56 journalists killed in 2019: UN

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."

Washington, Jun 17: The United States is closely monitoring the situation following a fierce clash between Indian and Chinese forces in eastern Ladakh and hopes that the differences will be resolved peacefully, officials said here.

Twenty Indian Army personnel including a colonel were killed in the clash with Chinese troops in the Galwan Valley in eastern Ladakh on Monday night, the biggest military confrontation in over five decades that has significantly escalated the already volatile border standoff in the region.

"We are closely monitoring the situation between Indian and Chinese forces along the Line of Actual Control," a State Department spokesperson said.

"We note the Indian military has announced that 20 soldiers have died, and we offer our condolences to their families," the official said.

Both India and China have expressed their desires to de-escalate and the US supports a peaceful resolution of the current situation, the spokesperson said.

"During their phone call on June 2, 2020, President Donald Trump and Prime Minister Narendra Modi had discussed the situation along the India-China border," the official added.

Tehran, Jun 29: Iran has issued an arrest warrant and asked Interpol for help in detaining President Donald Trump and dozens of others it believes carried out the drone strike that killed a top Iranian general in Baghdad, a local prosecutor reportedly said Monday.

While Trump faces no danger of arrest, the charges underscore the heightened tensions between Iran and the United States since Trump unilaterally withdrew America from Tehran’s nuclear deal with world powers.

Tehran prosecutor Ali Alqasimehr said Trump and more than 30 others whom Iran accuses of involvement in the Jan. 3 strike that killed Gen. Qassem Soleimani in Baghdad face “murder and terrorism charges,” the semiofficial ISNA news agency reported.

Alqasimehr did not identify anyone else sought other than Trump, but stressed that Iran would continue to pursue his prosecution even after his presidency ends.

Interpol, based in Lyon, France, did not immediately respond to a request for comment.

Alqasimehr also was quoted as saying that Iran requested a “red notice” be put out for Trump and the others, which represents the highest level arrest request issued by Interpol. Local authorities end up making the arrests on behalf of the country that request it. The notices cannot force countries to arrest or extradite suspects, but can put government leaders on the spot and limit suspects’ travel.

After receiving a request, Interpol meets by committee and discusses whether or not to share the information with its member states. Interpol has no requirement for making any of the notices public, though some do get published on its website.

It is unlikely Interpol would grant Iran’s request as its guideline for notices forbids it from “undertaking any intervention or activities of a political” nature.

The U.S. killed Soleimani, who oversaw the Revolutionary Guard’s expeditionary Quds Force, and others in the January strike near Baghdad International Airport. It came after months of incidents raising tensions between the two countries and ultimately saw Iran retaliate with a ballistic missile strike targeting American troops in Iraq.