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Clinician-scientists have found that Irish patients admitted to hospital with severe coronavirus (COVID-19) infection are experiencing abnormal blood clotting that contributes to death in some patients.

The research team from the Royal College of Surgeons in Ireland found that abnormal blood clotting occurs in Irish patients with severe COVID-19 infection, causing micro-clots within the lungs.

According to the study, they also found that Irish patients with higher levels of blood clotting activity had a significantly worse prognosis and were more likely to require ICU admission.

"Our novel findings demonstrate that COVID-19 is associated with a unique type of blood clotting disorder that is primarily focussed within the lungs and which undoubtedly contributes to the high levels of mortality being seen in patients with COVID-19," said Professor James O'Donnell from St James's Hospital in Ireland.

In addition to pneumonia affecting the small air sacs within the lungs, the research team has also hundreds of small blood clots throughout the lungs.

This scenario is not seen with other types of lung infection and explains why blood oxygen levels fall dramatically in severe COVID-19 infection, the study, published in the British Journal of Haematology said.

"Understanding how these micro-clots are being formed within the lung is critical so that we can develop more effective treatments for our patients, particularly those in high-risk groups," O'Donnell said.

"Further studies will be required to investigate whether different blood-thinning treatments may have a role in selected high-risk patients in order to reduce the risk of clot formation," Professor O'Donnell added.

According to the study, emerging evidence also shows that the abnormal blood-clotting problem in COVID-19 results in a significantly increased risk of heart attacks and strokes.

As of Friday morning, the cases increased to 20,612 cases in Ireland, with 1,232 deaths so far, according to the Johns Hopkins University.

17-year-old Pratyusha Jha, wakes up scrambling for newspapers these days to look for any news about her pending board exams and is anxious about what the future has in store for her.

Similar concerns are shared by Bipin Kumar, a class 12 student, who says the announcement of board exams from July 1 to 15 brought limited clarity as the larger questions remain unanswered.

The COVID-19 lockdown, came with a different set of concerns for class 12 students, whose board exams were postponed midway following the outbreak of coronavirus, putting on hold their future plans as well.

"Everyday I have been looking for news about the exams and about entrance exam dates. I feel unfortunate that this happened during the year I was supposed to take the big college leap. I don't want my future decisions to be shaped by this very year as what I opt to study now will remain with me lifelong," Pratyusha told PTI.

Ending some uncertainty for students, HRD Minister Ramesh Pokhriyal 'Nishank' on Friday announced that the pending class 10 and 12 board exams will be held from July 1 to 15. While class 12 exams will be conducted across the country, the class 10 exams are only pending in North East Delhi where they were affected due to the law and order situation.

"The anxiety doesn't end here, there is no date sheet yet. What will be the modalities of exams, how will we reach centres, what protocols have to be followed, there is no clarity on that. My friends and I keep calling our school teachers and also the CBSE helpline to seek some clarity," Bipin Kumar said.

Vaibhav Sharma, a class 12 student in Gurgaon said, "There is no clarity yet. I wanted to apply for DU, but now that the exams are taking place in July when will the results be declared, when will cut offs be announced. If I don't get a good college here, will I be able to travel to different cities for admission, nothing is known yet."

Similarly, for the students in northeast Delhi, the wait for the exams has become a "test of patience" as they were postponed first in the area due to law and order situation, and later due to the coronavirus outbreak, resulting in a four-month-long wait for the exams.

"It has become an endless wait and now I don't feel like studying too. Right from childhood, we are taught that board exams are too crucial and have to be focussed at least two years in advance. But now, it is a different picture altogether," Rani Kumari, a resident of Chandbagh said.

Universities and schools across the country have been closed and exams postponed since March 16 when the Centre announced a countrywide classroom shutdown as one of the measures to contain the COVID-19 outbreak.

Later, a nationwide lockdown was announced on March 24, which has now been extended till May 17.

