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Published on: Apr 28, 2020
4 minute read
By: Dr Rajan Choudhary

Strokes In The Young And How COVID Causing Clotting Disorders?

Strokes in the young and healthy: how is COVID causing clotting disorders?

In the news, there has been a rush in stories linking Strokes in young and healthy patients, patients who also have COIVD-19. This is certainly worrying news, and at first glance, it is difficult to explain. How does a respiratory virus, one that is very similar to the coronavirus responsible for the common cold, cause such serious issues in a completely unrelated organ system? In this two-part series we will first go over the basics of clotting and its function, how clotting can cause problems, and finally how COVID can lead to clotting disorders.

STROKES

Before we progress, if you or a family member are having any of the following symptoms, contact your local emergency services immediately. Strokes can be devastating, and treatment needs to be given as soon as possible to save as much of the brain as we can. Early recognition can be the difference between manageable long term effects and crippling disability.

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.

PLUGGING A HOLE

We have an intricate network of vessels to transport oxygen, nutrients, and signals to cells and organs across our bodies. Damage to these blood vessels causes blood loss, reduction in oxygen and nutrient delivery to these cells, and organ damage if the issue isn’t rectified. Failure in multiple organ systems across the body will eventually lead to death. Our blood has cells and proteins that work together to form a clot at the site of injury. This acts as a plug to physically stop the leak, but also encourages repair of the blood vessel and surrounding tissue.

A clot can be triggered in three different ways: blood stasis (pooling up in one area), exposure of blood vessel lining, and pro-coagulant factors released into the blood. When triggered a coagulation cascade occurs to form the building blocks of a clot – it works so well that even a small trigger can create a response big enough to repair the damage. These form a mesh trapping platelets and other blood cells into a plug. Immune cells also arrive to destroy any organisms that might enter from the trauma site that caused the injury, and these immune cells also instruct nearby cells to begin the repair process.

As with everything in our body the whole process is very tightly regulated. The cascade has triggers and accelerators, but it also has brakes. These brakes stop a clot from growing too big, or from clots forming spontaneously when they are not needed. They also help dissolve a clot once the vessel is repaired and it isn’t needed.

WHEN IT GOES WRONG

Heart attacks and strokes. These devastating cardiovascular diseases are well recognized by the public as a leading cause of disability and death. Both can be caused by abnormal clotting. How does our finely tuned clotting cascade turn abnormal? Let's go back to the three triggers of blood clotting.

Vessel damage: Eating a high fat and cholesterol diet can cause fatty plaques to build up in our arteries. This is known as atherosclerosis, and it is extremely common. The plaques can narrow your arteries and reduce blood flow. If this happens in your coronary arteries supplying your heart muscles, your heart might not receive enough oxygen when you exercise or exert yourself. This can cause chest pain, known as angina.

If the plaques burst open it can expose the vessel lining, causing a large clot to form. This clot can become dislodged and be carried away by the blood. It will eventually get lodged in a narrow artery, blocking it and stopping blood from entering. The tissue and cells supplied by that artery will not receive oxygen and eventually die. If this happens in the coronary arteries it can cause a heart attack. In the arteries supplying the brain, it can cause a stroke, leading to neurological deficits.

THIS IS THE MOST IMPORTANT LEARNING POINT, and this is why a healthy diet low in fat and sugars is so important.

Stasis: Our heart pumps blood at high pressures through the arteries. But in the veins, there is very little pressure to drive the blood back to the heart. In our arms and head, gravity helps blood flow down to the heart. But from our legs? When we walk the muscles in our legs squeeze the veins and move the blood. Valves make sure this flow is only one way, back to the heart.

If we sit or lie down in one place and don’t move, the blood isn’t pumped back and pools up in our legs, causing a clot to form. This usually happens in our calves (known as a DEEP VEIN THROMBOSIS, or DVT). The calf becomes swollen, painful, red, and hot. If this clot is dislodged, it can end up in our lungs causing a PULMONARY EMBOLISM. A large PE can block blood from entering the lungs and can be fatal. This is why you should take regular walks on long haul flights, to prevent blood from pooling.

Pro-coagulant: Sometimes the factors in our blood responsible for triggering a clot can be triggered accidentally. Cigarette smoke contains many toxins and harmful chemicals that, when inhaled, end up in your blood. These chemicals can cause damage to vessel linings, and also cause the clotting cascade to be triggered more easily. Some medications, such as the Combined Oral Contraceptive Pill, also have a similar effect, though the risk of getting a clot is still very low.

The immune system can also trigger a clot. The protein mesh formed in the blood can also capture bacteria and viruses around an infection site, making it easier for immune cells to find and destroy these invading organisms. In cancer patients, this process is sometimes triggered by unregulated cancer cells.

WHAT HAVE WE LEARNT?

Our clotting system stops us from bleeding to death from a small wound. People who have bleeding disorders are clear examples and need to be extremely careful if they injure themselves. But unregulated, our body can end up harming itself. If there is one thing you should take away from this, it is that a high sugar/high-fat diet with little exercise can directly increase your risk of having a heart attack or stroke. This is why doctors emphasize so much the importance of a good diet and exercise.

In our next blog, we will look at how this clotting problem is implicated in COVID patients.

