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Published on: Apr 30, 2020
3 minute read
By: Dr Rajan Choudhary

COVID AND CLOTTING: A BRIEF LOOK

At the Mount Sinai hospital, a case series of five patients have been put together, ready to be published in the New England Journal of Medicine. It details patients aged 33, 37, 39, 44, and 49 who all began to experience a sudden onset of symptoms including slurred speech, confusion, drooping on one side of the face, and feeling dead in one arm. At the time of writing one has sadly died, two remain hospitalized and one is in rehab. Only the youngest is able to speak. All of them were found to be COVID positive.

This drastic case series highlights a growing problem of strokes and clotting disorders in COVID patients, one noted by medics across the world. This blog looks at whether this is a common occurrence and what may be causing it.

Before reading this blog it will be helpful to read our previous blog on why and how blood clots.

THE START

In mid-February Tang et al published a paper noting that patients with abnormal clotting parameters were associated with a poorer prognosis. In their study, 11% of their patients died, but out of these patients, 71% had these abnormal parameters, compared to just 0.6% of survivors. The patients who died also demonstrated DIC (disseminated intravascular coagulation), a condition in which clotting is triggered in the patients' blood across the body, not just at the site of injury.

There is one major issue with this study. In most European hospitals patients receive anticoagulant medications on a daily basis. This is because lying in a hospital bed when ill can promote the formation of clots in your legs. Most hospitals in China do not provide this anticoagulation, but even then the incidence of clotting is remarkably high.

After this, the evidence begins piling up. 9th April, Cui et al found 25% of patients with severe COVID had clots in their legs, of which just under half died. Looking at a specific clotting parameter (D-DIMER) was remarkably accurate at predicting high-risk patients.

Italian doctors found in 16 patients in critical care with severe Acute Respiratory Distress Syndrome (a severe inflammatory condition caused by COVID) also had deranged clotting parameters.

French studies had found these sickest patients often had large clots in their lungs, blocking blood flow in the lung and causing severe issues in keeping the patient's blood well oxygenated.

Some studies showed even patients hooked up to artificial lungs (known as ECMO) were not safe from the problems caused by excessive clotting.

WHY?

So why is this occurring? As with everything in medicine, the answer is complicated and usually multifactorial. So we will simplify it.

We must look at the platelets in our blood. These fragmented cells have an important role in triggering the clotting cascade and creating a clot. During an infection white blood cells (important immune cells responsible for finding and destroying invading organisms) release many chemical signals around an infection site. This triggers platelets, the formation of small protein meshes that can literally net the viral particles in the blood.

But it looks like they have an anti-viral role as well. Researchers have found specialist receptors on platelets that recognize viruses in the blood, leading to the release of specialist anti-viral molecules that target and destroy the viruses. This is an interesting finding because it is white blood cells that are known to destroy invading organisms.

So how does it go wrong? In severe infections, there is a very large viral load, and this can cause an excessive response. Too many white blood cells release too many chemical signals, causing too many platelets to activate. The same thing can occur with the virus directly activating too many platelets at once. This results in clots forming in the blood throughout the body, including the lung and the brain. It is another instance of the body falling victim to its own protective mechanism.

A second problem is that as these platelets are activated, they and the clotting proteins in the patient’s blood are “used up”. This is dangerous, because without these platelets and clotting proteins the body is unable to stop any bleeding sites. Profuse bleeding can occur from small injuries, further complicating the treatment of the patient.

So what can be done?

Hospitals have already started looking at giving patients with severe COVID anticoagulation therapy. And it seems in patients with deranged clotting, giving anticoagulation therapy can lower mortality. The International Society on Thrombosis and Haemostasis (Clotting) has recommended that patients with severe COVID receive high dose anticoagulation medication to thin their blood, because these patients are at such high risk of clots. This regime will be used for hospital patients and those in critical care.

And what about for the everyday public? Should we be worried? So far the data suggests this is only happening in people suffering from severe symptoms of COVID. But the incident in New York certainly raises some questions, and it will be interesting to read their report in NEMJ. Should you panic and start taking anti-coagulant medication at home? Definitely not. But what you should do is be educated in the symptoms of common diseases caused by clots. Diseases such as strokes and DVTs.

STROKE

Remember, act F.A.S.T

Facial Droop on one side
Arm or hand on one side feels numb or weak with reduced power (same in one leg)
Slurred speech making it difficult to understand
Time to phone an ambulance

Other symptoms can include sudden loss in balance, sudden loss in vision in one eye, problems swallowing, and more.

DVT

Look out for a swollen, painful calf on one side that is hot to touch.

PULMONARY EMBOLISM

If you have a swollen, painful calf and are also having trouble breathing, with some sharp stabbing pain in your chest, contact the emergency services as soon as possible.

