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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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Best Home Remedies for Glowing Skin

Glowing skin is not simply a cosmetic goal. It is a visible reflection of skin health, hydration, and cellular repair. While the market is flooded with serums and treatments, dermatologists consistently observe that the most sustainable skin glow comes from consistent, simple, and evidence-supported practices. The good news is that many of the most effective ingredients are already available in an Indian kitchen.

Why Skin Loses Its Natural Glow

Before applying any remedy, understanding the root cause of dull skin is essential. Dermatologists identify the following as the most common triggers in the Indian context:

Cause	Effect on Skin
Pollution and sun exposure	Oxidative stress, pigmentation, uneven tone
Dehydration	Reduced elasticity, dryness, dullness
Poor diet and nutrient deficiency	Slowed cell renewal, loss of radiance
Disrupted sleep	Impaired skin repair, dark circles, puffiness
Hormonal imbalance	Acne, oiliness, pigmentation
Harsh skincare products	Damaged skin barrier, redness, sensitivity

Identifying and addressing the underlying cause is as important as applying any topical remedy. Skin that appears dull despite consistent care often signals an internal factor requiring dietary or medical attention.

Which Home Remedy is Best for Glowing Skin?

Among all widely used natural ingredients, raw honey combined with aloe vera gel is considered the most universally effective home remedy for glowing skin. Honey acts as a humectant, drawing moisture into the skin, while its antibacterial and antioxidant compounds protect against environmental damage. Aloe vera complements this by delivering vitamins A, C, and E directly into the skin, supporting collagen synthesis and reducing inflammation.

This combination works across all skin types, requires no preparation time, and demonstrates consistent results in clinical observations relating to skin hydration and barrier repair. Applied three times a week for 15 to 20 minutes, this remedy produces visible improvement in skin texture and brightness within two to three weeks of regular use. For individuals with oily or acne-prone skin, aloe vera used alone without honey is the preferred option as it is non-comedogenic and lightweight.

Top Home Remedies for Glowing Skin by Skin Type

One of the most significant gaps in standard advice is that remedies are rarely matched to skin type. Applying the wrong ingredient can worsen the skin condition rather than improve it. Dermatologists recommend the following skin-type specific approach:

Skin Type	Best Remedy	Key Benefit	Frequency
Dry Skin	Raw honey and milk paste	Deep hydration, lactic acid exfoliation	3 times per week
Oily Skin	Multani mitti with rose water	Sebum control, pore tightening	2 times per week
Combination Skin	Aloe vera gel	Balances moisture without clogging pores	Daily
Sensitive Skin	Oat flour and plain yogurt pack	Soothes inflammation, gentle exfoliation	2 times per week
Normal Skin	Turmeric and honey mask	Antioxidant boost, brightening	2 to 3 times per week
Dull or Pigmented Skin	Potato juice or tomato pulp	Natural kojic acid, reduces pigmentation	3 times per week

Matching the remedy to skin type is the single most important factor in achieving consistent results from any natural skincare routine.

Which Kitchen Ingredients Work Best for Skin Glow?

Several common Indian kitchen ingredients carry clinically recognised skin benefits. The mechanism behind each ingredient matters as much as the application method:

Turmeric (Haldi): Contains curcumin, a potent antioxidant and anti-inflammatory compound. Curcumin inhibits melanin synthesis, which helps reduce pigmentation and uneven skin tone over time. Used as a paste with milk or honey, turmeric is one of the most researched natural brightening agents.

Raw Milk: Contains lactic acid, a naturally occurring alpha hydroxy acid (AHA) that gently exfoliates dead skin cells, stimulates collagen production, and improves skin luminosity. Applying raw cold milk with a cotton pad and leaving it for 15 minutes is a simple and effective brightening practice.

Besan (Gram Flour): Functions as a mild physical exfoliant and oil absorber. Mixed with turmeric and rose water, besan-based face packs have been used across Indian households for generations and remain dermatologically appropriate for most skin types.

