• Published on: May 22, 2020
  • 1 minute read
  • By: Dr Rajan Choudhary

Corona Virus In Young Patients And Kids

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Kids seem to be relatively unaffected by COVID, but this does not mean they are invulnerable. As with adults, some children have pre-existing cardiac, respiratory, or metabolic conditions, and are therefore more vulnerable to the effects of COVID. Interestingly, children appear to have one more symptom when infected with coronavirus – COVID Toes.

I personally came across this phenomenon recently, with a young patient asymptomatic for COVID who presented with unusual symptoms of dark bruises on his toes. This had been present for just a few days. He did not have any pain, itching, swelling, no recent trauma, or injury to the feet. Circulation to his feet was normal, with no other rashes or skin changes, no other abnormal features in the history to note. It was certainly an odd presentation and certainly could have been an example of COVID toes.

This new phenomenon was noticed in April and has not gained as much notoriety because it is fairly rare compared to the major COVID symptoms, such as fever, cough, and lethargy.  Doctors have described lesions on the feet of young people, usually purple-colored, around the tips of the toes. They have been compared to chilblains, painful swellings on feet, and toes that appear in the cold. Similarly to chilblains they do not cause any permanent damage and usually regress in days to weeks.

It's not clear why they occur or the mechanism behind the discoloration, because the presentation is rare and in healthy patients. We know COVID can cause systemic inflammation and can increase the risk of clot formation. It may be that localized inflammation is occurring in the toes, causing the vessels to clamp down and reduce blood flow to the area. This is similar to the mechanism for chilblains forming in the foot. Micro-clotting could also be partially responsible for this phenomenon.

COVID Toes is not the only skin symptoms related to COVID. In a paper published in the British Journal of Dermatology, researchers described five common skin presentations in 375 COVID patients. These were:

  • Asymmetrical chilblain like lesions in the hands and feet, found in younger patients lasting up to 2 weeks.
  • Small itchy blisters in the trunk and limbs, found in middle-aged patients before they present with symptoms, lasting about 10 days
  • Pink or white areas of raised skin, itchy, usually on the body
  • Raised bumps called macropapules, lasting about a week, seen in more severe infections.
  • Mottled, blotchy red-blue skin (known as livedo) seen in patients with severe illness.

So if you are currently suffering from COVID or have recently recovered from an infection, and suddenly notice odd colored toes, you too may have a case of COVID toes.

Dr Rajan Choudhary, UK, Chief Product Officer, Second Medic Inc

www.secondmedic.com

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Chest pain

Chest Pain While Breathing: Causes, Warning Signs, and When to Seek Urgent Care

Chest pain is one of the most alarming symptoms a person can experience, especially when it worsens during breathing. Chest pain while breathing, also known as pleuritic chest pain, often indicates involvement of the lungs, chest wall or surrounding structures. While some causes are mild, others can be life-threatening and require immediate medical attention.

In India, respiratory infections, air pollution, sedentary lifestyles and delayed medical care contribute significantly to chest-related symptoms.

 

What Does Chest Pain While Breathing Mean?

Chest pain while breathing refers to pain that:

  • worsens with deep inhalation or exhalation

  • may feel sharp, stabbing or burning

  • can be localized or spread across the chest

Pain intensity often increases with coughing or movement.

 

Common Causes of Chest Pain While Breathing

Lung Infections (Pneumonia)

Pneumonia inflames lung tissue and surrounding membranes.

Symptoms include:

  • chest pain while breathing

  • fever

  • cough

  • breathlessness

ICMR data identifies pneumonia as a major cause of respiratory illness in India.

 

Pleuritis (Inflammation of Lung Lining)

The pleura are thin membranes surrounding the lungs.

When inflamed:

  • breathing causes friction

  • sharp chest pain occurs

Pleuritis often follows viral infections or pneumonia.

 

Pulmonary Embolism

A blood clot in the lungs causes:

  • sudden chest pain

  • rapid breathing

  • severe breathlessness

This is a medical emergency requiring immediate care.

 

Chest Wall Muscle Strain

Muscle strain due to:

  • heavy lifting

  • intense coughing

  • poor posture

can cause pain during breathing or movement.

 

Costochondritis

Inflammation of rib cartilage causes:

  • localized chest pain

  • pain worsened by breathing or pressing on the chest

This condition is painful but not life-threatening.

 

Pneumothorax (Collapsed Lung)

Air leakage into the chest cavity causes:

  • sudden sharp chest pain

  • breathlessness

Often seen after trauma or in individuals with lung disease.

 

Heart-Related Causes

Though heart pain usually does not worsen with breathing, conditions such as:

  • pericarditis (heart lining inflammation)

can cause chest pain that changes with respiration.

 

Acid Reflux and Esophageal Spasm

Gastrointestinal causes may mimic chest pain.

However:

  • pain usually relates to meals

  • breathing-related pain should be evaluated carefully

 

Anxiety and Panic Disorders

Anxiety can cause:

  • chest tightness

  • rapid breathing

  • discomfort while breathing

Medical causes must be ruled out before attributing pain to anxiety.

 

Warning Signs That Require Emergency Attention

Seek immediate medical care if chest pain while breathing is associated with:

  • sudden onset

  • severe breathlessness

  • bluish lips or fingers

  • dizziness or fainting

  • sweating

  • coughing up blood

These may indicate life-threatening conditions.

 

Risk Factors for Serious Chest Pain

Higher risk occurs in people with:

  • smoking history

  • recent surgery or long travel

  • lung disease

  • heart disease

  • clotting disorders

Early evaluation is critical.

 

Diagnostic Evaluation

Doctors may recommend:

  • physical examination

  • chest X-ray

  • ECG

  • blood tests

  • CT scan

Timely diagnosis saves lives.

 

Why Chest Pain Should Not Be Ignored

Ignoring chest pain can lead to:

  • delayed treatment

  • worsening respiratory failure

  • preventable complications

WHO emphasises early symptom recognition for better outcomes.

 

Impact of Air Pollution and Lifestyle

Air pollution increases:

  • lung inflammation

  • infection risk

Sedentary habits reduce lung capacity, worsening symptoms.

 

Preventive Measures

Helpful preventive steps include:

  • avoiding smoking

  • staying physically active

  • managing respiratory infections early

  • maintaining good posture

  • staying hydrated

Preventive care reduces risk.

 

Role of Preventive Health Checkups

Regular health screening helps detect:

  • early lung disease

  • heart risk factors

  • chronic inflammation

Early intervention prevents emergencies.

 

When Chest Pain Is Less Likely Serious

Pain may be less concerning if:

  • localized

  • reproducible on touch

  • improves with rest

However, medical confirmation is still necessary.

 

Importance of Timely Medical Consultation

Chest pain should always be evaluated by a healthcare professional.

Delaying care can:

  • increase complications

  • raise mortality risk

Early action saves lives.

 

Conclusion

Chest pain while breathing is a critical symptom that should never be ignored. While causes range from muscle strain and infections to serious lung and heart conditions, only proper medical evaluation can determine the exact cause. Early diagnosis, timely treatment and preventive care are essential to protect respiratory and cardiovascular health. When it comes to chest pain, it is always safer to act early than to wait.

 

References

  • Indian Council of Medical Research (ICMR) – Respiratory and Cardiovascular Health Reports

  • World Health Organization (WHO) – Chest Pain and Respiratory Symptoms Guidelines

  • National Family Health Survey (NFHS-5) – Adult Respiratory Health Data

  • Lancet – Pulmonary Embolism and Chest Pain Research

  • NITI Aayog – Preventive Healthcare and Early Symptom Recognition

See all

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