With Will Hughes and Craig Bryson both injured on the opening day of the campaign at Bolton, the Rams saw Jamie Hanson and Jeff Hendrick both come off during Tuesday night’s draw.
Clement does not yet know how long Hanson and Hendrick might be out, if at all, but he was already working on deals to bolster his options in the middle of the park.
However, he does not think that will be possible before the trip to St Andrew’s to face Birmingham on Friday night.
“As regards the injuries tonight, the first one was a bad challenge,” said Clement.
“He’s flipped him (Hanson) almost upside-down and he’s landed on his head. He had blurred vision so he came off with concussion. It was a definite yellow card. The second one was also a foul and he (Hendrick) has a dead leg.
“We’ve been unlucky. That’s four central midfielders in three games. We’re not sure how bad they are at the moment but I certainly don’t think they will be out for nearly the length of time as Bryson. We all know how long Will Hughes is out for (six months).”
Huddersfield have said Derby have made a bid for their midfielder Jacob Butterfield, but Clement refused to talk about individual players.
He said: “We are working on one at the moment. We’ve highlighted a few, we haven’t put all our eggs in one basket.
“I don’t want to mention who those names are. I don’t want to comment on that. That is between the clubs and it will remain private until we are in a position to announce a signing.”
Asked about the possibility of concluding a signing before Friday, Clement responded “that will be difficult”.’
As for the game itself, it looked like Kike’s 16th-minute strike would see all three points go back to Middlesbrough as Derby dominated possession but struggled to create openings.
But, with two minutes remaining, substitute Johnny Russell struck the equaliser to earn the Rams a third straight draw in the league.
Clement said: “I think we got our reward in the end. The players are a bit deflated in the dressing room as it’s our third game and third draw. But there are lots of positives to draw on.
“The two forced changes in the first half didn’t help us. We are down to the bare bones in midfield now. But what that does is make it impossible to make positive, attacking substitutions in the second half when there were some weary legs.
“Like Saturday against Charlton, I think we are little bit hard done by again.”
Despite the disappointment of conceding so late, Middlesbrough head coach Aitor Karanka was satisfied with a draw.
“Yes, I think it’s a very good point,” he said.
“It was not as great a performance as Saturday, we didn’t play in our way but I’m proud of all of them as they worked against a very good team.
“It was our third game in six days so it’s difficult to compete every single day, but for that reason I’m pleased.
“I would have liked to win the game, we were close, but we have to learn that one mistake (can cost you).
“We have to learn when we are tired, we have to concentrate more. But I’m pleased with the attitude as it was very difficult.”