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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

Read Blog

Wearable Health Monitoring India Market: Tracking Wellness & Chronic Care | SecondMedic

In India, wearable health monitoring is no longer a nice-to-have accessory - it’s becoming central to how people manage wellness, chronic conditions and preventive care. With the rise of lifestyle diseases, increasing smartphone penetration and growing consumer health awareness, the wearable health monitoring market is gaining serious momentum.

Market Size & Growth Outlook

According to a detailed study, the Indian wearable medical devices market generated approximately USD 2,344.5 million (USD 2.34 billion) in 2024 and is projected to reach USD 5,670.6 million by 2030, growing at a compound annual growth rate (CAGR) of about 16?tween 2025 and 2030. Grand View Research
Another research source puts the medical wearables market in India at USD 1.04 billion in 2024, forecast to reach USD 4.20 billion by 2033 at ~15.5?GR. IMARC Group

These figures underscore a major shift: wearables are becoming an integral part of India’s health-tech ecosystem - not just fitness gadgets, but devices capable of monitoring heart-rate, sleep, activity, arrhythmia, vitals, and enabling remote patient monitoring.

Why This Growth Is Happening

Chronic disease burden: With rising incidences of diabetes, hypertension, cardiovascular disease and obesity, there’s a greater demand for continuous monitoring and early alerts.
Digital health push: Government programmes like the National Digital Health Mission (NDHM) and greater smartphone/internet penetration support connected health solutions.
Consumer awareness & wellness culture: More Indians are adopting health-tech and wearables as part of lifestyle, not just for tracking steps but for meaningful health insights.
Home-based care & remote monitoring: The pandemic accelerated acceptance of home-based diagnostics and monitoring - making wearables more relevant for remote care models.
Device innovation & cost reduction: Improved sensors, cheaper manufacturing and localised device assembly are easing access and lowering barriers for adoption.

Segmentation & Key Areas of Impact

Product type: Smartwatches, fitness bands, smart rings, medical-grade monitors for vitals, remote patient monitoring sensors. For instance, the broader smart wearable market in India shows health & fitness tracking made up ~54.35% of the market in 2024. Mordor Intelligence+1
Application: Chronic disease monitoring, preventive wellness, senior care, remote patient monitoring. The largest revenue segment in 2024 is chronic disease management. Grand View Research
Geography & access: Urban metros lead adoption today but Tier-2/3 towns and rural areas represent the next frontier, especially when paired with telehealth and wearable-data integration.

How SecondMedic Fits In

At SecondMedic, we believe monitoring is as important as diagnostics - and wearables are key to that vision. Our platform integrates wearable-generated data into our digital health ecosystem so we can provide:

Continuous monitoring for individuals managing chronic conditions - enabling earlier interventions when trends suggest risk.
Preventive insights for health-conscious users - wearable data feeds into our dashboards to flag deviations and prompt doctor consults.
Remote care models for seniors or mobility-limited users - wearable alerts tie into tele-consultation and remote monitoring workflows.
Data-driven coaching - using wearable metrics (sleep, activity, heart-rate variability) to personalise lifestyle recommendations and follow-up plans.

By combining wearable health monitoring with virtual consultations, diagnostics and preventive screening, SecondMedic offers a holistic digital health solution - not just episodic care but continuous well-being.

Challenges Ahead

Despite strong growth, wearable health monitoring in India faces some headwinds:

Affordability & accessibility: While top-tier wearables are affordable for many urban users, the device cost and ecosystem (apps, data, follow-ups) can be a barrier for rural and lower-income groups.
Device accuracy & clinical validation: Consumer-grade wearables may lack medical-grade accuracy. For serious clinical usage, device certification and integration with health records are required.
Data integration & usability: Wearable data alone isn’t enough - it needs to be integrated into clinical workflows, trusted by doctors and actionable.
Digital literacy & internet/connectivity: Rural areas and older populations may face challenges using wearables effectively or syncing data.
Regulatory and privacy issues: With health data being sensitive, wearables must ensure strong data security, interoperability and comply with frameworks like NDHM.

Real-World Calculation & Uptake Example

If the market grows from USD 2.34 billion in 2024 to USD 5.67 billion by 2030, that’s roughly a 2.4× increase in six years.
At 16?GR, wearable adoption is expected to double approximately every 4.5 years.
If chronic disease monitoring is the largest segment today, then targeting those affected by diabetes/hypertension (over ~100 million Indians) gives enormous addressable potential for wearable monitoring + telehealth.
For SecondMedic platform users: even if 1% of chronic-disease patients adopt wearables and remote monitoring via our service, that could represent hundreds of thousands of people nationwide - driving meaningful growth in preventive care utilisation.

Looking Ahead

As sensors get cheaper, wearables become more accurate and integrated with digital health platforms, we expect:

Wearables prescribed by doctors as part of home-care plans for chronic patients.
Insurance-linked models where usage of wearables triggers incentives or premium discounts.
Data ecosystems where wearable telemetry flows into platforms like SecondMedic, enabling predictive analytics, alerts and personalised care.
Greater rural uptake with low-cost devices, smartphone penetration and telehealth coupling.

Conclusion

The wearable health monitoring market in India is at an inflection point - moving from fitness gadgets to serious health-tech tools.
For health platforms like SecondMedic, this is a major opportunity: wearable data becomes another input in delivering continuous, personalised, preventive and remote care.

Because health isn’t just about testing now - it’s about monitoring, tracking, and intervening early.

Discover how SecondMedic integrates wearable health monitoring into your care journey at www.secondmedic.com

References

Grand View Research: India wearable medical devices market USD 2,344.5 million in 2024, projected USD 5,670.6 million by 2030. Grand View Research
IMARC Group: India medical wearables market USD 1.04 billion in 2024; projected USD 4.20 billion by 2033. IMARC Group
Mordor Intelligence: India smart wearable market – 54.35% of revenue from health & fitness in 2024; chronic-disease monitoring CAGR ~24.7%. Mordor Intelligence

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