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

www.secondmedic.com

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Monthly Field Day with Patients & Staff: Building Stronger Connections for Better Health

Healthcare outcomes are shaped not only by medical treatments but also by trust, communication and community engagement. As healthcare systems in India move toward preventive and patient-centric models, initiatives that foster meaningful interaction between patients and healthcare professionals are gaining importance. One such initiative is the Monthly Field Day with Patients & Staff.

A field day creates a shared space where patients and healthcare teams interact beyond clinical settings. These interactions humanise healthcare, improve understanding and encourage long-term wellness practices.

Why Community Engagement Matters in Healthcare

Modern healthcare recognises that health is influenced by behaviour, awareness and social support. According to the World Health Organization (WHO) and NITI Aayog, community-based health engagement improves preventive care adoption and patient outcomes.

Field days help bridge the gap between healthcare providers and patients by:

encouraging open dialogue
reducing fear and hesitation
promoting shared responsibility for health

What Is a Monthly Field Day with Patients & Staff?

A Monthly Field Day with Patients & Staff is a structured wellness initiative organised outside the routine clinical environment. It focuses on interaction, education and preventive health activities.

Typical elements include:

basic health screenings
lifestyle education sessions
fitness or relaxation activities
informal conversations with healthcare staff
family and caregiver participation

The aim is to create a supportive and approachable healthcare experience.

Why Monthly Frequency Matters

Consistency is key in behaviour change and preventive health.

Monthly field days:

reinforce health messages regularly
build familiarity and trust
allow continuous follow-up
keep wellness top of mind

According to public health studies, repeated engagement significantly improves health literacy and adherence.

Benefits for Patients

1. Improved Health Awareness

Patients gain better understanding of:

chronic disease management
preventive screenings
nutrition and lifestyle habits

Education in informal settings improves retention.

2. Increased Comfort with Healthcare Teams

Regular interaction reduces anxiety and hesitation around seeking medical care.

Patients are more likely to:

ask questions
follow medical advice
attend follow-ups

3. Early Risk Identification

Field days often include basic screenings that help detect:

high blood pressure
elevated blood sugar
obesity risk

Early identification enables timely intervention.

4. Enhanced Emotional Wellbeing

Social interaction and community activities reduce feelings of isolation, especially among elderly or chronically ill patients.

Benefits for Healthcare Staff

1. Better Understanding of Patient Needs

Direct interaction outside clinical settings helps staff understand patient challenges more holistically.

2. Improved Communication Skills

Informal engagement strengthens empathy and communication effectiveness.

3. Reduced Burnout

Positive patient interaction and community appreciation contribute to staff morale and job satisfaction.

WHO recognises staff wellbeing as a critical factor in healthcare quality.

Role of Field Days in Preventive Healthcare

Preventive healthcare focuses on reducing disease burden before complications arise. Field days support prevention by:

promoting routine screenings
encouraging healthy lifestyle habits
addressing myths and misconceptions
reinforcing long-term care plans

NITI Aayog identifies community engagement as a cornerstone of preventive healthcare strategies.

Activities Commonly Included in Field Days

Health Screening Stations

Blood pressure, blood sugar, BMI and basic assessments.

Wellness Education

Short talks on nutrition, exercise, sleep and stress.

Interactive Sessions

Q&A discussions with doctors, nurses and health educators.

Physical Activities

Group walks, yoga sessions or light exercises.

Family Engagement

Including caregivers improves adherence and support systems.

Impact on Chronic Disease Management

For patients with chronic conditions such as diabetes or hypertension, regular engagement:

improves medication adherence
reinforces lifestyle modification
reduces emergency visits

Lancet studies highlight that community-based interventions improve chronic disease outcomes.

Building Trust Through Transparency

Field days foster trust by:

making healthcare providers approachable
encouraging open dialogue
demonstrating commitment to patient wellbeing

Trust improves treatment adherence and satisfaction.

Role of Data and Feedback

Feedback collected during field days helps healthcare organisations:

identify common concerns
refine wellness programs
personalise future interventions

Data-driven engagement enhances program effectiveness.

Long-Term Impact on Healthcare Outcomes

Organisations that invest in regular patient-staff engagement observe:

higher patient satisfaction
improved preventive screening rates
reduced disease complications
stronger community relationships

According to WHO, patient-centred care models improve health outcomes and system efficiency.

Why Field Days Are Especially Relevant in India

India’s diverse population faces challenges such as:

limited health literacy
delayed care-seeking
chronic disease burden

Community-based initiatives like field days address these challenges through education and trust-building.

Conclusion

A Monthly Field Day with Patients & Staff is more than a community event—it is a strategic preventive healthcare initiative. By fostering open communication, promoting health awareness and strengthening relationships, field days improve patient engagement and staff wellbeing alike. In a healthcare landscape increasingly focused on prevention and community trust, regular field days play a vital role in building healthier, more connected communities.

References

ICMR – Community Health and Preventive Care Reports
National Family Health Survey (NFHS-5) – Health Awareness and Engagement Dat
NITI Aayog – Community-Based Preventive Healthcare Strategies
WHO – Patient-Centred Care and Community Health Guidelines
Lancet – Community Engagement and Health Outcome Studies
Statista – Healthcare Engagement and Preventive Care Trends India
EY-FICCI – Healthcare Workforce and Patient Engagement Reports

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