Call
+918447748545

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

Read Blog

Importance of Hydration for Organs: How Water Keeps the Body Functioning

Water is the most essential nutrient for human survival, yet it is often the most neglected. Every cell, tissue and organ in the body depends on adequate hydration to function properly. The importance of hydration for organs becomes clear when we understand how even mild dehydration can disrupt critical physiological processes.

In India’s climate, with high temperatures and humidity in many regions, dehydration risk is especially high, making conscious hydration a daily health priority.

Why Water Is Vital for the Human Body

The human body is made up of approximately 60 percent water. This water:

transports nutrients and oxygen
regulates body temperature
removes waste products
supports metabolic reactions

Without adequate hydration, organ systems begin to struggle.

Hydration and Kidney Health

The kidneys are among the most hydration-dependent organs.

Proper hydration:

helps kidneys filter blood efficiently
flushes out toxins and waste
reduces risk of kidney stones

Chronic dehydration forces kidneys to concentrate urine, increasing strain and long-term damage risk. According to Indian Council of Medical Research data, dehydration is a major contributor to kidney stone formation in India.

Brain Function and Hydration

The brain is highly sensitive to hydration levels.

Even mild dehydration can cause:

headaches
difficulty concentrating
memory issues
irritability

Studies published in the Lancet show that dehydration negatively affects cognitive performance and mood, even before thirst becomes noticeable.

Heart and Circulatory System

Hydration plays a critical role in cardiovascular health.

Adequate water intake:

maintains blood volume
supports smooth circulation
reduces strain on the heart

Dehydration thickens blood, making the heart work harder and potentially increasing the risk of low blood pressure, dizziness and cardiovascular stress.

Digestive System and Hydration

Water supports digestion at every stage.

It helps:

break down food
absorb nutrients
prevent constipation

Chronic low water intake is linked to digestive discomfort, bloating and poor gut motility.

Liver Function and Detoxification

The liver relies on water to:

metabolise nutrients
detoxify harmful substances
support metabolic balance

Inadequate hydration slows detoxification processes and increases metabolic strain.

Muscle and Joint Health

Muscles and joints contain significant water content.

Hydration:

prevents muscle cramps
supports joint lubrication
reduces injury risk

Dehydrated muscles fatigue faster and recover more slowly.

Skin as an Organ and Hydration

The skin is the body’s largest organ.

Adequate hydration:

maintains skin elasticity
supports barrier function
reduces dryness and irritation

While water alone is not a cure for skin problems, chronic dehydration worsens skin health.

Hydration and Immune Function

Water supports immune health by:

enabling transport of immune cells
aiding removal of toxins
supporting lymphatic circulation

WHO recognises hydration as a foundational element of immune system support.

Effects of Dehydration on Multiple Organs

Dehydration affects the body systemically.

Common effects include:

fatigue
dizziness
reduced urine output
dark-coloured urine
dry mouth and eyes

Severe dehydration can lead to organ failure if untreated.

Why Dehydration Often Goes Unnoticed

Many people confuse thirst with hunger or fatigue.

Risk factors include:

busy work schedules
excessive caffeine intake
high temperatures
inadequate fluid intake

By the time thirst is felt, dehydration has already begun.

Hydration Needs Vary by Individual

Water requirements depend on:

age
body size
physical activity
climate
health conditions

General guidelines suggest 2–3 litres daily for adults, but individual needs may vary.

Hydration and Chronic Disease Prevention

Proper hydration supports prevention of:

kidney disease
urinary tract infections
constipation
heat-related illness

NITI Aayog and WHO highlight hydration as a basic preventive health measure.

Best Practices for Staying Hydrated

Effective hydration strategies include:

drinking water regularly throughout the day
increasing intake during heat or physical activity
consuming water-rich foods such as fruits and vegetables
limiting sugary and caffeinated beverages

Consistency matters more than quantity in a single sitting.

Signs You May Need More Water

Watch for:

frequent fatigue
headaches
dry skin
reduced urination
poor concentration

These are early indicators of dehydration.

Role of Preventive Health Awareness

Preventive healthcare focuses on simple daily habits.

Hydration:

costs nothing
supports every organ
reduces disease risk

Small habits deliver large long-term benefits.

When to Seek Medical Advice

Consult a healthcare professional if experiencing:

persistent dehydration symptoms
kidney or urinary issues
dizziness or fainting
chronic fatigue

Underlying conditions may require medical evaluation.

Conclusion

The importance of hydration for organs cannot be overstated. Water supports kidney filtration, brain function, heart circulation, digestion, immunity and overall metabolic balance. Even mild dehydration disrupts organ performance and increases health risks over time. In busy modern lifestyles, consciously prioritising daily hydration is one of the simplest and most effective ways to protect vital organs and maintain long-term health. Consistent water intake is not just a habit—it is a foundation for organ health and wellbeing.

References

Indian Council of Medical Research (ICMR) – Hydration and Kidney Health Studies
World Health Organization (WHO) – Water Intake and Health Guidelines
National Family Health Survey (NFHS-5) – Nutrition and Lifestyle Data
Lancet – Hydration, Cognitive Function and Organ Health Research
NITI Aayog – Preventive Healthcare and Lifestyle Recommendations
Statista – Global Hydration and Health Trends

Request A Callback

+91

By using this website/app, I confirm that I am at least 18 years old and consent to the processing of my personal data in accordance with the Terms of Service, Privacy Policy, and Declaration.