monday, the WHO said that an independent review of the global coronavirus response would begin at the earliest and it received backing from China, where the virus was first discovered.

Comments

Add new comment

  • Coastaldigest.com reserves the right to delete or block any comments.
  • Coastaldigset.com is not responsible for its readers’ comments.
  • Comments that are abusive, incendiary or irrelevant are strictly prohibited.
  • Please use a genuine email ID and provide your name to avoid reject.
News Network
January 10,2020

Washington, Jan 10: It is “highly likely” that Iran shot down the civilian Ukrainian jetliner that crashed near Tehran late Tuesday, killing all 176 people on board, U.S., Canadian and British officials declared Thursday.

They said the fiery missile strike could well have been a mistake amid rocket launches and high tension throughout the region.

The crash came just a few hours after Iran launched a ballistic attack against Iraqi military bases housing U.S. troops in its violent confrontation with Washington over the U.S. drone strike that killed an Iranian Revolutionary Guard general. The airliner could have been mistaken for a threat, said four U.S. officials, speaking on condition of anonymity to discuss sensitive intelligence.

Canadian prime minister Justin Trudeau, whose country lost at least 63 citizens in the downing, said in Toronto: “We have intelligence from multiple sources including our allies and our own intelligence. The evidence indicates that the plane was shot down by an Iranian surface-to-air missile.”

Likewise, U.K. prime Minister Boris Johnson and Australian prime minister Scott Morrison offered similar statements. Morrison also said it appeared to be a mistake. “All of the intelligence as presented to us today does not suggest an intentional act,” he said.

The assessment that 176 people were killed as collateral damage in the Iranian-U.S. conflict cast a new pall over what had at first appeared to be a relatively calm aftermath following the U.S. military operation that killed Iranian Gen. Qassem Soleimani.

At the White House, U.S. president Donald Trump suggested he believed Iran was responsible for the shootdown and dismissed Iran's initial claim that it was a mechanical issue with the plane.

“Somebody could have made a mistake on the other side.” Trump said, noting the plane was flying in a “pretty rough neighborhood."

Comments

Add new comment

  • Coastaldigest.com reserves the right to delete or block any comments.
  • Coastaldigset.com is not responsible for its readers’ comments.
  • Comments that are abusive, incendiary or irrelevant are strictly prohibited.
  • Please use a genuine email ID and provide your name to avoid reject.