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

www.secondmedic.com

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5K Run for a Cause: How Community Fitness Drives Preventive Health Awareness

Physical activity is one of the most effective tools for disease prevention, yet it remains underutilised in everyday life. Community-based fitness initiatives such as a 5K Run for a Cause play a powerful role in bridging this gap by making movement accessible, meaningful and socially engaging. These events combine the benefits of exercise with awareness-building, creating lasting impact on public health.

In India, lifestyle-related diseases such as diabetes, heart disease and obesity are rising rapidly. According to the Indian Council of Medical Research (ICMR) and National Family Health Survey (NFHS-5), physical inactivity is a major contributor to this growing burden. Events that encourage structured, enjoyable physical activity help counter this trend.

What Is a 5K Run for a Cause?

A 5K Run for a Cause is a short-distance running or walking event designed to promote fitness while supporting a health, social or community objective. Participants may run, jog or walk the 5-kilometre distance, making the event inclusive for people of varying fitness levels.

Beyond physical activity, these runs aim to:

raise awareness about preventive health
encourage active lifestyles
build community participation
support wellness-driven causes

Why 5K Is an Ideal Distance

The 5-kilometre distance is widely recognised as:

achievable for beginners
challenging enough to promote fitness
safe for most age groups with minimal training

WHO physical activity guidelines support moderate-intensity exercise like running or brisk walking for improving cardiovascular and metabolic health.

Health Benefits of Participating in a 5K Run

Improved Cardiovascular Health

Running and brisk walking strengthen the heart, improve circulation and lower blood pressure. Regular participation reduces the risk of heart disease and stroke.

Better Metabolic Health

Physical activity improves insulin sensitivity and supports weight management. ICMR data shows that regular movement significantly reduces diabetes risk.

Enhanced Mental Wellbeing

Exercise releases endorphins that reduce stress, anxiety and depression. Community runs add a social element that further supports mental health.

Improved Musculoskeletal Strength

Running strengthens muscles, bones and joints, reducing the risk of age-related mobility issues.

Role of 5K Runs in Preventive Healthcare

Preventive healthcare focuses on reducing disease risk before illness develops. A 5K Run for a Cause supports prevention by:

promoting physical activity
encouraging regular movement habits
raising awareness about lifestyle diseases
motivating health-conscious behaviour

NITI Aayog identifies physical activity promotion as a key pillar of preventive healthcare in India.

Community Impact of a 5K Run for a Cause

Building Health Awareness

Runs often highlight specific causes such as heart health, diabetes prevention or mental wellbeing, reinforcing public health messages.

Strengthening Social Bonds

Community participation fosters shared goals and mutual motivation, increasing long-term adherence to healthy habits.

Encouraging Family Participation

Inclusive events encourage families to adopt healthier lifestyles together.

5K Runs and Corporate Wellness Programs

Corporate wellness programs increasingly include physical activity initiatives.

Benefits for organisations include:

improved employee engagement
reduced absenteeism
enhanced team bonding
positive employer branding

EY-FICCI reports show that wellness initiatives focused on physical activity deliver strong participation and measurable health benefits.

Accessibility and Inclusivity

A key strength of 5K runs is inclusivity.

They accommodate:

first-time runners
walkers
older adults
people transitioning to active lifestyles

This inclusiveness reduces barriers to participation.

Supporting Long-Term Behaviour Change

One-time events create awareness, but their true value lies in inspiring long-term change.

Participants often:

continue walking or running regularly
become more conscious of fitness
seek preventive health checkups

Lancet studies indicate that community-based physical activity initiatives can influence long-term health behaviours.

Safety and Health Considerations

For safe participation:

individuals should assess fitness levels
warm-up and cool-down are essential
hydration should be prioritised
those with medical conditions should seek medical advice

Proper guidance ensures benefits without injury.

Role of Awareness and Education

Successful runs integrate education through:

health talks
informational materials
screening camps
wellness resources

This combination reinforces preventive health messages.

Measuring Impact

Impact can be assessed through:

participation rates
follow-up health initiatives
employee engagement metrics
community feedback

Data-driven evaluation improves future program design.

Why 5K Runs Matter in India

India faces challenges such as:

rising sedentary lifestyles
limited health awareness
increasing chronic disease burden

Community fitness events provide a scalable, low-cost solution to promote active living and prevention.

Conclusion

A 5K Run for a Cause is more than a fitness event—it is a preventive health movement. By combining physical activity with purpose, these runs encourage healthier lifestyles, strengthen community bonds and raise awareness about long-term wellbeing. In a country where lifestyle diseases are growing rapidly, initiatives that make movement accessible and meaningful are essential. A simple 5K run can be a powerful step toward a healthier, more active society.

References

ICMR – Physical Activity and Lifestyle Disease Prevention Reports
National Family Health Survey (NFHS-5) – Physical Activity and Health Data
NITI Aayog – Preventive Healthcare and Physical Activity Promotion Strategy
WHO – Physical Activity and Health Guideline
Lancet – Community Fitness and Preventive Health Studies
Statista – Fitness Events and Participation Trends India
EY-FICCI – Corporate Wellness and Physical Activity Reports

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