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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."

Geneva, Apr 23: The World Health Organisation (WHO) on Wednesday (local time) said that the COVID-19 crisis will not end any time soon, with several countries only in the initial stages of the fight against the virus.

"Make no mistake, we have a long way to go. Coronavirus will be with us for a long time. There is no question that stay at home orders and other physical distancing measures have successfully suppressed transmission in many countries," WHO chief Tedros Adhanom Ghebreyesus said in a press conference.

"Most countries are in the early stages of their epidemics. And some, which were affected early in the pandemic, are now starting to see a resurgence in the number of cases," he added.

COVID-19 has infected more than 2.6 million people around the world and a total of 1,83,027 people have died due to coronavirus, according to data from US-based Johns Hopkins University.

Italian researchers have claimed that they have successfully developed a vaccine to contain coronavirus (COVID-19) which is likely to work on humans, a report said.

Luigi Aurisicchio, CEO of Takis, the firm developing the medication, said that a coronavirus candidate vaccine has neutralised the virus in human cells for the first time, the Arab News reported.

"This is the most advanced stage of testing of a candidate vaccine created in Italy. Human tests are expected after this summer," Aurisicchio was quoted as saying to Italian news agency ANSA.

"According to the Spallanzani Hospital, as far as we know we are the first in the world so far to have demonstrated neutralisation of the coronavirus by a vaccine. We expect this to happen in humans too," he added.

The researchers experimented with the vaccine on mice that had successfully developed antibodies that blocked the virus from infecting the cells. They further observed that the five vaccine candidates generated a large number of antibodies, and selected two with the best results.

All of the vaccine candidates currently being developed are based on the genetic material of DNA protein "spike", the molecular tip used by the coronavirus to enter human cells.

They are injected with the so-called "electroporation" technique, which consists of an intramuscular injection followed by a brief electrical impulse, helping the vaccine break into the cells and activating the immune system, the report said.

Researchers believe that this makes their vaccine particularly effective for generating functional antibodies against the "spike" protein, in particular in the lung cells, which are the most vulnerable to coronavirus.

"We are working hard for a vaccine coming from Italian research, with an all-Italian and innovative technology, tested in Italy and made available to everyone," Aurisicchio was quoted by the Arab News report.

"In order to reach this goal, we need the support of national and international institutions and partners who may help us speed up the process," he noted.

The total number of COVID-19 infections, fatalities and recoveries since the pandemic began has risen to 213,013 in the country.