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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."

Islamabad, May 25: Pakistan’s coronavirus cases on Monday reached 56,349 with 1,748 new patients while the death toll climbed to 1,167, the health ministry said.

The Ministry of National Health Services reported that 22,491 cases were diagnosed in Sindh, 20,077 in Punjab, 7,905 in Khyber-Pakhtunkhwa, 3,407 in Balochistan, 1,641 in Islamabad, 619 in Gilgit-Baltistan and 209 in Pakistan-occupied Kashmir.

So far 1,167 people have died of the COVID-19 including 34 who lost their lives in the last 24 hours. A total of 17,482 patients have recovered from the deadly contagion.

The authorities have conducted 483,656 tests in the country, including 10,049 on Sunday. The trajectory showed that the number was steadily going up with authorities fearing a rise in cases in the wake of the easing of lockdown before Eid which was observed in the country on Sunday.

New Delhi, Mar 15: Dozens of Hindu activists held a cow urine party in New Delhi on Saturday to protect themselves from the new coronavirus, as countries around the world struggle to control the deadly pandemic.

Members and supporters of the All India Hindu Mahasabha staged fire rituals and drank from earthen cups to fight the Covid-19 virus at the gathering in New Delhi dubbed a "gaumutra (cow urine) party".

"Whoever drinks cow urine will be cured and protected," Hari Shankar Kumar, a volunteer at the event, said as he served the remedy in brown clay cups.

Governments and scientists have said no medicine or vaccine is available to protect or cure people of the infection that has killed more than 5,400 people and infected nearly 150,000 across six continents.

Two people have died in India while more than 80 have fallen ill, and the government has ordered the closure of some land routes into the country and cancelled all visas to stop the spread of the virus in the world's second most populous country.

Members draped in saffron clothes chanted Hindu hymns at the fire ritual as devotees sang paeans for the sacred animal.

"We have gathered here and prayed for world peace and we will make an offering to the corona (virus) to calm it," Chakrapani Maharaj, the group's leader, told reporters before gulping down a cup of urine.

He then offered a glass to a devil-shaped caricature of the virus to "pacify" it.

He urged people to adopt the "tried and tested" practice of drinking cow urine to ward off diseases, and desist from killing animals and eating meat.

"The coronavirus is also a bacteria and cow urine is effective against all forms of bacteria that harm us," claimed Om Prakash, a participant from the neighbouring state of Uttar Pradesh.

One legislator from the BJP last week suggested use of the urine as well as cow dung can cure the coronavirus.