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First came a high fever, drenching sweats and muscle aches. Then, almost a month later, a weird numbness that spread down the right side of her body.Darlene Gildersleeve thought she had recovered from COVID-19. Doctors said she just needed rest. And for several days, no one suspected her worsening symptoms were related — until a May 4 video call, when her physician heard her slurred speech and consulted a specialist.“You’ve had two strokes,” a neurologist told her at the hospital. The Hopkinton, New Hampshire, mother of three is only 43.Blood clots that can cause strokes, heart attacks and dangerous blockages in the legs and lungs are increasingly being found in COVID-19 patients, including some children. Even tiny clots that can damage tissue throughout the body have been seen in hospitalized patients and in autopsies, confounding doctors’ understanding of what was once considered mainly a respiratory infection.“I have to be humble and say I don’t know what’s going on there, but boy we need to find that out because unless you know what the pathogenic (disease-causing) mechanism is, it’s going to be tough to do intervention,” Dr. Anthony Fauci, the nation’s top infectious disease expert, remarked during a medical journal interview last month.Doctors and scientists at dozens of hospitals and universities around the globe are seeking answers while trying to measure virus patients’ risks for clots and testing drugs to treat or prevent them.Gildersleeve said health authorities “need to put out an urgent warning about strokes” and coronavirus. Not knowing the possible link “made me doubt myself” when symptoms appeared, she said.Some conditions that make some COVID-19 patients vulnerable to severe complications, including obesity and diabetes, can increase clot risks. But many authorities believe how the virus attacks and the way the body responds both play a role.“COVID-19 is the most thrombotic (clot-producing) disease we’ve ever seen in our lifetime,” said Dr. Alex Spyropoulos, a clot specialist and professor at Feinstein Institutes for Medical Research in Manhasset, New York.Clotting has been seen in other coronavirus infections, including SARS, but on a much smaller scale, he said.Scientists believe the coronavirus enters the body through enzyme-receptors found throughout the body, including in cells lining the inside of blood vessels. Some theorize that it may promote clotting by somehow injuring those vessels as it spreads. That injury may cause a severe immune response as the body tries to fight the infection, resulting in inflammation that may also damage vessels and promote clotting, said Dr. Valentin Fuster, director of Mount Sinai Heart hospital in New York.It’s unclear how many COVID-19 patients develop clots. Studies from China, Europe and the United States suggest rates ranging from 3% to 70% of hospitalized COVID-19 patients; more rigorous research is needed to determine the true prevalence, the National Institutes of Health says.Prevalence in patients with mild disease is unknown and the agency says there isn’t enough evidence to recommend routine clot screening for all virus patients without clotting symptoms, which may include swelling, pain or reddish discoloring in an arm or leg.Some hospitals have found 40% of deaths in COVID-19 patients are from blood clots. Spyropoulos said that’s been true at his 23-hospital system in the New York City area, Northwell Health, which has treated over 11,000 COVID-19 patients.Cases there have dropped by almost half in the past month, allowing more time for research before an expected second and maybe third wave of infections, he said, adding: “We’re racing against time to answer the key clinical questions.”Patients hospitalized with any severe illness face increased risks for clots, partly from being bedridden and inactive. They commonly receive blood-thinning drugs for prevention. Some doctors are trying higher-than-usual doses for prevention in hospitalized coronavirus patients.A few have used powerful clot-busting medicines typically used to treat strokes, with mixed results. In guidance issued May 12, the NIH said more research is needed to show whether that approach has any benefits.Fuster was involved in preliminary research on nearly 2,800 COVID-19 patients at five hospitals in the Mount Sinai system. A look at their outcomes suggests slightly better survival chances for virus patients on ventilators who received blood thinners than among those who didn’t. Although the results are not conclusive, all COVID-19 patients at Mount Sinai receive blood thinners for clot prevention unless they are at risk for bleeding, a potential side effect, Fuster said.Some COVID-19 patients, like Gildersleeve, develop dangerous clots when their infections seem to have subsided, Spyropoulos said. Patients treated at Northwell for severe disease are sent home with a once-a-day blood thinner and a soon to be published study will detail their experiences. Spyropoulos has been a paid consultant to Janssen Pharmaceuticals, makers of Xarelto, the drug’s brand name.In addition, Northwell is taking part in a multi-center study that will test using blood thinners for clot prevention in COVID-19 patients not sick enough to require hospitalization.In a small study published May 15, University of Colorado doctors found that combined scores on two tests measuring clotting markers in the blood can help determine which patients will develop large dangerous clots. One test measures a protein fragment called D-dimer, a remnant of dissolved clots. High levels sometimes indicate dangerous clots that form deep in leg veins and travel to the lungs or other organs.Dr. Behnood Bikdeli of Columbia University’s Irving Medical Center, said D-dimer levels in many of his COVID-19 patients have been alarmingly high, as much as 50 times higher than normal.Concerns about blood clots in COVID-19 patients prompted a recent 30-page consensus statement from an international group of physicians and researchers. Bikdeli is the lead author.It says that testing to find clots that require treatment includes X-rays or ultrasound exams, but poses a risk for health care workers because the virus is so contagious. Bikdeli said he fears when protective gear was more scarce, some dangerous clots were undiagnosed and untreated.Social distancing may make people more sedentary and more vulnerable to clots, particularly older adults, so doctors should encourage activity or exercises that can be done in the home as a preventive measure, the statement says.Warnell Vega got that advice after collapsing at home April 19 from a large clot blocking a lung artery. Doctors at Mount Sinai Morningside think it was coronavirus-related. Vega, 33, a lunch maker for New York City school children, spent a week in intensive care on oxygen and blood thinners, which he’s been told to continue taking for three months.“I just have to watch out for any bleeding, and have to be careful not to cut myself,” Vega said.Gildersleeve, the New Hampshire stroke patient, was also sent home with a blood thinner. She gets physical therapy to improve strength and balance. She still has some numbness and vision problems that mean driving is out, for now.Doctors are unable to predict when or whether she’ll regain all her abilities.”I’m trying to remain positive about recovering,” she said. ’’I just have to be patient and listen to my body and not push too hard.”___Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’ 7639

