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Published on: Apr 30, 2020
3 minute read
By: Dr Rajan Choudhary

COVID AND CLOTTING: A BRIEF LOOK

At the Mount Sinai hospital, a case series of five patients have been put together, ready to be published in the New England Journal of Medicine. It details patients aged 33, 37, 39, 44, and 49 who all began to experience a sudden onset of symptoms including slurred speech, confusion, drooping on one side of the face, and feeling dead in one arm. At the time of writing one has sadly died, two remain hospitalized and one is in rehab. Only the youngest is able to speak. All of them were found to be COVID positive.

This drastic case series highlights a growing problem of strokes and clotting disorders in COVID patients, one noted by medics across the world. This blog looks at whether this is a common occurrence and what may be causing it.

Before reading this blog it will be helpful to read our previous blog on why and how blood clots.

THE START

In mid-February Tang et al published a paper noting that patients with abnormal clotting parameters were associated with a poorer prognosis. In their study, 11% of their patients died, but out of these patients, 71% had these abnormal parameters, compared to just 0.6% of survivors. The patients who died also demonstrated DIC (disseminated intravascular coagulation), a condition in which clotting is triggered in the patients' blood across the body, not just at the site of injury.

There is one major issue with this study. In most European hospitals patients receive anticoagulant medications on a daily basis. This is because lying in a hospital bed when ill can promote the formation of clots in your legs. Most hospitals in China do not provide this anticoagulation, but even then the incidence of clotting is remarkably high.

After this, the evidence begins piling up. 9th April, Cui et al found 25% of patients with severe COVID had clots in their legs, of which just under half died. Looking at a specific clotting parameter (D-DIMER) was remarkably accurate at predicting high-risk patients.

Italian doctors found in 16 patients in critical care with severe Acute Respiratory Distress Syndrome (a severe inflammatory condition caused by COVID) also had deranged clotting parameters.

French studies had found these sickest patients often had large clots in their lungs, blocking blood flow in the lung and causing severe issues in keeping the patient's blood well oxygenated.

Some studies showed even patients hooked up to artificial lungs (known as ECMO) were not safe from the problems caused by excessive clotting.

WHY?

So why is this occurring? As with everything in medicine, the answer is complicated and usually multifactorial. So we will simplify it.

We must look at the platelets in our blood. These fragmented cells have an important role in triggering the clotting cascade and creating a clot. During an infection white blood cells (important immune cells responsible for finding and destroying invading organisms) release many chemical signals around an infection site. This triggers platelets, the formation of small protein meshes that can literally net the viral particles in the blood.

But it looks like they have an anti-viral role as well. Researchers have found specialist receptors on platelets that recognize viruses in the blood, leading to the release of specialist anti-viral molecules that target and destroy the viruses. This is an interesting finding because it is white blood cells that are known to destroy invading organisms.

So how does it go wrong? In severe infections, there is a very large viral load, and this can cause an excessive response. Too many white blood cells release too many chemical signals, causing too many platelets to activate. The same thing can occur with the virus directly activating too many platelets at once. This results in clots forming in the blood throughout the body, including the lung and the brain. It is another instance of the body falling victim to its own protective mechanism.

A second problem is that as these platelets are activated, they and the clotting proteins in the patient’s blood are “used up”. This is dangerous, because without these platelets and clotting proteins the body is unable to stop any bleeding sites. Profuse bleeding can occur from small injuries, further complicating the treatment of the patient.

So what can be done?

Hospitals have already started looking at giving patients with severe COVID anticoagulation therapy. And it seems in patients with deranged clotting, giving anticoagulation therapy can lower mortality. The International Society on Thrombosis and Haemostasis (Clotting) has recommended that patients with severe COVID receive high dose anticoagulation medication to thin their blood, because these patients are at such high risk of clots. This regime will be used for hospital patients and those in critical care.

And what about for the everyday public? Should we be worried? So far the data suggests this is only happening in people suffering from severe symptoms of COVID. But the incident in New York certainly raises some questions, and it will be interesting to read their report in NEMJ. Should you panic and start taking anti-coagulant medication at home? Definitely not. But what you should do is be educated in the symptoms of common diseases caused by clots. Diseases such as strokes and DVTs.

STROKE

Remember, act F.A.S.T

Facial Droop on one side
Arm or hand on one side feels numb or weak with reduced power (same in one leg)
Slurred speech making it difficult to understand
Time to phone an ambulance

Other symptoms can include sudden loss in balance, sudden loss in vision in one eye, problems swallowing, and more.

DVT

Look out for a swollen, painful calf on one side that is hot to touch.

PULMONARY EMBOLISM

If you have a swollen, painful calf and are also having trouble breathing, with some sharp stabbing pain in your chest, contact the emergency services as soon as possible.

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

www.secondmedic.com

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Virtual Clinic India: How SecondMedic Is Transforming Digital Healthcare

Healthcare in India is undergoing a significant transformation as digital platforms reshape how people access medical care. Virtual clinics have emerged as a powerful solution, offering patients immediate access to doctors, diagnostics, prescriptions, and continuous monitoring—without the need for physical hospital visits. This model has become increasingly important in a country where population density, geographical barriers, and long wait times often make healthcare inaccessible or inconvenient.

A virtual clinic uses telemedicine, digital records, online diagnostics, AI tools, and remote monitoring to offer a full healthcare experience through smartphones or computers. SecondMedic is among the leaders in this space, providing a robust virtual clinic ecosystem designed to support preventive health, chronic disease management, and immediate care for everyday medical needs.

