• 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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How Cold Weather Affects Health: Understanding Winter’s Impact on the Body

How Cold Weather Affects Health: Understanding Winter’s Impact on the Body

Seasonal changes influence human health more than most people realise. Cold weather, in particular, places unique stress on the body and can worsen existing health conditions while increasing susceptibility to new illnesses. Understanding how cold weather affects health is essential for preventing seasonal complications and maintaining wellbeing during winter months.

In India, winter-related health issues vary by region but commonly include respiratory infections, cardiovascular strain and joint discomfort. According to the Indian Council of Medical Research (ICMR) and World Health Organization (WHO), cold exposure is associated with increased morbidity, especially among older adults and people with chronic conditions.

 

Why Cold Weather Impacts the Body

The human body works constantly to maintain core temperature. In cold environments:

  • blood vessels constrict to conserve heat
     

  • energy expenditure increases
     

  • immune responses may weaken
     

  • organs work harder to maintain balance
     

These adaptations, while protective, also create health vulnerabilities.

 

Increased Risk of Infections

Weakened Immune Response

Cold weather can suppress immune function, making it harder for the body to fight infections.

Factors contributing to winter infections include:

  • reduced vitamin D due to less sunlight
     

  • dry air affecting mucosal defenses
     

  • closer indoor contact
     

Common winter infections include colds, flu and respiratory illnesses.

 

Respiratory Health Problems

Cold air irritates the respiratory tract.

This can lead to:

  • worsening asthma symptoms
     

  • bronchitis flare-ups
     

  • increased cough and breathlessness
     

WHO reports higher hospital admissions for respiratory illnesses during colder months.

 

Impact on Heart Health

Cold temperatures affect cardiovascular function.

Blood Vessel Constriction

Cold causes blood vessels to narrow, increasing:

  • blood pressure
     

  • heart workload
     

This raises the risk of:

  • heart attacks
     

  • strokes
     

People with existing heart disease are particularly vulnerable.

 

Joint and Muscle Pain

Cold weather affects musculoskeletal health.

Common complaints include:

  • joint stiffness
     

  • muscle aches
     

  • worsening arthritis pain
     

Lower temperatures reduce joint lubrication and increase sensitivity to pain.

 

Metabolic and Weight Changes

Winter often leads to:

  • reduced physical activity
     

  • increased calorie intake
     

  • metabolic slowdown
     

These changes contribute to weight gain and worsen metabolic conditions such as diabetes.

 

Skin and Hydration Issues

Cold air holds less moisture.

This leads to:

  • dry skin
     

  • cracked lips
     

  • worsening eczema
     

Dehydration is also common as thirst perception reduces in cold weather.

 

Mental Health Effects

Seasonal changes can influence mental wellbeing.

Cold weather is associated with:

  • low mood
     

  • reduced motivation
     

  • seasonal affective symptoms
     

Limited sunlight affects circadian rhythm and serotonin levels.

 

Cold Weather and Older Adults

Elderly individuals face higher risks due to:

  • reduced temperature regulation
     

  • weaker immunity
     

  • existing chronic conditions
     

Winter-related complications are a significant cause of hospitalisation in older populations.

 

Why Chronic Diseases Worsen in Winter

Conditions such as:

  • hypertension
     

  • arthritis
     

  • asthma
     

  • diabetes
     

often worsen due to reduced activity, stress on organs and infection risk.

 

Preventive Strategies for Winter Health

Maintain Body Warmth

Layered clothing and warm environments reduce cold stress.

 

Support Immunity

Adequate nutrition, vitamin intake and sleep strengthen immune defences.

 

Stay Physically Active

Indoor exercises and regular movement prevent stiffness and metabolic decline.

 

Manage Chronic Conditions

Regular monitoring and medication adherence are critical during winter.

 

Hydration and Skin Care

Drinking fluids and using moisturisers prevent dehydration and skin damage.

 

Role of Preventive Healthcare

Preventive healthcare helps:

  • identify seasonal risk factors
     

  • adjust treatment plans
     

  • prevent winter complications
     

NITI Aayog highlights seasonal preparedness as an important public health strategy.

When to Seek Medical Help

Medical attention is necessary if:

  • infections persist or worsen
     

  • chest pain or breathlessness occurs
     

  • joint pain limits mobility
     

  • mental health symptoms interfere with daily life
     

Early care prevents serious outcomes.

 

Long-Term Impact of Ignoring Winter Health Risks

Ignoring cold weather effects may lead to:

  • severe infections
     

  • cardiovascular events
     

  • chronic pain progression
     

  • reduced quality of life
     

Seasonal awareness plays a critical role in long-term health.

 

Conclusion

Understanding how cold weather affects health allows individuals to take timely preventive measures. Winter increases the risk of infections, heart strain, respiratory problems, joint pain and mental health challenges. With proper warmth, nutrition, activity and preventive healthcare, most cold-related health issues are manageable and preventable. Seasonal care is not optional—it is essential for protecting health and wellbeing throughout the colder months.

 

References

  • ICMR – Seasonal Health and Infectious Disease Reports

  • National Family Health Survey (NFHS-5) – Seasonal Morbidity Data

  • NITI Aayog – Preventive Healthcare and Seasonal Preparedness Strategy

  • WHO – Cold Weather and Health Impact Guideline

  •  Lancet – Seasonal Variation in Cardiovascular and Respiratory Diseases

  • Statista – Winter Health Trends and Illness Data

  • Indian Journal of Public Health – Climate and Health Studies

See all

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