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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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Telemedicine Platform Comparison India: Evaluating the Best Digital Healthcare Providers

Telemedicine has transformed the healthcare landscape in India by making medical services more accessible, affordable, and patient-friendly. With growing smartphone usage, improved internet penetration, and digital health adoption under the Ayushman Bharat Digital Mission (ABDM), teleconsultation platforms have become a primary mode of healthcare for millions. But with multiple platforms available, choosing the right one requires a proper telemedicine platform comparison India.

This blog provides a detailed comparison of India’s leading telemedicine providers and evaluates what sets SecondMedic apart in terms of accessibility, specialist availability, user experience, and overall digital healthcare value.

Why Telemedicine Is Growing Rapidly in India

The demand for digital healthcare platforms is driven by:

Busy lifestyles limiting hospital visits
Rising chronic diseases needing follow-ups
Rural populations needing specialist access
Post-pandemic digital health acceptance
Cost efficiency
Faster access to care

According to Statista, the telemedicine market size in India is increasing significantly, driven by digital transformation and patient willingness to adopt virtual care.

Key Parameters for Comparing Telemedicine Platforms

When comparing telemedicine platforms, users should evaluate the following:

1. Doctor Availability

The range of specialists available-cardiology, dermatology, pediatrics, gynecology, orthopedics, etc.-is crucial.

2. Pricing and Consultation Fees

Costs vary significantly between platforms. Affordable, transparent pricing determines long-term usability.

3. User Interface (UI/UX)

The platform must be easy to navigate, especially for elderly patients.

4. Appointment Wait Time

Faster access to doctors enhances the value of telemedicine.

5. E-Prescriptions

Availability of legal, digital prescriptions is essential for seamless continuity of care.

6. Electronic Health Records (EHR)

Platforms offering unified records improve patient experience.

7. Service Range

A good telemedicine platform should provide:

Teleconsultations
Second opinions
Remote monitoring
Home diagnostics
Preventive health packages

SecondMedic is one of the few platforms offering this full ecosystem.

Comparison of Major Telemedicine Platforms in India

1. SecondMedic

Specialties: Full range including cardiology, dermatology, neurology
Strengths:

Instant teleconsultation
Online specialist access
Remote monitoring tools
Second opinion services
Preventive health packages
Strong chronic care management
Patient-first experience
Easy EHR access
Best For: Those wanting comprehensive digital healthcare

2. Practo

Strengths:

Wide doctor network
Pharmacy integration
Lab test bookings
Limitations:
Higher consultation fees
Variable doctor response times

3. Apollo 24/7

Strengths:

Strong specialist network
Integration with Apollo hospitals
Limitations:
High cost
Limited remote monitoring features

4. Tata 1mg

Strengths:

Affordable consultations
Pharmacy + lab tests
Limitations:
Limited specialist variety
Heavy focus on diagnostics and medicines rather than telemedicine

5. MFine

Strengths:

Good specialist availability
Partner-hospital model
Limitations:
Service coverage varies
Less personalized care

This comparison shows that while multiple telemedicine platforms serve specific needs, SecondMedic provides a more integrated healthcare experience connecting consultations, preventive care, and chronic disease management.

What Makes SecondMedic Stand Out

1. Comprehensive Specialty Coverage

From general physicians to cardiologists, dermatologists, neurologists, endocrinologists, and pediatricians, SecondMedic covers major medical specialties.

2. Strong Chronic Disease Management

Continuous monitoring and scheduled check-ins help manage long-term conditions effectively.

3. Online Second Opinions

Patients needing specialist reassessment benefit from high-quality second opinions from top doctors.

4. Remote Monitoring Ecosystem

Compatible with digital ECGs, glucometers, BP monitors, and other wearable tools.

5. Affordable and Transparent Pricing

SecondMedic offers cost-effective consultations without hidden charges.

6. Easy-to-Use Interface

Designed for all age groups with minimal complexity.

7. Integration with Preventive Health Packages

Users can also book diagnostics, screenings, and wellness plans.

Importance of EHR in Telemedicine Platform Comparison India

Electronic Health Records improve:

Safety
Accuracy
Convenience
Treatment continuity

SecondMedic’s EHR system is aligned with ABDM guidelines, making health data secure and portable.

User Experience and Accessibility

A good telemedicine platform must offer:

Multilingual support
Low-bandwidth compatibility
Easy appointment scheduling
Quick report upload

SecondMedic excels in offering a smooth, user-friendly experience.

Future of Telemedicine Platforms in India

The next evolution includes:

AI-assisted triage
Wearable tech integration
Predictive health alerts
Virtual healthcare kiosks
Full ABDM interoperability

SecondMedic is aligning with these innovations to build the next-generation digital healthcare ecosystem.

Conclusion

Telemedicine platform comparison India reveals that while several platforms offer strong digital health services, SecondMedic stands out due to its integrated care model, specialist availability, chronic disease support, remote monitoring tools, and preventive healthcare programs. For patients seeking a complete, reliable, and patient-centric telemedicine experience, SecondMedic remains a top choice.

To explore telemedicine services, visit www.secondmedic.com

References

NITI Aayog - Telemedicine guidelines for India
Statista - Telemedicine adoption and market size
ABDM - Digital health mission framework
WHO - Teleconsultation standards
IMARC - Digital health ecosystem growth
SecondMedic platform insights

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