The Role of Virtual Clinics in India’s Healthcare Evolution

India faces significant challenges including uneven specialist distribution, crowded hospitals, and rising lifestyle diseases. Virtual clinics bridge these gaps by making healthcare more accessible, affordable, and continuous. They enable patients from metropolitan areas, rural communities, and even remote regions to receive quality care without leaving home.

Key drivers behind virtual clinic growth include:

Growing smartphone and internet penetration
Increased comfort with digital health platforms
The need for safe and convenient care
Rising chronic illnesses requiring ongoing monitoring
Awareness of preventive healthcare

As a result, virtual clinics are becoming the first point of contact for many health concerns.

How Virtual Clinics Deliver Complete Healthcare

Virtual clinics are more than video consultations. They integrate multiple components of healthcare into a unified digital experience. SecondMedic’s virtual clinic model ensures continuity of care by bringing together doctors, diagnostics, monitoring tools, pharmacy support, and digital health records.

Core pillars of virtual clinic care include:

Instant doctor access
Seamless diagnostic testing
AI-based symptom evaluation
E-prescriptions
Medication delivery
Chronic disease monitoring
Preventive health programs

This creates an end-to-end flow that mirrors the experience of visiting a physical clinic, but with added convenience and personalization.

Online Consultations: Immediate Access to Specialists

One of the strongest features of a virtual clinic is the ability to consult qualified doctors quickly. Instead of waiting days for appointments or traveling long distances, patients can connect with specialists through secure video calls or chat.

Virtual consultations are especially useful for:

Common illnesses
Follow-up appointments
Second opinions
Chronic condition management
Mental health support
Elderly care
Pediatric queries

SecondMedic ensures that all consultations are supported by electronic health records, making the experience seamless and informed.

Digital Diagnostics and At-Home Lab Testing

Diagnostics are a core component of healthcare, and virtual clinics have made them significantly more accessible. Users can book lab tests online and have samples collected from their home. Results are delivered digitally, enabling faster diagnosis and treatment.

Advantages of digital diagnostics include:

No travel or waiting lines
Fast report turnaround
Integration with doctor consultations
Easy follow-up and comparisons over time
Better compliance for chronic disease tracking

SecondMedic partners with certified diagnostic labs to ensure high-quality test processing and accurate digital reporting.

Remote Monitoring and Chronic Disease Care

Chronic diseases such as diabetes, hypertension, heart illness, and thyroid disorders require ongoing monitoring. Virtual clinics use connected devices and AI-driven alerts to help patients stay on track with their health goals.

Common remote monitoring tools include:

Glucometers
Blood pressure monitors
Heart-rate trackers
Pulse oximeters
Weight and BMI tools
Sleep monitors
Wearable sensors

SecondMedic uses advanced analytics to detect risk patterns early, send reminders, and support long-term condition management.

E-Prescriptions and Digital Pharmacy Support

Virtual clinics simplify the process of receiving medical prescriptions and ordering medicines. E-prescriptions are accurate, tamper-proof, and instantly shareable with online pharmacies.

Digital pharmacy support helps with:

Medication delivery
Monthly chronic care refills
Transparent drug information
Avoiding prescription errors
Improving medication adherence

SecondMedic integrates e-prescriptions directly with its pharmacy partners, making the treatment process seamless.

Preventive Healthcare Through Virtual Clinics

Preventive care is becoming a priority for many Indians due to rising lifestyle diseases and increasing awareness of early screening. Virtual clinics support this need through personalized health plans designed using AI assessments, digital screenings, and doctor insights.

Preventive healthcare offerings include:

Annual full-body checkups
Lifestyle assessments
Diet and fitness plans
Stress and sleep guidance
Vaccination reminders
Long-term wellness tracking

SecondMedic’s preventive programs are designed to detect risks early and help users adopt healthier habits.

How Virtual Clinics Improve Healthcare Accessibility in India

Virtual clinics remove geographical barriers by bringing medical care to people who otherwise face difficulty accessing doctors. This includes:

Rural regions with limited healthcare facilities
Urban areas with long hospital wait times
Elderly individuals who cannot travel easily
Busy professionals needing flexible care
Patients seeking discretion for sensitive concerns

With increased digital literacy and affordable smartphones, virtual clinics are becoming accessible to a wide demographic.

The Future of Virtual Clinics in India

The future of virtual clinics is strong, supported by national initiatives like the Ayushman Bharat Digital Mission (ABDM), which encourages digital health adoption. AI-driven diagnostics, intelligent triaging, predictive health tools, and integrated hospital systems will further strengthen the virtual care model.

Upcoming trends include:

AI chat-based symptom evaluation
Virtual reality rehabilitation sessions
Smart device-linked monitoring
AI-based early disease detection
Comprehensive preventive health ecosystems
Hybrid care combining virtual and in-clinic visits

SecondMedic is actively developing next-generation virtual clinic technologies to make healthcare more proactive and patient-centered.

Conclusion

Virtual clinics are revolutionizing healthcare delivery in India by offering convenient, reliable, and digitally connected care. They bring together consultations, diagnostics, monitoring, and preventive health in one platform, reducing barriers and enabling patients to receive high-quality medical support anytime, anywhere. SecondMedic leads this transformation with a comprehensive virtual clinic model designed to support long-term health and wellbeing.

To access virtual consultations, digital diagnostics, and remote care services, visit www.secondmedic.com

References

NITI Aayog - Telemedicine and Digital Health Report 2024
Statista - Telehealth Usage India 2025
WHO - Digital Health Standards
IMARC - India Telemedicine Market Forecast
ABDM - Ayushman Bharat Digital Health Guidelines

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