Not easy to get global support on Kashmir: Pak foreign minister Qureshi

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."

Beijing, Jan 25: The death toll due to the novel coronavirus (2019-nCoV) outbreak in China has soared to 41, while the number of infected persons were 1,287, the National Health Commission said on Saturday.

The Commission said that 444 fresh cases were reported since Friday, with 237 patients in serious conditions, while 38 had been cured and discharged from hospitals, reports Efe news.

Health authorities have carried out check-ups on 15,197 people who have come into close contact with the infected persons. Nearly 14,000 of them continue to be monitored for symptoms.

The others cases outside of China were reported in France (two), Australia (one), Thailand (four including two cured), Japan (two including one cured), South Korea (two), the US (two), Vietnam (two), Singapore (three), Nepal (one), Hong Kong (five), Macao (two) and Taiwan (three).

The symptoms of the new coronavirus, provisionally designated by the World Health Organization as 2019-nCoV, are similar to those of cold but may be accompanied by fever and fatigue, dry cough and dyspnea (shortness of breath).

The WHO has so far to declared the outbreak as an international health emergency.

Strict measures were being carried out in China, which include complete suspension of transport in around a dozen cities in Hubei province and also cancelling Chinese New Year celebrations.

Traditional events at Lama Temple and Ditan Park in Beijing were cancelled due to the risk of spreading the virus, authorities reported Friday, while the famous Forbidden City has also been closed indefinitely.

Wuhan, the capital of Hubei, where the virus was first reported, has been on lockdown since Thursday to prevent further spread of the virus and the city's authorities have begun to build a "special hospital" with 1,000 beds for infected patients.

"Construction of the special hospital with a capacity of 1,000 beds for patients with #nCoV2019 has begun in Wuhan," official China Daily said on Twitter.

The hospital in Wuhan will be based on the model of a similar facility that was built in just seven days in Beijing to deal with SARS in 2003.

Washington, May 30: US President Donald Trump on Friday said that America is terminating its relationship with the World Health Organization as he blamed it and China for the deaths and destruction caused by the COVID-19 pandemic across the globe.

Stating that the funding of the WHO would now be diverted to other global public health organisations, Trump announced a series of decisions against China including issuing proclamation to deny entry to certain Chinese nationals and tightening of regulations against Chinese investments in America.

"Because they (WHO) have failed to make the requested and greatly needed reforms, we will be today terminating our relationship with the World Health Organization and redirecting those funds to other worldwide and deserving urgent global public health needs, Trump said.