• Published on: Apr 28, 2020
  • 4 minute read
  • By: Dr Rajan Choudhary

Strokes In The Young And How COVID Causing Clotting Disorders?

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Strokes in the young and healthy: how is COVID causing clotting disorders?

In the news, there has been a rush in stories linking Strokes in young and healthy patients, patients who also have COIVD-19. This is certainly worrying news, and at first glance, it is difficult to explain. How does a respiratory virus, one that is very similar to the coronavirus responsible for the common cold, cause such serious issues in a completely unrelated organ system? In this two-part series we will first go over the basics of clotting and its function, how clotting can cause problems, and finally how COVID can lead to clotting disorders.

STROKES

Before we progress, if you or a family member are having any of the following symptoms, contact your local emergency services immediately. Strokes can be devastating, and treatment needs to be given as soon as possible to save as much of the brain as we can. Early recognition can be the difference between manageable long term effects and crippling disability.

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.

PLUGGING A HOLE

We have an intricate network of vessels to transport oxygen, nutrients, and signals to cells and organs across our bodies. Damage to these blood vessels causes blood loss, reduction in oxygen and nutrient delivery to these cells, and organ damage if the issue isn’t rectified. Failure in multiple organ systems across the body will eventually lead to death. Our blood has cells and proteins that work together to form a clot at the site of injury. This acts as a plug to physically stop the leak, but also encourages repair of the blood vessel and surrounding tissue.

A clot can be triggered in three different ways: blood stasis (pooling up in one area), exposure of blood vessel lining, and pro-coagulant factors released into the blood. When triggered a coagulation cascade occurs to form the building blocks of a clot – it works so well that even a small trigger can create a response big enough to repair the damage. These form a mesh trapping platelets and other blood cells into a plug. Immune cells also arrive to destroy any organisms that might enter from the trauma site that caused the injury, and these immune cells also instruct nearby cells to begin the repair process.

As with everything in our body the whole process is very tightly regulated. The cascade has triggers and accelerators, but it also has brakes. These brakes stop a clot from growing too big, or from clots forming spontaneously when they are not needed. They also help dissolve a clot once the vessel is repaired and it isn’t needed.

WHEN IT GOES WRONG

Heart attacks and strokes. These devastating cardiovascular diseases are well recognized by the public as a leading cause of disability and death. Both can be caused by abnormal clotting. How does our finely tuned clotting cascade turn abnormal? Let's go back to the three triggers of blood clotting.

Vessel damage: Eating a high fat and cholesterol diet can cause fatty plaques to build up in our arteries. This is known as atherosclerosis, and it is extremely common. The plaques can narrow your arteries and reduce blood flow. If this happens in your coronary arteries supplying your heart muscles, your heart might not receive enough oxygen when you exercise or exert yourself. This can cause chest pain, known as angina.

If the plaques burst open it can expose the vessel lining, causing a large clot to form. This clot can become dislodged and be carried away by the blood. It will eventually get lodged in a narrow artery, blocking it and stopping blood from entering. The tissue and cells supplied by that artery will not receive oxygen and eventually die. If this happens in the coronary arteries it can cause a heart attack. In the arteries supplying the brain, it can cause a stroke, leading to neurological deficits.

THIS IS THE MOST IMPORTANT LEARNING POINT, and this is why a healthy diet low in fat and sugars is so important. 

Stasis: Our heart pumps blood at high pressures through the arteries. But in the veins, there is very little pressure to drive the blood back to the heart. In our arms and head, gravity helps blood flow down to the heart. But from our legs? When we walk the muscles in our legs squeeze the veins and move the blood. Valves make sure this flow is only one way, back to the heart.

If we sit or lie down in one place and don’t move, the blood isn’t pumped back and pools up in our legs, causing a clot to form. This usually happens in our calves (known as a DEEP VEIN THROMBOSIS, or DVT). The calf becomes swollen, painful, red, and hot. If this clot is dislodged, it can end up in our lungs causing a PULMONARY EMBOLISM. A large PE can block blood from entering the lungs and can be fatal. This is why you should take regular walks on long haul flights, to prevent blood from pooling.

Pro-coagulant: Sometimes the factors in our blood responsible for triggering a clot can be triggered accidentally. Cigarette smoke contains many toxins and harmful chemicals that, when inhaled, end up in your blood. These chemicals can cause damage to vessel linings, and also cause the clotting cascade to be triggered more easily. Some medications, such as the Combined Oral Contraceptive Pill, also have a similar effect, though the risk of getting a clot is still very low.

The immune system can also trigger a clot. The protein mesh formed in the blood can also capture bacteria and viruses around an infection site, making it easier for immune cells to find and destroy these invading organisms. In cancer patients, this process is sometimes triggered by unregulated cancer cells.

WHAT HAVE WE LEARNT?

Our clotting system stops us from bleeding to death from a small wound. People who have bleeding disorders are clear examples and need to be extremely careful if they injure themselves. But unregulated, our body can end up harming itself. If there is one thing you should take away from this, it is that a high sugar/high-fat diet with little exercise can directly increase your risk of having a heart attack or stroke. This is why doctors emphasize so much the importance of a good diet and exercise.

In our next blog, we will look at how this clotting problem is implicated in COVID patients.

