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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."

Brasilia, Jul 14: Brazil has reported new 20,286 coronavirus cases in last 24 hours taking the country's total to 1.8 million, Sputnik reported citing the health ministry.

The country's death toll has increased by 733 in the same period of time. The death toll from the infection has touched 72,833.

Over 1.1 million people have recovered from COVID-19 in Brazil since the start of the epidemic in the country, according to the health ministry.

Brazil has the second-highest coronavirus death toll, it is surpassed only by the United States.

Manila, Mar 16: The Philippines has detected an outbreak of avian flu in a northern province after tests showed presence of the highly infectious H5N6 subtype of the influenza A virus in a quail farm, the country's farm minister said on Monday.

Agriculture Secretary William Dar said the bird flu virus, the same strain that hit some local poultry farms in 2017, was detected in Jaen municipality in Nueva Ecija province, where about 1,500 quails had died on one farm alone.

A total of 12,000 quails have been destroyed and buried to prevent further infections, Dar said, citing field reports.

"We are on top of the situation," he said. "Surveillance around the 1-km and 7-km radius will be carried out immediately to ensure that the disease has not progressed around the said perimeter."

Animal quarantine checkpoints have also been set up to restrict the movement of all live domestic birds to and from the quarantine area, he said.

"We would like to emphasise that this is a single case affecting one quail farm only," Dar said.

Dr. Arlene Vytiaco, technical spokeswoman for avian flu at the agriculture department, said that while there is a possibility of transmission to humans through excretion and secretion, "the chances are very slim".

"There is also zero mortality rate," she said.

Dar said his department and the local government were jointly conducting an investigation and contact-tracing to determine the source of infection.

To ensure steady domestic supply of poultry, he said the transport of day-old chicks, hatching eggs and chicken meat will be allowed provided the source farms have tested negative for bird flu.