Copycat worked on Mona Lisa real-time , by da Vinci's side

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."

Paris, Apr 9: More than 1.5 million cases of the novel coronavirus have been registered worldwide, according to a tally compiled by AFP at 0530 GMT Thursday from official sources.

Of the 1,502,478 infections, 87,320 people have died across 192 countries and territories since the epidemic first emerged in China late last year.

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 only testing the most serious cases.

Washington, Jan 11: US President Donald Trump has signed an executive order imposing another set of crippling sanctions against Iran, targeting several of its top leaders, military commanders, and its infrastructure industry, according to a statement from the White House on Friday.

Trump said the executive order authorises the imposition of sanctions against any individual or entity operating in the construction, manufacturing, textiles, or mining sectors of the Iranian economy or anyone assisting those who engage in this sanctioned business.

The sanctions are the latest in a series of retaliatory measures between the two nations.

Iran's powerful military commander Qasem Soleimani was killed last Friday in US drone strikes, ordered by President Trump, bringing the entire Gulf region close to a full-blown conflict.

Regional tensions remained high after Iran on Wednesday fired missiles at two bases in Iraq used by US forces.

"Today, I am holding the Iranian regime responsible for attacks against United States personnel and interests by denying it substantial revenue that may be used to fund and support its nuclear program, missile development, terrorism and terrorist proxy networks, and malign regional influence," said Trump on Friday, after signing the executive order.

"This order will have a major impact on the Iranian economy, authorising powerful secondary sanctions on foreign financial institutions.

"The Iranian regime has threatened United States military service members, diplomats, and civilians, as well as the citizens and interests of our allies and partners, through military force and proxy groups. The United States will continue to counter the Iranian regime's destructive and destabilising behaviour," the president said.

Trump said the economic sanctions will remain till the Iranian regime changes its behaviour.

Earlier at a White House news conference, Treasury Secretary Steven Mnuchin, along with cabinet colleague Secretary of State Mike Pompeo, said the US will continue its economic and diplomatic sanctions on Iran till Tehran announces it will not pursue the nuclear weapons program and stop its destabilising behaviour in the region.

The eight senior Iranian regime officials against whom sanctions have been issued include Ali Shamkhani, the Secretary of Iran's Supreme National Security Council, Mohammad Reza Ashtiani, the Deputy Chief of Staff of Iranian armed forces, and Gholamreza Soleimani, the head of the Basij militia of the Islamic Revolutionary Guards Corps (IRGC).

The sanction on the Iranian officials would mean denial of visa to the US and seizure of assets, among others.

In addition, the treasury designated 17 Iranian metals producers and mining companies, a network of three China-and Seychelles-based entities, and a vessel involved in the purchase, sale, and transfer of Iranian metals products, as well as in the provision of critical metals production components to Iranian metal producers.

"The United States is targeting senior Iranian officials for their involvement and complicity in Tuesday's ballistic missile strikes," Mnuchin said.

"We are also designating Iran's largest metals manufacturers, and imposing sanctions on new sectors of the Iranian economy including construction, manufacturing, and mining. These sanctions will continue until the regime stops the funding of global terrorism and commits to never having nuclear weapons," he added.

Pompeo told reporters that Iran was planning "broad, large-scale attacks" against American interests in the Middle East, including embassies.

The latest round of sanctions are aimed at striking at the heart of Iran's internal security apparatus, he said.

"The president has been very clear: we will continue to apply economic sanctions until Iran stops its terrorist activities and commits that it will never have nuclear weapons," Mnuchin said.