US songwriter Bob Dylan wins Nobel Literature Prize

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."

Rome, Mar 11: Italy has recorded its deadliest day of the coronavirus crisis despite locking down the entire country, as New York deployed the National Guard to contain a disease that has sown worldwide panic.

The hardest-hit country in Europe said its death toll from the COVID-19 virus had risen Tuesday by a third to 631, with the surging epidemic taking its toll on global sporting, cultural and political events.

While authorities in China, where the outbreak began, have declared it "basically curbed", cases are multiplying around the world, sparking panic buying in shops, and wild swings on financial markets.

China remains the hardest-hit overall with more than 80,000 cases and over 3,000 deaths, out of a global total of 117,339 cases and 4,251 deaths across 107 countries and territories, according to an AFP tally.

The virus is infecting all walks of life, including politics, with US Democratic presidential hopefuls Bernie Sanders and Joe Biden both cancelling campaign rallies and British health minister Nadine Dorries saying she had tested positive.

And amid criticism of the US authorities' response, New York deployed the National Guard for the first time during the crisis to help contain the spread of the disease from an infection-hit suburb.

There have been 173 confirmed cases in New York state, including 108 in Westchester County, home to New Rochelle where the majority of infections have been detected.

"It is a dramatic action, but it is the largest cluster in the country. This is literally a matter of life and death," said state governor Andrew Cuomo.

"People are scared, it's an unusual situation to be in," Miles Goldberg, who runs a New Rochelle bar, told AFP.

"It makes people nervous to be around others, it makes people nervous to get inside into businesses and such," he said.

In an unprecedented move, Italian Prime Minister Giuseppe Conte has told the 60 million residents of his country they should travel only for the most urgent work or health reasons.

And while squares in Milan and Rome were emptied of their usual bustle and traffic, some residents appeared uncertain if they were even allowed to leave their homes for everyday tasks like shopping.

The virus has battered tourism around the world, as people scrap travel plans, and a restaurant owner in Florence in northern Italy said that the impact on business had been catastrophic.

"We hope that we will see the end of it, because from around 140 covers a day, this afternoon, we've gone down to 20-25," Agostino Ferrara told AFP.

Pope Francis also seemed to muddy the waters, holding a mass in which he urged priests to go out and visit the sick -- something Conte has specifically discouraged.

Sporting events continued to fall victim to the virus as authorities urge people to avoid large gatherings.

Arsenal's game at Manchester City was postponed after players from the London club were put into quarantine, making it the first Premier League fixture to be called off because of the virus.

The virus has sparked doubts about the Olympics due to open in Tokyo on July 24 and the traditional flame lighting ceremony in Greece is set to be held without spectators.

In the United States, organisers rescheduled the two-week Coachella music festival for October.

The virus and the response to the crisis has prompted pandemonium on global markets with volatility not seen since the world financial crisis in 2008.

After suffering its worst session in more than 11 years at the beginning of the week, the Dow Jones Index in New York bounced back significantly, rising five percent on Tuesday.

Politicians around the world have scrambled to put together emergency packages to ease the significant financial hardships the virus is expected to cause for households and businesses.

US President Donald Trump, who is relying on a strong economy to boost his re-election hopes, promised to announce "major" economic measures on Tuesday.

The biggest item on his wish list is a cut in payroll taxes. But even allies in Congress and reportedly some aides in the White House are sceptical, questioning the cost.

Italy prepared Tuesday to let families skip mortgage and some tax payments while Japan unveiled a second emergency package to tackle economic woes stemming from the outbreak, including $15 billion in loan programmes to support small businesses.

Analysts warned of further volatility ahead however.

"It's like winding up a rubber band. The more you wind it, when you let go, the more it pops," said LBBW's Karl Haeling.

"A lot of the uncertainty goes to the root of the virus itself."

Paris, Jun 29: More than half a million people have been killed by the novel coronavirus, nearly two thirds of them in the United States and Europe, according to an news agency tally at 2200 GMT Sunday based on official sources.

The official death count for the disease now stands at 500,390 deaths from 10,099,576 cases recorded worldwide. The United States has suffered the highest death count (125,747), followed by Brazil (57,622) and the United Kingdom (43,550).

The tallies, using data collected by AFP from national authorities and information from the World Health Organization (WHO), probably reflect only a fraction of the actual number of infections.

Many countries are testing only the most serious cases.