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

COVID AND CLOTTING: A BRIEF LOOK

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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

Read Blog
Overthinking Affects Your Immune System

How Overthinking Affects Your Immune System

We all overthink at times—whether it’s replaying past mistakes or worrying about the future. But when overthinking becomes a habit, it doesn’t just affect your peace of mind. Research shows that excessive worrying and stress can directly harm your body’s defense system. Your immune system, which protects you from infections, becomes weaker when your brain is stuck in a constant loop of thoughts.

In this blog, we’ll explore the science behind how overthinking affects your immune system, the symptoms you might notice, and practical ways to protect both your mind and body.

 

The Science: Why Overthinking Impacts Immunity

Overthinking often triggers chronic stress. When you worry, your body produces stress hormones like cortisol and adrenaline. These hormones are helpful in short bursts, but when they stay elevated for a long time, they can suppress your immune system.

  • Cortisol suppresses immune cell activity, making it harder for your body to fight off bacteria and viruses.
     

  • Stress reduces the production of lymphocytes, the white blood cells that fight infections.
     

  • Overthinking keeps your body in “fight-or-flight mode,” which drains energy from essential healing processes.
     

As a result, people who overthink often notice that they fall sick more easily, recover slower, and feel tired even after rest.

 

Early Signs That Overthinking Is Affecting Your Health

If you’ve been stuck in a cycle of overthinking, watch out for these warning signs:

  1. Frequent colds or flu – A weak immune system means your body struggles to defend itself.
     

  2. Slower wound healing – Cuts, bruises, or even post-surgery recovery may take longer.
     

  3. Constant fatigue – Even after proper sleep, your body feels drained.
     

  4. Digestive issues – Stress can upset your gut health, which is linked to immunity.
     

  5. Skin breakouts or rashes – A stressed immune system can worsen inflammation.
     

These symptoms may look minor at first but can become more serious if ignored.

 

How Overthinking Increases Risk of Chronic Illness

Prolonged stress doesn’t just weaken immunity temporarily—it can also contribute to long-term health conditions:

  • Autoimmune diseases: Overactive stress responses may confuse the immune system, making it attack healthy cells.
     

  • Chronic inflammation: A stressed mind can keep the body in a state of constant inflammation, increasing risks of arthritis, diabetes, or heart disease.
     

  • Mental health decline: Anxiety and depression often go hand-in-hand with overthinking, which worsens immunity further.
     

This shows why mental health and physical health are deeply connected.

 

Practical Ways to Break the Cycle and Protect Immunity

The good news is that you can rebuild your immunity by calming your mind. Here are some proven strategies:

1. Practice Mindfulness

Meditation, deep breathing, or simply focusing on the present moment reduces stress hormones and boosts immunity. Even 10 minutes a day can make a difference.

2. Maintain Healthy Sleep

Overthinking often keeps you awake at night, which further weakens immunity. Aim for 7–8 hours of quality sleep, and create a screen-free bedtime routine.

3. Exercise Regularly

Physical activity reduces stress, improves circulation, and enhances immune responses. Even a 30-minute walk daily helps regulate mood and immunity.

4. Eat Immune-Boosting Foods

A balanced diet with fruits, vegetables, whole grains, and protein supports your immune system. Foods rich in Vitamin C, Vitamin D, and Zinc are especially helpful.

5. Journaling and Thought Control

Writing down your thoughts before bedtime can prevent overthinking from spiraling. Challenge negative thoughts with positive affirmations.

6. Limit Caffeine and Alcohol

Both can increase anxiety and disturb sleep, making overthinking worse. Opt for herbal teas and adequate hydration instead.

 

When to Seek Professional Help

If overthinking is persistent and starts interfering with your daily life—causing panic attacks, insomnia, or severe anxiety—it’s time to consult a doctor or therapist. Sometimes, professional guidance, counseling, or medical treatment is needed to restore balance.

 

Lab Tests That May Help

If you’re struggling with stress-related health issues, doctors may recommend tests like:

  • Complete Blood Count (CBC) – to check for immune cell levels
     

  • Vitamin D & B12 Tests – deficiencies worsen stress and fatigue
     

  • Thyroid Function Test – as thyroid imbalance can cause anxiety and fatigue
     

  • Cortisol Test – to assess stress hormone levels
     

  • Blood Sugar Test – since stress and overthinking may worsen diabetes risk
     

 

Final Thoughts

Your thoughts are powerful—they can either heal or harm your body. Overthinking may feel harmless, but it silently weakens your immune system, making you more vulnerable to infections and chronic illness. By practicing mindfulness, improving sleep, and balancing lifestyle habits, you can protect both your mental and physical health.

If you want to stay healthy and stress-free, start working on breaking the cycle of how overthinking affects your immune system today.

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