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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."

Geneva, Jul 11: The World Health Organization said Friday that it is still possible to bring coronavirus outbreaks under control, even though case numbers have more than doubled in the past six weeks.

WHO chief Tedros Adhanom Ghebreyesus said the examples of Italy, Spain, South Korea and India's biggest slum showed that however bad a outbreak was, the virus could still be reined in through aggressive action.

"In the last six weeks cases have more than doubled," Tedros told a virtual press conference in Geneva.

However, "there are many examples from around the world that have shown that even if the outbreak is very intense, it can still be brought back under control," said Tedros.

"And some of these examples are Italy, Spain and South Korea, and even in Dharavi -- a densely packed area in the megacity of Mumbai -- a strong focus on community engagement and the basics of testing, tracing, isolating and treating all those that are sick is key to breaking the chains of transmission and suppressing the virus."

The novel coronavirus has killed at least 555,000 people worldwide since the outbreak emerged in China last December, according to a tally from official sources compiled by AFP on Friday.

Nearly 12.3 million cases have been registered in 196 countries and territories.

"Across all walks of life, we are all being tested to the limit," Tedros said, "from countries where there is exponential growth, to places that are loosening restrictions and now starting to see cases rise.

"Only aggressive action combined with national unity and global solidarity can turn this pandemic around."

New Delhi, May 19: The number of coronavirus cases crossed the one lakh mark in the country on Tuesday, while the death toll due to the infection touched 3,163, according to the Union Health Ministry.

A total of 134 deaths and 4,970 COVID-19 cases were reported in the country in the past 24 hours since 8 pm on Monday, it said.

The total number of coronavirus cases has risen to 1,01,139, the ministry said.

The number of active COVID-19 cases stood at 58,802 while 39,173 people have recovered and one patient has migrated, it said.

"Thus, around 38.73 per cent patients have recovered so far," a senior health ministry official said.

The total confirmed cases include foreigners.

Of the 134 deaths reported since Monday morning, 51 were in Maharashtra, 35 in Gujarat, 14 in Uttar Pradesh, eight in Delhi, seven in Rajasthan, six in West Bengal, four in Madhya Pradesh, three in Tamil Nadu, two each in Punjab and Jammu and Kashmir, and one each in Bihar and Telangana.

Of the 3,163 fatalities, Maharashtra tops tally with 1,249 deaths. Gujarat comes second with 694 deaths, followed by Madhya Pradesh at 252, West Bengal at 244, Delhi at 168, Rajasthan at 138, Uttar Pradesh at 118, Tamil Nadu at 81 and Andhra Pradesh at 50.

The death toll reached 37 each in Karnataka and Punjab and 35 in Telangana.

Jammu and Kashmir has reported 15 fatalities due to the disease, Haryana has 14 deaths while Bihar has registered nine and Kerala and Odisha each have reported four deaths.

Jharkhand, Chandigarh and Himachal Pradesh each have recorded three COVID-19 fatalities, while Assam has reported two deaths.

 Meghalaya, Uttarakhand and Puducherry have reported one fatality each, according to the data provided by the ministry.

According to the ministry's website, more than 70 per cent of the deaths are due to comorbidities, the existence of multiple disorders in the same person.

According to the health ministry's data updated in the morning, the highest number of confirmed cases in the country are from Maharashtra at 35,058, followed by Tamil Nadu at 11,760, Gujarat at 11,745, Delhi at 10,054, Rajasthan at 5,507, Madhya Pradesh at 5,236 and Uttar Pradesh at 4,605.

The number of COVID-19 cases has gone up to 2,825 in West Bengal, 2,474 in Andhra Pradesh and 1,980 in Punjab.

It has risen to 1,597 in Telangana, 1,391 in Bihar, 1,289 in Jammu and Kashmir, 1,246 in Karnataka and 928 in Haryana.

Odisha has reported 876 coronavirus infection cases so far, while Kerala has 630 cases. A total of 223 people have been infected with the virus in Jharkhand and 196 in Chandigarh.

Tripura has reported 167 cases, Assam has 107, Uttarakhand and Chhattisgarh have 93 cases each, Himachal Pradesh has 90 and Ladakh has registered 43 cases so far.

Goa has reported 38 COVID-19 cases, while the Andaman and Nicobar Islands has registered 33 infections.

Puducherry has registered 18 cases, Meghalaya has 13 and Manipur has seven cases. Mizoram, Arunachal Pradesh and Dadar and Nagar Haveli have reported a case each till how.

"814 cases are being reassigned to states," the ministry said on its website, adding "our figures are being reconciled with the ICMR".

State-wise distribution is subject to further verification and reconciliation, it said.