As Canada’s population ages, there is increasing demand on our health-care system. A simple blood test may help doctors predict who is at risk of imminent death, according to a study published Monday in the Canadian Medical Association Journal.
Dr. Stig Bojesen and colleagues from the University of Copenhagen studied 108,135 Danish people ages 20 to 100 years who were part of the Copenhagen General Population Study. During the study period, a total of 10,372 people died. The researchers combed through the health records of those who died in search of abnormal blood test results.
They found that the people who died during the study period had lower levels of a white blood cell called a lymphocyte. The researchers crunched the numbers. Compared with those with a normal lymphocyte count, those patients with a low lymphocyte count were 1.6 times more likely to die during the study period.
There are several possible ways in which a low lymphocyte count might be connected to an early demise.
One clue is that the current study found that a low lymphocyte count was associated with an increased risk of death from cancer, cardiovascular disease, respiratory disease, infections and other causes. These are chronic diseases that are common in older patients.
Lymphocytes are part of the immune system and the immune system is necessary to help patients fight off chronic diseases. The researchers speculated that a weak immune system might be one of the reasons why diseases like cancer and respiratory disease are more common the older we get.
Another theory is that a low lymphocyte count might indicate that the patient is frail. We know from other research that frailty can lead to illness and death.
Other tests to predict risk of imminent death
The lymphocyte count is not the only blood test that can help predict the risk of dying.
A number of studies have looked at another simple blood test called C reactive protein or CRP. Elevated levels of CRP are associated with increased risk of imminent death. A recent study found that patients in Japan who come to the emergency department with a heart attack and who have a high CRP level are more likely to die during the ensuing hospital stay.
A 2019 study in the journal Nature Communications identified 14 new biomarkers that can be measured in the bloodstream that could predict the risk of dying within five or 10 years. The study found these tests would likely be more accurate than the conventional risk factors (for example, smoking and heart disease) that doctors use currently.
The practical value of these kinds of tests to doctors in their work and to patients in their lives is still somewhat unclear.
The researchers say they hope the findings help doctors identify patients at risk of death within two years. Such patients might be followed more closely for signs of life-threatening illnesses and perhaps treated more aggressively. Patients could then be re-tested to see if the lymphocyte count, CRP and other blood tests returned to normal levels as the imminent risk of death is reduced.
Down the road, researchers say they would like to use those abnormal tests and biomarkers to design targeted treatments that might stave off death.
It’s worth keeping in mind that studies like this one confirm what doctors already know. Studies show that doctors are good at identifying patients whose imminent death would not surprise them.
I think patients and their families might be very surprised that their doctors believe them at imminent risk of dying. I believe doctors need to share that information with patients and families to encourage them to live healthier or at very least prepare them for what lies ahead.
Six Vaccines Show Promise as Boosters, Led by Pfizer and Moderna – BNN
(Bloomberg) — A U.K. study testing seven different Covid-19 vaccines as booster doses found most of them increased antibodies, with shots from Moderna Inc. and the Pfizer Inc.-BioNTech SE partnership performing best.
The results, published Thursday, tested the vaccines in more than 2,800 volunteers 30 and older who had already received two doses of the AstraZeneca Plc or Pfizer shots. All seven vaccines boosted immunity after the Astra vaccine, compared with a placebo, while six raised antibody levels after Pfizer, the study found.
Still, there were large variations between the antibody and cellular immune responses of the different vaccines, with the biggest boosts seen from the messenger-RNA vaccines from Pfizer and Moderna. Antibody levels were measured four weeks after the booster was given.
It’s unclear how many doses of the vaccines will be needed to provide the longest-lasting protection, or whether yearly Covid shots will be required, but the level of antibodies induced by a number of the vaccines wanes after a few months, pushing the case for boosters. With the new omicron variant spreading, countries are looking to protect their populations as quickly as they can.
The Valneva SE vaccine, which performed well in trials but hasn’t yet been authorized for use, was the only shot that didn’t increase antibody levels after two doses of Pfizer compared with a placebo, though the vaccine was only tested in about 100 people. The study found all seven shots were safe to use as third doses.
The other vaccines tested were from Johnson & Johnson, CureVac NV and Novavax Inc. The shots were given 10 to 12 weeks after a second dose of either the Astra or Pfizer vaccines.
Early results from the study were used to inform Britain’s initial booster program in September, which was focused on older people and relied on the Pfizer and Moderna shots as third doses. The U.K. expanded the rollout of boosters to all adults this week in light of the new omicron variant, and cut the time from six months after a second dose to three.
