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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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Anemia Diet Plan: What to Eat to Improve Hemoglobin Levels Naturally

Anemia is one of the most widespread nutritional disorders in India, affecting people across age groups. According to NFHS-5 and ICMR data, more than half of Indian women and a significant proportion of men suffer from anemia. While supplements are sometimes required, a structured anemia diet plan plays a central role in preventing and managing the condition.

Anemia occurs when the body lacks sufficient healthy red blood cells or hemoglobin to carry oxygen efficiently. Nutrition is the foundation of hemoglobin production, making dietary correction essential.

Understanding the Nutritional Causes of Anemia

Anemia commonly results from deficiencies of:

iron
vitamin B12
folate

Each nutrient plays a specific role in red blood cell formation.

Iron: The Core Nutrient in Anemia

Iron is a key component of hemoglobin.

Iron deficiency leads to:

fatigue
weakness
pale skin
shortness of breath

ICMR identifies iron deficiency as the leading cause of anemia in India.

Types of Dietary Iron

Heme Iron

Found in animal foods and absorbed efficiently.

Sources include:

eggs
fish
chicken
liver

Non-Heme Iron

Found in plant-based foods and absorbed less efficiently.

Sources include:

spinach
lentils
chickpeas
jaggery
dates

Vitamin C improves non-heme iron absorption.

Role of Vitamin B12 in Anemia

Vitamin B12 is essential for red blood cell maturation.

Deficiency causes:

megaloblastic anemia
nerve symptoms
memory issues

Vegetarians are at higher risk due to limited dietary sources.

Role of Folate

Folate supports:

DNA synthesis
red blood cell formation

Low folate intake worsens anemia, especially during pregnancy.

Foods to Include in an Anemia Diet Plan

Iron-Rich Foods

green leafy vegetables (spinach, amaranth)
legumes and pulses
dates, raisins and figs
jaggery
red meat and eggs

Vitamin C-Rich Foods

citrus fruits
guava
tomatoes
bell peppers

These enhance iron absorption.

Vitamin B12 Sources

milk and dairy products
eggs
fish
fortified cereals

Folate-Rich Foods

green leafy vegetables
beans and peas
peanuts
whole grains

Sample Daily Anemia Diet Plan

Breakfast

vegetable omelette or sprouted moong
citrus fruit or guava

Mid-Morning

soaked raisins or dates
lemon water

Lunch

brown rice or roti
dal or chickpeas
green leafy vegetable sabzi
salad with lemon dressing

Evening Snack

roasted peanuts or chana
fruit rich in vitamin C

Dinner

vegetable curry with paneer or fish
whole wheat roti
lightly cooked greens

Bedtime

warm milk if tolerated

Foods That Reduce Iron Absorption

Certain foods interfere with iron absorption:

tea and coffee
excess calcium
highly processed foods

These should be avoided close to iron-rich meals.

Special Considerations for Women

Women require more iron due to:

menstruation
pregnancy
lactation

NFHS-5 highlights anemia as a major women’s health concern in India.

Anemia in Men and Older Adults

In men and elderly individuals, anemia may signal:

nutritional deficiency
chronic disease
gastrointestinal issues

Dietary correction should be combined with medical evaluation.

When Diet Alone Is Not Enough

Diet may not be sufficient if:

anemia is severe
absorption is impaired
chronic illness is present

In such cases, supplements or treatment of underlying causes is required.

Importance of Regular Blood Tests

Monitoring hemoglobin helps:

assess improvement
guide dietary adjustments
prevent recurrence

Preventive checkups are essential for high-risk groups.

Lifestyle Factors That Support Recovery

Along with diet:

adequate sleep
stress management
regular physical activity

support blood health and recovery.

Preventing Anemia Long-Term

Long-term prevention includes:

balanced meals
iron-rich cooking methods
avoiding excessive junk food
periodic screening

WHO and NITI Aayog emphasize nutrition education as a preventive strategy.

Conclusion

A well-structured anemia diet plan is the cornerstone of improving hemoglobin levels and restoring energy. By including iron-rich foods, supporting nutrients like vitamin B12 and folate, and improving absorption through smart food combinations, anemia can be effectively managed and prevented. Early dietary intervention, supported by regular health monitoring, helps avoid long-term complications and improves overall quality of life.

References

Indian Council of Medical Research (ICMR) – Anemia and Micronutrient Deficiency Reports
National Family Health Survey (NFHS-5) – Anemia Prevalence Data
World Health Organization (WHO) – Nutrition and Anemia Guidelines
Lancet – Micronutrient Deficiency and Public Health Research
NITI Aayog – Poshan Abhiyaan and Nutrition Policy Reports
Statista – Nutrition and Health Trends in India

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