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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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Why Always Tired Even After Proper Sleep

Feeling tired after a long workday is normal. But if you still feel exhausted even after a full night’s sleep, it could mean that something else is affecting your energy levels. Many people experience this and often overlook the actual cause. Understanding why always tired even after proper sleep can help you take practical steps to regain energy and improve your daily life.

1. Poor Sleep Quality

You may be in bed for 7–8 hours, but that doesn’t mean your body gets proper rest. Sleep quality is just as important as the number of hours. Disturbed sleep, frequent waking, or light sleep can prevent your body from entering deep sleep stages, which are necessary for repair and recovery.

Fix it:

Maintain a fixed sleep routine
Avoid screens 1 hour before bed
Keep your bedroom quiet, dark, and cool
Limit caffeine after afternoon

2. Vitamin and Mineral Deficiencies

One of the most common hidden causes of constant fatigue is nutrient deficiency. Low Vitamin D and B12 levels or iron deficiency can cause tiredness, low concentration, and muscle weakness even if you get enough sleep.

Fix it:

Get a lab test for Vitamin D, B12 and Hemoglobin
Eat foods like leafy greens, eggs, fish, and whole grains
Take supplements if advised by a doctor

3. Thyroid Imbalance

An underactive thyroid (hypothyroidism) slows metabolism. This makes you feel tired all the time, even after proper rest. Thyroid disorders can also cause weight gain, dry skin, and low mood.

Fix it:

Get a Thyroid Function Test (T3, T4, TSH)
Follow up with medication and regular monitoring if needed

4. Poor Diet and Dehydration

Eating high sugar, fried, or processed foods can lead to spikes and drops in energy levels. Dehydration reduces circulation and affects oxygen supply to the brain and muscles, making you feel sluggish and tired.

Fix it:

Eat balanced meals with complex carbs, vegetables, and lean protein
Drink at least 2–2.5 liters of water daily
Avoid skipping meals

5. Stress and Mental Fatigue

High mental stress keeps your nervous system active at night, which interferes with deep sleep. Even if you fall asleep, your brain continues to stay active, which reduces the quality of rest.

Fix it:

Practice relaxation techniques such as deep breathing or short meditation
Reduce screen time, especially work-related tasks before bed
Set clear boundaries between work and personal time

6. Lack of Physical Activity

It might seem surprising, but lack of exercise can actually make you feel more tired. Regular physical activity improves circulation, oxygen delivery, and hormone regulation. All these support better sleep and higher daytime energy levels.

Fix it:

Aim for at least 30 minutes of walk or light exercise daily
Choose activities you enjoy to stay consistent

7. Hidden Medical Conditions

Certain medical conditions such as sleep apnea, anemia, diabetes, and heart disorders can also cause fatigue even when you sleep adequately. In such cases, early diagnosis is essential to prevent complications.

Fix it:

Schedule a health check-up if fatigue persists
Follow medical advice and treatment plans as directed

Conclusion

Waking up tired every day can affect your productivity, mood, and overall quality of life. If you want to boost your energy levels, look beyond just “getting enough sleep”. Pay attention to your diet, activity levels, stress, and underlying health issues. A simple set of tests and small lifestyle changes can make a big difference in your daily energy.

Take the first step today and find out why always tired even after proper sleep — and get back to feeling healthy and energetic again.

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