Searchers fail to find any confirmed clues about missing plane

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."

Geneva, Mar 30: The number of confirmed COVID-19 cases worldwide has reached 634,835, among them 29,957 fatalities, the World Health Organization (WHO) said on Sunday.

Over the past 24 hours, 63,159 people were confirmed to be infected with the novel coronavirus and 3,464 people died, the WHO said.

According to the latest situation report, the majority of the confirmed cases - more than 361,000 - are presently concentrated in Europe, with Italy leading the tally with over 92,000 cases, followed by Spain with over 72,000 cases, and Germany with over 52,000 cases.

Italy and Spain are also the countries that top the worldwide death toll from COVID-19, with 10,023 and 5,690 fatalities, respectively.

The second most affected region is currently the Americas with over 120,000 verified COVID-19 cases, of which the majority - over 103,000 - have been found in the United States. The US is also the country with the highest single tally of COVID-19 cases at the moment.
The WHO declared COVID-19 a pandemic on March 11.

Scientists predict the world may have a COVID-19 vaccine within one year or even a few months earlier, said the Director-General of the World Health Organisation even as he underlined the importance of global cooperation to develop, manufacture and distribute vaccines.

However, making the vaccine available and distributing it to all will be a challenge and requires political will, Tedros Adhanom Ghebreyesus said on Thursday during a meeting with the European Parliament's Committee for Environment, Public Health and Food Safety.

One option would be to give the vaccine only to those that are most vulnerable to the virus.

There are currently over 100 COVID-19 vaccine candidates in various stages of development.

Adhanom Ghebreyesus said the pandemic has highlighted the importance of global solidarity and that health should not be seen as a cost but an investment.

He added that all countries in the world must strengthen primary health care and crisis preparedness and stressed the need for EU leadership globally.

While the Director-General said the situation in the EU has improved significantly, he underlined that COVID-19 is very much still circulating globally, with more than four million new cases in the last month.

Many Members of European Parliament said that the global community must cooperate including in developing, manufacturing and distributing vaccines against COVID-19 and asked when a safe vaccine could be available.

Several Members of European Parliament underlined the importance of the WHO but also said it has made mistakes in its response to the pandemic.

The Director-General admitted everyone makes mistakes and informed the members that an independent panel will evaluate the WHO response to the pandemic to learn from any mistakes made.

It will start its work soon, he said.