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

www.secondmedic.com

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Insomnia in Teens and How to Manage It

Insomnia in Teens and How to Manage It

Sleep is essential for growing teens, yet many struggle to get enough of it. From school stress to social media scrolling, teenagers today face multiple challenges that affect their sleep. One of the most common sleep disorders among adolescents is insomnia—the inability to fall asleep, stay asleep, or wake up feeling rested.

In this blog, we’ll break down the causes, effects, and simple strategies to handle insomnia in teens and how to manage it naturally.

 

What is Insomnia?

Insomnia is a sleep disorder that makes it hard to fall asleep, stay asleep, or get quality rest. Teens with insomnia often feel tired during the day, even if they’ve spent enough time in bed.

There are two main types:

  • Short-term insomnia: Lasts for a few days or weeks, often triggered by stress or changes in routine.
     

  • Chronic insomnia: Occurs at least three times a week for over three months.
     

 

Why Is Insomnia Common in Teens?

Teenagers go through many physical, emotional, and social changes. All these factors can disturb their sleep:

1. Hormonal Shifts

During puberty, the sleep hormone melatonin is released later at night. This shifts the body clock, making teens naturally want to sleep and wake up later.

2. Screen Time

Excessive use of phones, tablets, or laptops before bedtime exposes the brain to blue light, which delays melatonin release and interferes with sleep.

3. Academic Stress

Homework, exams, and performance pressure can cause anxiety and overthinking at night, preventing restful sleep.

4. Caffeine Intake

Energy drinks, tea, coffee, and cola consumed in the evening can make it difficult to fall asleep due to their stimulating effects.

5. Mental Health Issues

Anxiety, depression, and emotional distress are often linked with poor sleep in teens.

 

Signs of Insomnia in Teenagers

  • Difficulty falling asleep at night
     

  • Waking up multiple times during the night
     

  • Feeling tired or sleepy during the day
     

  • Irritability or mood swings
     

  • Trouble focusing in school
     

  • Frequent headaches or stomach issues
     

  • Increased use of stimulants (coffee, energy drinks)
     

 

How Insomnia Affects Teens

Sleep deprivation can harm a teen's physical and mental health. Here are a few ways it affects their well-being:

  • Poor concentration in school
     

  • Weakened immunity
     

  • Increased risk of depression and anxiety
     

  • Weight gain due to hormonal imbalance
     

  • Risky behaviors due to impaired judgment
     

Teens who consistently sleep less than 7–8 hours are more likely to face emotional and academic challenges.

 

Natural Ways to Manage Insomnia in Teens

Thankfully, insomnia doesn’t always need medication. Many teens can improve their sleep with simple lifestyle changes.

1. Set a Regular Sleep Schedule

Encourage going to bed and waking up at the same time every day—even on weekends. This helps reset the body’s internal clock.

2. Limit Screen Time Before Bed

Avoid phones, TVs, and tablets at least 1 hour before bedtime. Use “night mode” or blue light filters if screen use is necessary.

3. Practice Relaxation Techniques

Deep breathing, meditation, gentle yoga, or reading a book before bed can calm the mind and prepare the body for sleep.

4. Watch Food and Drink

Avoid heavy meals, sugar, or caffeine in the evening. A light snack like warm milk, bananas, or almonds can promote better sleep.

5. Get Daily Exercise

Physical activity during the day can improve sleep quality—but avoid intense workouts right before bedtime.

6. Create a Sleep-Friendly Environment

Keep the bedroom cool, dark, and quiet. Use blackout curtains, soft bedding, and remove distractions like phones or bright lights.

 

When to See a Doctor

If your teen’s insomnia lasts longer than 3 weeks or affects their daily life, school, or mood, it’s important to consult a doctor or sleep specialist. Underlying conditions like anxiety, ADHD, or depression might need professional care.

 

Lab Tests That May Help

If your teen complains of constant fatigue or disrupted sleep, you might consider lab tests to rule out medical reasons such as:

  • Thyroid Function Test (for hormonal imbalance)
     

  • Vitamin D & B12 Tests (deficiency can affect sleep)
     

  • Stress Hormone Panel (Cortisol)
     

  • Iron Levels (especially in girls)
     

These tests are available through diagnostic providers like Thyrocare on platforms like SecondMedic.

 

Helping Teens Build Healthy Sleep Habits

As a parent, here’s how you can support better sleep:

  • Encourage open conversations about school pressure or emotional issues.
     

  • Set boundaries for screen use, especially at night.
     

  • Make the home environment calm and supportive before bedtime.
     

  • Lead by example—follow healthy sleep habits yourself.
     

 

Quick Tips for Teens

  • Sleep 8–10 hours every night
     

  • Don’t study in bed
     

  • Use a sleep diary or app to track sleep patterns
     

  • Avoid naps longer than 30 minutes in the day
     

  • Try journaling to clear the mind before sleep
     

 

Conclusion

Teenage insomnia is more common than many people realize. Fortunately, with the right support, structure, and healthy routines, it can be managed without medication.

If your teen shows signs of poor sleep, don’t ignore it. Better sleep leads to better mood, focus, and health.

So, if you’re wondering how to support better sleep for your child, remember to understand insomnia in teens and how to manage it the natural way—with empathy, good habits, and expert care when needed.

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