Russia's covid-19 cases rise by 9K overnight; total approaches 2 lakh

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, Apr 19: President Donald Trump has expressed his doubts over the official Chinese figures on the number of deaths in their country due to the novel coronavirus pandemic, claiming that the fatalities were way ahead of the US.

Trump's comments come two days after another 1,300 fatalities were added to the official count in the city of Wuhan, where the outbreak started. The revision puts China's overall death toll to more than 4,600.

"We are not number one; China is number one just so you understand," Trump told reporters at a White House news conference on Saturday. "They are way ahead of us in terms of death. It's not even close."

According to Trump, when highly-developed healthcare systems of the UK, France, Belgium, Italy and Spain had high fatality rates, it was O.33 in China.

The president asserted that the actual number was much more than the official Chinese death toll figures, which he said were "unrealistic".

"You know it, I know it and they know it, but you don't want to report it. Why?" he asked. "You will have to explain that. Someday I will explain it."

He also highlighted that on a per-capita basis, the mortality rate in the US was far lower than other nations of Western Europe.

Tehran, Mar 10: Twenty-seven people have died from methanol poisoning in Iran after rumours that drinking alcohol can help cure the novel coronavirus infection, state news agency IRNA reported on Monday. The outbreak of the virus in Islamic republic is one of the deadliest outside of China, where the disease originated.

Twenty have died in the southwestern province of Khuzestan and seven in the northern region of Alborz after consuming bootleg alcohol, IRNA said.

Drinking alcohol is banned in Iran for everyone except some non-Muslim religious minorities. Local media regularly report on lethal cases of poisoning caused by bootleg liquor.

A spokesman for Jundishapur medical university in Ahvaz, the capital of Khuzestan, said 218 people had been hospitalised there after being poisoned.

The poisonings were caused by "rumours that drinking alcohol can be effective in treating coronavirus," Ali Ehsanpour said.

The deputy prosecutor of Alborz, Mohammad Aghayari, told IRNA the dead had drunk methanol after being "misled by content online, thinking they were fighting coronavirus and curing it." If ingested in large quantities, methanol can cause blindness, liver damage and death.

Iran has been scrambling to contain the spread of the COVID-19 illness which has hit all of the country's 31 provinces, killing 237 people and infecting 7,161.

According to IRNA, 16 out of 69 confirmed cases have died of coronavirus infection in Khuzestan as of Sunday.