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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."

Feb 13: Two Indian crew on board a cruise ship off the Japanese coast have tested positive for the novel coronavirus, the Indian Embassy in Japan said on Wednesday as authorities confirmed that 174 people have been infected with the deadly disease.

The cruise ship Diamond Princess with 3,711 people on board arrived at the Japanese coast early last week and was quarantined after a passenger who de-boarded last month in Hong Kong was found to be the carrier of the novel virus on the ship.

A total of 138 Indians, including passengers and crew, were on board the ship.

“Due to the suspicion of novel coronavirus (nCoV) infection, the ship has been quarantined by the Japanese authorities till February 19, 2020,” the embassy said in a statement.

“Altogether 174 people have been tested positive for nCoV, including two Indian crew members,” it said.

All the infected people have been taken to hospitals for adequate treatment, including further quarantine, in accordance with the Japanese health protocol, it said.

Melbourne, Mar 18: Australian Prime Minister Scott Morrison on Wednesday warned its citizens not to travel abroad and banned "non-essential" gatherings of 100 people or more as the government declared the deadly coronavirus, that has infected over 450 people in the country, a "human biosecurity emergency".

Prime Minister Morrison on Wednesday said Australians should abandon all overseas travel because of the coronavirus epidemic. There have been 40 new cases since Tuesday.

Of the 454 confirmed cases in Australia, 43 have recovered and 5 have died from the COVID-19, according to the official figures.

Morrison declared a national "human biosecurity emergency" and ordered a halt to "non-essential" indoor gatherings of more than 100 people, on top of an existing ban on outdoor events of more than 500.

He said, "We haven't seen this sort of thing in Australia since the end of the First World War. This is a once-in-a-100-year-type event," Morrison said.

"Life is changing in Australia, as it is changing all around the world. Life is going to continue to change. The travel advice to every Australian is do not travel abroad. Do not go overseas."

However, schools across the country were still to remain open.

Morrison said Australia should prepare for "at least six months" of disruption as health authorities attempt to get on top of the coronavirus.

"For those of you thinking about going overseas for the school holidays, don’t. Don't go overseas," he said.

Morrison said there would be no short-term, quick fix to deal with the COVID-19 crisis in Australia, and warned that "tens of thousands of jobs" could be lost.

Responding to the panic buying, the prime minister urged the public to "Stop hoarding."

"I can't be more blunt about it. Stop it. It is not sensible, it is not helpful and it has been one of the most disappointing things I have seen in Australian behaviour in response to this crisis," he said.

On Wednesday, the New South Wales recorded a massive jump in new 59 cases as travellers returned from overseas. The cases jumped from 210 to 269 in the past 24 hours, according to the media reports here.

Queensland's total number of confirmed cases stood at 94.

State Premier Annastacia Palaszczuk said it is now "a different world" from just last week.

For Victoria, the Premier Daniel Andrew said the government could also ban gatherings of fewer than 100 people, noting he could not rule out further changes.

Chief Health Officer Brett Sutton said the spike in cases has been due to people who have travelled overseas.

Sutton said that the transmission in Victoria was not because of community transition like Italy.

Sutton has continued to urge people to wash their hands, socially distance and stay home if they are unwell.

"These are critical measures to be applied regardless of the 100 and 500 threshold,” he said.

In Western Australia, Health Minister Roger Cook said four new coronavirus cases have been confirmed overnight, taking the State's total to 35.

McGowan also condemned panic buyers in supermarkets as "jerks, drongos and bloody idiots."

He said there was "plenty of food to go round" and no need for people to buy in excessive quantities.

The outbreak, which first emerged in China's Wuhan city last year, has marched across the globe, infecting 198,006 people and killing 7,948, according to a tracker maintained by the Johns Hopkins University.