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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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."

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Agencies
July 18,2020

Days after Twitter accounts of several billionaires were hacked to engineer a crypto scam, Twitter on Saturday said it is embarrassed, disappointed and, more than anything, sorry for what happened with some of its high-profile users as attackers successfully manipulated its employees and used their credentials to access internal systems, including getting through the two-factor protections.

In the first detailed summary of the "social engineering attack" via a crypto scam that hit at least 130 users this week, Twitter said for 45 of those accounts, the attackers were able to initiate a password reset, login to the account and send Tweets.

"We are continuing our forensic review of all of the accounts to confirm all actions that may have been taken. In addition, we believe they may have attempted to sell some of the usernames," the micro-blogging platform said in a statement.

For up to eight of the Twitter accounts involved, the attackers took the additional step of downloading the account's information via "Your Twitter Data" tool.

This is a tool that is meant to provide an account owner with a summary of their Twitter account details and activity.

"We are reaching out directly to any account owner where we know this to be true. None of the eight were verified accounts," said Twitter.

The company said the attackers were not able to view previous account passwords, as those are not stored in plain text or available through the tools used in the attack.

"Attackers were able to view personal information including email addresses and phone numbers, which are displayed to some users of our internal support tools," informed Twitter.

In cases where an account was taken over by the attacker, they may have been able to view additional information, Twitter added, saying its forensic investigation of these activities was still ongoing.

"We are actively working on communicating directly with the account-holders that were impacted".

The company said it will soon restore access for all account owners who may still be locked out as a result of the remediation efforts.

The New York Times reported on Friday that the Twitter crypto scam can be traced back to a group of hackers who congregate online at OGusers.com, a username-swapping community where people buy and sell coveted online handles.

The report said that the Twitter hack is not from Russian, Chinese or North Korean hackers but was done by a group of young people, "one of whom says he lives at home with his mother".

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News Network
May 5,2020

May 5: Global coronavirus deaths reached 250,000 on Monday after recorded infections topped 3.5 million, a news agency tally of official government data showed, although the rate of fatalities has slowed.

North America and European countries accounted for most of the new deaths and cases reported in recent days, but numbers were rising from smaller bases in Latin America, Africa and Russia.

Globally, there were 3,062 new deaths and 61,923 new cases over the past 24 hours, taking total cases to 3.58 million.

That easily exceeds the estimated 140,000 deaths worldwide in 2018 caused by measles, and compares with around 3 million to 5 million cases of severe illness caused annually by seasonal influenza, according to the World Health Organization (WHO).

While the current trajectory of COVID-19 falls far short of the 1918 Spanish flu, which infected an estimated 500 million people, killing at least 10% of patients, experts worry the available data is underplaying the true impact of the pandemic.

The concerns come as several countries begin to ease strict lockdowns that have been credited with helping contain the spread of the virus.

"We could easily have a second or a third wave because a lot of places aren't immune," Peter Collignon, an infectious diseases physician and microbiologist at Canberra Hospital, told Reuters. He noted the world was well short of herd immunity, which requires around 60% of the population to have recovered from the disease.

The first death linked to COVID-19 was reported on Jan. 10 in Wuhan, China after the coronavirus first emerged there in December. Global fatalities grew at a rate of 1-2% in recent days, down from 14% on March 21, according to the Reuters data.

DEATH RATE ANOMALIES

Mortality rates from recorded infections vary greatly from country to country.

Collignon said any country with a mortality rate of more than 2% almost certainly had underreported case numbers. Health experts fear those ratios could worsen in regions and countries less prepared to deal with the health crisis.

"If your mortality rate is higher than 2%, you've missed a lot of cases," he said, noting that countries overwhelmed by the outbreak were less likely to conduct testing in the community and record deaths outside of hospitals.

In the United States, around half the country's state governors partially reopened their economies over the weekend, while others, including New York Governor Andrew Cuomo, declared the move was premature.

In Britain, Prime Minister Boris Johnson, who battled COVID-19 last month, has said the country was over the peak but it was still too early to relax lockdown measures.

Even in countries where the suppression of the disease has been considered successful, such as Australia and New Zealand which have recorded low daily rates of new infections for weeks, officials have been cautious.

Australian Prime Minister Scott Morrison has predicated a full lifting of curbs on widespread public adoption of a mobile phone tracking app and increased testing levels.

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