Aloe Vera: Rich in polysaccharides that support skin hydration and mucilaginous compounds that form a protective barrier. Clinical data supports its use in reducing UV-induced skin damage and accelerating epidermal repair.

Potato Juice: Contains catecholase, an enzyme with mild skin-lightening properties. Particularly useful for reducing dark circles, tan lines, and post-inflammatory hyperpigmentation.

How to Get Glowing Skin Naturally in One Week

Most competitors list remedies without telling readers how to actually use them together. The following 7-day routine is structured to progressively address cleansing, exfoliation, hydration, and brightening within a single week:

Day	Morning	Evening
Day 1	Raw milk cotton pad cleanse	Aloe vera gel application
Day 2	Rose water toner	Honey and aloe vera mask (15 min)
Day 3	Raw milk cleanse	Turmeric and honey mask (10 min)
Day 4	Rose water toner	Aloe vera gel application
Day 5	Raw milk cleanse	Besan, turmeric and rose water pack (15 min)
Day 6	Rose water toner	Potato juice on dark spots (20 min)
Day 7	Raw milk cleanse	Honey and aloe vera mask (15 min)

This routine uses no more than three to four ingredients across the entire week, minimising the risk of ingredient overload or skin irritation. Always perform a patch test on the inner forearm before applying any new ingredient to the face.

Lifestyle Habits That Support Glowing Skin From Within

Topical remedies address the surface. Skin glow that is deep and lasting is primarily determined by internal health factors that all four competitor articles fail to address:

Hydration: Dermatologists observe that inadequate water intake is the single most common and most overlooked cause of dull skin among Indian adults. A minimum of 2.5 to 3 litres of water daily supports cellular metabolism and maintains skin turgor.

Diet: Skin cells require vitamins C, E, and A along with zinc and omega-3 fatty acids for repair and renewal. Indian dietary staples such as amla (Indian gooseberry), carrots, spinach, walnuts, and flaxseeds provide these nutrients in bioavailable forms. Reducing refined sugar intake is equally important, as excess glucose triggers glycation, a process that breaks down collagen and accelerates skin ageing.

Sleep: The skin's repair cycle peaks during deep sleep between 11 PM and 3 AM. Chronic sleep deprivation elevates cortisol, which degrades collagen and increases inflammatory skin conditions. Clinical specialists recommend seven to eight hours of uninterrupted sleep as a non-negotiable component of any skin improvement plan.

Gut Health: Emerging dermatological research on the gut-skin axis confirms that dysbiosis (imbalance of gut bacteria) is linked to acne, rosacea, and dull skin. Incorporating fermented foods such as curd and buttermilk into the daily diet supports gut microbiome balance, which in turn improves skin clarity.

Home Remedies to Avoid: What Dermatologists Warn Against

This section exists in none of the competing articles and represents the most clinically important addition to this topic. Several widely promoted "natural" skin remedies are actively harmful:

Lemon juice directly on skin: Lemon juice has a pH of approximately 2, far too acidic for direct skin application. It disrupts the skin's natural acid mantle (pH 4.5 to 5.5), causes photosensitivity, and can result in chemical burns or permanent pigmentation when skin is exposed to sunlight post-application.

Baking soda: Despite its popularity on social media, baking soda has an alkaline pH of 9, which severely disrupts the skin barrier, strips natural oils, and causes microbial imbalance on the skin surface.

Toothpaste on pimples: Toothpaste contains fluoride, menthol, and hydrogen peroxide, none of which are formulated for skin. It causes contact dermatitis, dryness, and post-inflammatory hyperpigmentation, particularly on Indian skin tones.

Undiluted essential oils: Applying undiluted tea tree oil, lavender oil, or any essential oil directly on the face without a carrier oil causes irritant contact dermatitis and skin sensitisation.

Dermatologists advise that if a remedy causes stinging, redness, or visible irritation, it should be discontinued immediately regardless of how widely it is recommended online.

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