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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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Health Problems Linked to Excessive Caffeine Intake: When Too Much Becomes Harmful

Caffeine is one of the most widely consumed stimulants in the world. Found in coffee, tea, energy drinks and many soft drinks, it is often used to improve alertness and combat fatigue. While moderate caffeine consumption can be safe for most people, understanding the health problems linked to excessive caffeine intake is important, especially as daily consumption levels continue to rise in India.

Urban lifestyles, long working hours and increased reliance on energy drinks have made caffeine overconsumption a growing public health concern.

How Caffeine Works in the Body

Caffeine stimulates the central nervous system by blocking adenosine, a chemical responsible for promoting sleep and relaxation.

This results in:

increased alertness
faster heart rate
heightened mental activity

However, overstimulation places stress on multiple body systems.

What Is Considered Excessive Caffeine Intake?

According to WHO and global health guidelines:

up to 400 mg per day is considered safe for most healthy adults

Excessive intake occurs when:

multiple caffeinated beverages are consumed daily
energy drinks are used frequently
caffeine is consumed late in the day

Many people unknowingly exceed safe limits.

Nervous System Overstimulation

Excess caffeine overstimulates the brain.

Common symptoms include:

restlessness
nervousness
tremors
irritability

Chronic overstimulation can worsen stress and reduce emotional stability.

Anxiety and Panic Symptoms

Caffeine increases adrenaline release.

This can:

trigger anxiety attacks
worsen panic disorder
increase feelings of unease

ICMR mental health studies note caffeine as a common trigger for anxiety symptoms in sensitive individuals.

Sleep Disruption and Insomnia

Sleep is one of the first systems affected.

Excessive caffeine:

delays sleep onset
reduces deep sleep
shortens total sleep duration

Even caffeine consumed 6–8 hours before bedtime can impair sleep quality.

Impact on Heart Health

High caffeine intake affects the cardiovascular system.

Possible effects include:

increased heart rate
palpitations
irregular heart rhythm

People with underlying heart conditions are particularly vulnerable.

Blood Pressure Elevation

Caffeine temporarily raises blood pressure.

Chronic excessive intake may:

worsen hypertension
increase cardiovascular risk

NFHS-5 data highlights rising hypertension prevalence in India, making caffeine moderation important.

Digestive System Problems

Caffeine stimulates stomach acid production.

This can cause:

acidity
heartburn
gastritis
bloating

People with sensitive digestion may experience symptoms even at lower doses.

Dependency and Withdrawal Symptoms

Regular high intake leads to caffeine dependence.

Withdrawal symptoms include:

headaches
fatigue
irritability
difficulty concentrating

Dependence reinforces overconsumption cycles.

Effect on Bone Health

Excessive caffeine:

increases calcium loss through urine
may affect bone density over time

This is particularly concerning for older adults and women.

Dehydration and Electrolyte Imbalance

Caffeine has a mild diuretic effect.

High intake without adequate hydration may lead to:

dehydration
muscle cramps
fatigue

Hot climates increase this risk.

Impact on Blood Sugar and Metabolism

Caffeine affects glucose metabolism.

Excessive intake:

worsens insulin sensitivity
increases stress hormone release

This may increase diabetes risk when combined with poor lifestyle habits.

Energy Drinks and Hidden Risks

Energy drinks often contain:

very high caffeine levels
added sugar
stimulants

Lancet reports associate energy drink overuse with heart rhythm disturbances and metabolic stress.

High-Risk Groups

Certain individuals should be especially cautious:

people with anxiety disorders
those with heart disease
pregnant women
individuals with sleep disorders

Safe limits may be lower for these groups.

Signs You May Be Consuming Too Much Caffeine

Warning signs include:

frequent palpitations
chronic insomnia
persistent anxiety
digestive discomfort
reliance on caffeine to function

These signals indicate the need for reduction.

How to Reduce Caffeine Intake Safely

Effective strategies include:

gradual reduction rather than abrupt stopping
switching to decaffeinated options
avoiding caffeine after mid-afternoon
improving sleep and nutrition

Small steps prevent withdrawal symptoms.

Healthier Alternatives for Energy

Better ways to improve energy include:

adequate sleep
balanced meals
hydration
regular physical activity

These support sustained energy without overstimulation.

Role of Preventive Health Awareness

Preventive healthcare focuses on:

identifying lifestyle triggers
reducing dependency habits

NITI Aayog highlights lifestyle modification as key to non-communicable disease prevention.

Long-Term Health Consequences of Ignoring Excess Intake

Chronic caffeine overuse increases risk of:

sleep disorders
anxiety and mood issues
heart rhythm problems
digestive disorders

These conditions often develop gradually.

Conclusion

The health problems linked to excessive caffeine intake extend beyond temporary jitters or sleep loss. Chronic overconsumption strains the nervous system, disrupts sleep, affects heart rhythm, worsens anxiety and impacts digestion and metabolism. While caffeine can be enjoyed safely in moderation, recognising personal limits and maintaining balance is essential for long-term health. Listening to early warning signs and adopting healthier energy habits can prevent serious health consequences.

References

World Health Organization (WHO) – Caffeine Intake and Health Guidelines
Indian Council of Medical Research (ICMR) – Nutrition and Mental Health Studies
National Family Health Survey (NFHS-5) – Hypertension and Lifestyle Risk Data
Lancet – Energy Drinks, Caffeine and Cardiovascular Effects
NITI Aayog – Preventive Health and Lifestyle Modification Reports
Statista – Caffeine Consumption Trends in India

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