The board was not able to conduct class 10 and 12 exams on eight examination days due to the coronavirus outbreak. Further, due to the law and order situation in North East Delhi, the board was not able to conduct exams on four examination days, while a very small number of students from and around this district were not able to appear in exams on six days.

The board had last month announced that it will only conduct pending exams in 29 subjects which are crucial for promotion and admission to higher educational institutions. The modalities of assessment for the subjects for which exams are not being conducted will be announced soon by the board.

The schedule has been decided in order to ensure that the board exams are completed before competitive examinations such as engineering entrance JEE-Mains, which is scheduled from July 18-23, and medical entrance exam NEET, which is scheduled on July 26.

The University Grants Commission (UGC) has issued guidelines to universities that new academic session for freshers will begin from September while for the existing students from August.

As the COVID-19 wave sweeps strongly across the country, including in Tamil Nadu, mental health experts say the pandemic has triggered panic attacks among those who tested positive for the virus, causing bouts of depression and even driving some to the brink of suicide.

According to experts, nervousness, fear of contamination, panic attacks, constant reassurance seeking behaviour, sleep disturbance, excessive worry, feelings of helplessness and probability of an economic slowdown are the major factors leading to depression and anxiety among the people.

Potential job losses, financial burden, uncertainty about the future and fears of running out of food and necessities add to the worries.

Online platforms too have seen a growing number of people seeking help for mental health issues, ranging from anxiety and loneliness to concerns over productivity and job loss since the outbreak of COVID-19.

Director of Institute of Mental Health here, Dr R Purna Chandrika said towards April end about 3,632 calls were received and psychiatric counselling was provided to 2,603 callers.

"We have dedicated services at our centres in the districts and the calls meant for government medical college hospitals are routed to the respective institutions," she said.

Due to heavy virus caseloads, making this city the major contributor to the state's tally, the Greater Chennai Corporation too started a free helpline to help residents cope up with stress during the pandemic.

"From the psychological perspective, we don't find a single human being who is not feeling some degree of stress or anxiety due to coronavirus. The intensity and impact varies from person to person," said Lt Col N T Rajan, director of Chennai-based Mastermind Foundation.

The organisation is involved in free counselling throughout India ever since the first case of the deadly virus was reported in the country.

The foundation's recommendation on not to deploy the vulnerable in the police force, especially those above 50 years and women personnel with children below five years for COVID-19 related duty, was accepted and implemented by the Punjab government.

Psychiatrists feel that further worsening situations could lead to severe mental health issues, even triggering suicidal tendencies.

"Further worsening depression may lead to severe mental health issues and suicidal tendencies," said Dr S Senthil Kumar, a psychiatrist.

However, not all of them require medicines, he added.

"The situation is serious. There should be counselling at three stages--on coping with the virus, how to face it if tested positive and how to face life once treated and discharged from the hospital," Rajan said.

Awareness was of paramount importance, he said and warned the pandemic could cause panic attacks while in hospital or drive them to the brink of suicide.

Tamil Nadu, one of the worst affected states with a virus count in excess of 74,000 as of Friday, has witnessed a few instances of suicides allegedly related to COVID-19.

Hari Singh, owner of popular 'Iruttu Kadai' halwa shop in Tirunelveli, allegedly died by committing suicide on Thursday after being tested positive for COVID-19. He was 80.

Earlier in May, two COVID-19 patients in their 50s allegedly committed suicide in separate instances, at the government hospitals they were admitted to for treatment.

In the city corporation limits, a three-member team comprising a psychiatrist, counsellor and a social worker work for the respective zones.

"We direct certain sections of people like those with withdrawal symptoms and people requiring pills, to visit the doctor at their corporation zonal at a specific time, for medicines," a health worker of the civic body said.

Health platform, Lybrate reported an increase of 180 per cent in online patient consultations related to mental health on its platform between March 1 and June 20 across the country.

The largest increase came from Mumbai and Delhi, followed by Pune, Ahmedabad, Chennai and Bengaluru.

The biggest jump was witnessed in the age group of 25 and 45 years.