Fall is the time of year parents, teens and college students are buying books for their school's required reading.And if the teacher says you need a classic, it's tempting to buy the version on Amazon, for instance if you need a copy of George Orwell's "1984," or maybe "The Adventures of Huckleberry Finn."But buyer beware. A recent 349

Former Vice President Joe Biden is projected to win the Democratic primaries in Michigan, Missouri and Mississippi on Tuesday, after winning 10 out of 14 states on Super Tuesday. With Biden's win in Michigan, he earned a state that was won by Sen. Bernie Sanders in 2016. Winning Michigan was the biggest prize in Tuesday's six-state primary with 125 delegates up for grabs. Democrats award delegates proportionally, but Biden could rack up a large delegate haul between Michigan, Missouri and Mississippi.The races in Idaho, North Dakota and Washington have not been called.DELEGATE MATH:March 10 primaries:Biden: 131Sanders: 72Overall:Biden: 801Sanders: 646Needed to win: 1991Sanders entered Tuesday's set of primaries trailing Biden in national delegates. It appears the gap between Biden and Sanders will grow from Tuesday's votes. As votes were tabulated on Tuesday, former candidate Andrew Yang announced he is endorsing Biden."I believe Joe Biden will be the Democratic nominee....and I hereby endorse Joe Biden," Yang said. 1044

For the 10th straight week, weekly initial claims for unemployment have totaled in the millions.On Thursday, the Department of Labor reported that 2.1 million people filed initial claims for unemployment for the week ending May 23. In the last 10 weeks, 40 million Americans have filed claims for unemployment.Thursday's report marked the eighth straight week in declining unemployment figures, but unemployment claims remain historically high. Prior to the pandemic, the record high for weekly unemployment claims came in 2006, when 665,000 people filed for unemployment. The Department of Labor has been tracking the statistics since 1967.While economists often use weekly unemployment figures to gauge how many Americans lost their jobs, surveys suggest that these figures are underestimating the true number of Americans who have lost their jobs in the pandemic. 879

How bad is the flooding across the central United States? A total of 70 river gauges along the Mississippi River and its tributaries are experiencing major flooding, and another 104 are seeing moderate flooding, as of Wednesday's latest data.In all, cities across the region, from Minneapolis down to New Orleans, have been slammed by heavy rain and flooding.And it's not over yet. More heavy rain is in the forecast for today, and over 10 million remain under flood warnings from Oklahoma into Kansas, Missouri and Illinois. The greatest flash flood potential will be from Texas into Arkansas, where 2 to 4 inches of rainfall will be common.Here's a look at the extent of this flooding across the region.OklahomaThe hardest hit areas will likely be along the Arkansas River, with a crest today in Tulsa near the record for the river. Floodwaters from the Arkansas River have inundated homes outside Tulsa, such as in these photos from May 23 in Sand Springs.Debbie Chavez, who has lived with her family in Sand Springs for 24 years, said evacuation started after the water was in the driveway of her neighbors' house last week. She took the below photos of the rising water.Tulsa Mayor G.T. Bynum warned his city to prepare for the "worst case scenario we've had" in the city's history of flooding.US Rep. Kevin Hern, who represents parts of Tulsa County and Sand Springs, said he was extremely concerned about the aging levees in his district."The devastation from the Arkansas River flooding is real, and the continued risk to citizens and businesses is equally as real," he said.ArkansasThe Arkansas River, already rising, will reach near-record or record levels -- above 40 feet in some areas -- Thursday afternoon, officials said."This is looking to be record-breaking all along the Arkansas River, and this is something we have never seen before," state emergency management spokeswoman Melody Daniel said.In Fort Smith, for example, people stood and looked out over the flooded Massard Creek last Saturday.While in Chaffee Crossing, volunteers filled sand bags in a parking lot, readying to distribute them to flood prone areas around homes.In Logan County, the sheriff posted photos of a levee along Highway 309 that has overtopped due to flooding.Arkansas Gov. Asa Hutchinson announced that he'd conduct an aerial tour Thursday out of Fort Smith."This is a flood of historic magnitude, it surpasses all Arkansas flooding in our recorded history. That should be enough to get everyone's attention."MissouriJust in Missouri, 52 river gauges are in major flooding, and another 40 river gauges are experiencing moderate flooding. The flooding is particularly prevalent around St. Louis and its border with Illinois.One resident in Winfield, a city northwest of St. Louis, waded through the floodwater last Friday.Residents in Portage Des Sioux, outside St. Louis, watched as the water rose up to their home on Tuesday.IowaMississippi River gauges in Scott County, which includes Davenport, were in a major flooding zone on Wednesday.The flooding in Iowa was so bad that a Scott County flood assistance event scheduled for Wednesday was postponed because of rising waters.Continued rainfall and saturated ground conditions have affected the Iowa county for most of the year, according to the Scott County website. Earlier in May, 3347

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