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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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Heat Exhaustion Warning Signs: Symptoms You Should Never Ignore

Heat-related illnesses are common during hot weather, particularly in tropical countries like India where summer temperatures can become extreme. Heat exhaustion is a serious condition that occurs when the body overheats due to prolonged exposure to high temperatures and inadequate hydration.

Recognizing heat exhaustion warning signs early can prevent life-threatening complications such as heatstroke.

What Is Heat Exhaustion?

Heat exhaustion is a heat-related illness caused by:

Excessive heat exposure
Dehydration
Loss of electrolytes through sweating

It often occurs during outdoor work, exercise or travel in hot environments.

If untreated, it may progress to heatstroke — a medical emergency.

Common Heat Exhaustion Warning Signs

1. Heavy Sweating

Excessive sweating is one of the earliest signs.

The body attempts to cool itself through perspiration, leading to fluid loss.

2. Dizziness or Lightheadedness

Low blood pressure due to dehydration may cause:

Feeling faint
Blurred vision
Weakness

3. Fatigue and Weakness

Muscle weakness and exhaustion occur as the body struggles to regulate temperature.

4. Nausea and Vomiting

Digestive discomfort is common in heat-related illnesses.

5. Headache

Dehydration and heat stress can trigger throbbing headaches.

6. Muscle Cramps

Electrolyte imbalance may cause painful muscle cramps, especially in legs.

7. Rapid Heartbeat

Increased heart rate helps circulate blood for cooling but may indicate strain.

8. Cool, Clammy Skin

Despite hot weather, skin may feel cool and moist due to heavy sweating.

Who Is at Higher Risk?

Certain groups are more vulnerable:

Outdoor laborers
Athletes
Elderly individuals
Children
People with chronic illnesses
Individuals on certain medications

Urban heat exposure increases risk during peak summer months in India.

Heat Exhaustion vs Heatstroke

Heat exhaustion is serious but manageable if treated promptly.

Heatstroke symptoms include:

High body temperature (above 40°C)
Confusion or disorientation
Dry, hot skin
Seizures
Loss of consciousness

Heatstroke requires immediate emergency medical attention.

Immediate Steps to Take

If heat exhaustion is suspected:

Move to a cool, shaded area
Loosen tight clothing
Drink water or oral rehydration solution
Apply cool cloths to body
Rest until symptoms improve

Seek medical care if symptoms persist beyond one hour.

Prevention Tips

Stay Hydrated

Drink water regularly, even if not thirsty.

Avoid Peak Sun Hours

Limit outdoor activity between 12 PM and 4 PM.

Wear Light Clothing

Choose loose, breathable fabrics.

Use Sun Protection

Wear hats and sunglasses when outdoors.

Take Frequent Breaks

Rest in shaded or air-conditioned areas.

Maintain Electrolyte Balance

Use oral rehydration solutions if sweating heavily.

Heat Illness in the Indian Context

India frequently experiences heatwaves, especially in northern and central regions. Public awareness about hydration and heat safety is essential to reduce hospitalizations and fatalities.

Community-level education can significantly improve prevention.

When to Seek Medical Help

Immediate medical attention is required if:

Symptoms worsen
Body temperature rises significantly
Confusion develops
Fainting occurs
Vomiting persists

Early treatment prevents severe complications.

Conclusion

Heat exhaustion is a preventable but potentially dangerous condition. Recognizing warning signs such as heavy sweating, dizziness, nausea and muscle cramps allows timely intervention.

With rising summer temperatures, especially in India, proactive hydration and heat safety measures are essential. Preventive care and awareness can protect vulnerable individuals and reduce health risks.

Staying cool and hydrated is the simplest way to safeguard your health during hot weather.

References

Indian Meteorological Department – Heatwave Reports
World Health Organization – Heat-Related Illness Guidelines
Indian Council of Medical Research – Public Health Advisory
National Disaster Management Authority (India) – Heatwave Action Plan
Lancet Planetary Health – Climate and Health Research

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