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Published on: May 22, 2020
1 minute read
By: Dr Rajan Choudhary

Corona Virus In Young Patients And Kids

Kids seem to be relatively unaffected by COVID, but this does not mean they are invulnerable. As with adults, some children have pre-existing cardiac, respiratory, or metabolic conditions, and are therefore more vulnerable to the effects of COVID. Interestingly, children appear to have one more symptom when infected with coronavirus – COVID Toes.

I personally came across this phenomenon recently, with a young patient asymptomatic for COVID who presented with unusual symptoms of dark bruises on his toes. This had been present for just a few days. He did not have any pain, itching, swelling, no recent trauma, or injury to the feet. Circulation to his feet was normal, with no other rashes or skin changes, no other abnormal features in the history to note. It was certainly an odd presentation and certainly could have been an example of COVID toes.

This new phenomenon was noticed in April and has not gained as much notoriety because it is fairly rare compared to the major COVID symptoms, such as fever, cough, and lethargy. Doctors have described lesions on the feet of young people, usually purple-colored, around the tips of the toes. They have been compared to chilblains, painful swellings on feet, and toes that appear in the cold. Similarly to chilblains they do not cause any permanent damage and usually regress in days to weeks.

It's not clear why they occur or the mechanism behind the discoloration, because the presentation is rare and in healthy patients. We know COVID can cause systemic inflammation and can increase the risk of clot formation. It may be that localized inflammation is occurring in the toes, causing the vessels to clamp down and reduce blood flow to the area. This is similar to the mechanism for chilblains forming in the foot. Micro-clotting could also be partially responsible for this phenomenon.

COVID Toes is not the only skin symptoms related to COVID. In a paper published in the British Journal of Dermatology, researchers described five common skin presentations in 375 COVID patients. These were:

Asymmetrical chilblain like lesions in the hands and feet, found in younger patients lasting up to 2 weeks.
Small itchy blisters in the trunk and limbs, found in middle-aged patients before they present with symptoms, lasting about 10 days
Pink or white areas of raised skin, itchy, usually on the body
Raised bumps called macropapules, lasting about a week, seen in more severe infections.
Mottled, blotchy red-blue skin (known as livedo) seen in patients with severe illness.

So if you are currently suffering from COVID or have recently recovered from an infection, and suddenly notice odd colored toes, you too may have a case of COVID toes.

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

www.secondmedic.com

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How Poor Hydration Affects Joint Health: Why Water Matters for Mobility

Water is essential for nearly every function in the human body, yet many people underestimate its importance for joint health. While hydration is commonly associated with digestion and skin health, it also plays a crucial role in maintaining smooth and pain-free joint movement.

Understanding how poor hydration affects joint health can help prevent stiffness, discomfort and long-term mobility issues.

The Role of Water in Joint Function

Joints are where two bones meet, allowing movement and flexibility. Healthy joints rely on:

Cartilage
Synovial fluid
Ligaments
Tendons

Cartilage, which cushions bones, contains a high percentage of water. Synovial fluid acts as a lubricant, reducing friction during movement.

Proper hydration ensures these components function effectively.

What Happens When You Are Dehydrated?

When the body lacks sufficient water:

Synovial fluid production may decrease
Cartilage may lose elasticity
Joint cushioning becomes less effective

This can result in stiffness and discomfort.

1. Reduced Joint Lubrication

Synovial fluid requires adequate hydration to maintain volume and viscosity.

Without enough water:

Friction between bones increases
Movement becomes less smooth
Risk of wear and tear rises

2. Increased Joint Stiffness

Dehydration may cause joints to feel tight, especially:

In the morning
After prolonged sitting
During physical activity

Stiffness may limit flexibility.

3. Higher Risk of Injury

Poorly lubricated joints may be more prone to:

Sprains
Strains
Cartilage damage

Hydration supports tissue resilience.

4. Worsening of Existing Joint Conditions

Individuals with conditions such as osteoarthritis may experience increased discomfort if hydration is inadequate.

While water does not cure arthritis, it supports overall joint function.

5. Reduced Nutrient Delivery

Water helps transport nutrients to joint tissues.

Dehydration may impair circulation and nutrient exchange, slowing tissue repair.

Signs of Dehydration That May Affect Joints

Dry mouth
Dark urine
Fatigue
Headaches
Muscle cramps
Joint stiffness

Recognizing early dehydration signs prevents complications.

How Much Water Do You Need?

Hydration needs vary depending on:

Body weight
Climate
Physical activity level
Health conditions

On average, adults may require 2–3 liters of water daily.

In hot climates such as India, higher intake may be necessary due to increased sweating.

Tips to Maintain Proper Hydration

1. Drink Water Regularly

Do not wait until you feel thirsty.

2. Eat Water-Rich Foods

Include:

Cucumbers
Watermelon
Oranges
Tomatoes

3. Limit Excessive Caffeine and Alcohol

These may contribute to fluid loss.

4. Carry a Water Bottle

Keeping water accessible encourages consistent intake.

5. Hydrate Before and After Exercise

Physical activity increases fluid loss through sweat.

Hydration and Joint Health in India

In India’s hot and humid climate, dehydration is common, especially during summer months.

Outdoor workers, athletes and elderly individuals are particularly vulnerable.

Maintaining adequate hydration supports not only joint health but overall wellbeing.

When to Consult a Doctor

Seek medical advice if you experience:

Persistent joint pain
Swelling
Limited range of motion
Redness or warmth around joints

These may indicate underlying joint disorders requiring evaluation.

Conclusion

Poor hydration can negatively affect joint health by reducing lubrication, increasing stiffness and raising injury risk. Since cartilage and synovial fluid depend heavily on water, maintaining adequate hydration is essential for smooth movement and long-term mobility.

Drinking sufficient water daily is a simple yet powerful step toward protecting joint health. Combined with regular exercise and balanced nutrition, proper hydration supports active and pain-free living.

Small daily hydration habits can make a significant difference in how your joints feel and function.

References

Indian Council of Medical Research – Hydration Guidelines
World Health Organization – Water and Health Resources
Indian Journal of Orthopaedics – Joint Health Studies
National Institute of Nutrition India – Fluid Intake Recommendations
Journal of Sports Medicine – Hydration and Musculoskeletal Health Research

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