“These data are directly relevant to the decision-making this week,” Saul Faust, a professor of pediatric immunology and infectious diseases, and the lead investigator on the study, said at a press briefing. If a “country or region of the world only has one of the vaccines that we’ve shown that boost then that will be fine to use as a booster and safe to do it. It’s not all about mRNA.”
Most of the vaccines also produced good T-cell responses, another arm of a person’s immune defense, though the effect of Valneva as a booster was less strong.
Three of the vaccines haven’t yet been authorized in the U.K. or European Union. CureVac abandoned its first-generation vaccine in October after disappointing trial results. Novavax is expected to receive clearance in Europe in the coming weeks, while Valneva should get the green light from the U.K. and EU early next year.
©2021 Bloomberg L.P.
In a first, three white-tailed deer test positive for Covid in Canada – WION
In a first, Canada has detected coronavirus cases in three white-tailed deer. While humans were struggling to battle with the deadly virus and its newly emerging variant, now, even the wildlife is also in danger of being infected by the virus.
According to the National Centre for Foreign Animal Disease, the samples were collected early in November in the Estrie region of Quebec. The samples were collected through a “big-game” registration station.
“Similar to findings in the United States, the deer showed no evidence of clinical signs of disease, and were all apparently healthy. The World Organisation for Animal Health (OIE) was notified on December 1, 2021,” read the statement by the agency.
The agency further stated that as of now, there is limited information on the spread of the virus in wild deer.
“COVID-19 remains largely a disease of human concern and typically spreads from human to human. Adhering to public health advice and getting fully vaccinated are key ways to protect against COVID-19,” read the statement.
Meanwhile, earlier in November, cases of Alpha variant of Covid virus were detected in pets when two cats and dogs tested positive in a PCR test.
The team, which conducted the study, also clarified Covid in pets remained ‘relatively rare’. The transmission seems to be taking place from humans to pets and not the other way round.
In addition to these animals, two other cats and a dog displayed antibodies 2-6 weeks after developing signs of cardiac disease.
These pets had an acute onset of cardiac disease, which includes severe myocarditis.
(With inputs from agencies)
Covid NI: Executive issues statement on Omicron variant and keeping schools open – Belfast Live
The Northern Ireland Executive has said its priority remains keeping children and young people in school as it issued an update on the current Covid-19 situation.
In a joint statement on Thursday afternoon, Stormont ministers said that while no cases of the Omicron variant have yet been confirmed here, the situation is likely to change in the coming days.
They said: “Today we received an update from our medical and scientific advisers on the latest Covid-19 situation and, in particular, the emergence of the Omicron variant.
“The emergence of this new strain of the virus is a serious and concerning development worldwide. And while there is no need for alarm, it is vitally important that everyone redoubles their efforts to drive infection rates down.
“The evidence on the new variant is being very closely monitored. And our public health experts will continue to liaise with colleagues in other jurisdictions as the situation develops globally and locally.
“No cases of the Omicron variant have yet been confirmed here, but that situation is likely to change in the coming days. The public will be kept informed and health protection measures will be actioned as appropriate.”
Urging people to use this time wisely to drive Covid infection rates down, the Executive statement added: “It is still unclear whether the clinical impact of this new coronavirus variant will be more serious so it is essential that we take preventative action now.
“We are grateful to the public for how they have responded so far. People’s actions are already having an impact and we thank everyone for the steps they are taking.
“The effectiveness of the booster vaccination programme is evidenced in reduced hospital admissions; the large number of people coming forward for first dose vaccine in recent weeks will make a real difference; and the collective effort to adhere to the public health advice has helped in reducing the number of cases.
“We know what works. And as we approach Christmas, it is vital that we all continue to work together to keep our society open, protect our health service and save lives.”
We urge everyone to remain vigilant and play your part in slowing the spread of the virus by following these simple steps:
- Get first and second vaccine doses, and get your booster when eligible- up to date information is available at nidirect.gov.uk/covidvaccine;
- Limit your social contacts;
- Meet outdoors when possible;
- If meeting indoors, make sure rooms are well-ventilated;
- Wear a face covering in crowded or indoor settings;
- Work from home if possible;
- Practise good hand and respiratory hygiene;
- If you have symptoms of COVID-19, isolate immediately and get a PCR test as soon as possible.
“We thank everyone for continuing to make safer choices that will help to protect you, your family and our society.”
Earlier this week, teaching unions called for a ‘circuit breaker’ to be introduced over the Christmas period to control the spread of Covid-19 infection in Northern Ireland’s schools.
In response, Stormont said today: “Our priority remains keeping our children and young people in school.
“We recognise the challenges being faced across all our educational settings and the work that teachers and all staff are doing at this difficult time to support young people.
“We will continue to work with all concerned to keep our schools open and safe.”
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