Lymphopenia is linked with a higher risk for both all-cause and cause-specific mortality, a study with more than 100,000 participants found.
The study builds on previous work that has linked lymphopenia with higher risk for cancer, cardiovascular disease, liver disease, and systemic autoimmune disease.
The study by Marie Warny, MD, with the Department of Hematology at Herlev and Gentofte Hospital and Copenhagen University Hospital in Herlev, Denmark, and colleagues was published online January 13 in the Canadian Medical Association Journal.
After adjusting for age and sex, lymphopenia (defined as a lymphocyte count <1.1 × 109/L) was associated with a 63% increase in all-cause mortality (hazard ratio, 1.63) and with a 1.5- to 2.8-fold increased risk of dying from causes such as hematologic and nonhematologic cancer, cardiovascular and respiratory disease, and infections.
Table. Cause-Specific Mortality Risk Linked With Lymphopenia
Cause of Mortality
Hazard Ratio
95% Confidence Interval
Nonhematologic cancers
1.67
1.42 – 1.97
Hematologic cancers
2.79
1.82 – 4.28
Cardiovascular disease
1.88
1.61 – 2.20
Respiratory diseases
1.88
1.55 – 2.29
Infectious diseases
1.86
1.53 – 2.25
Other causes
1.50
1.19 – 1.88
The researchers examined and followed 108,135 white, Danish participants in the Copenhagen General Population Study (mean age, 68 years). They concluded that individuals with lymphopenia were at higher risk of dying from any cause, regardless of other risk factors, including age. They note that lymphopenia may be an underrecognized sign of frailty that signals higher risk for death.
The authors say their findings may help predict who might benefit from more surveillance after a blood test indicates lymphopenia. In current practice in Denmark, such patients are not generally referred for further examination because the possible connection with mortality risk has been unclear.
They note, “For all-cause mortality, the highest absolute 2-year risks of death were observed in women (61%) and men (75%) who smoked and were aged 80 years or older with lymphocyte counts less than 0.5 × 109/L.”
The authors acknowledge that the study involved only white, Danish participants and that the generalizability of the findings could not therefore be determined.
Findings Similar in US Research
Cardiologist David A. Zidar, MD, PhD, and colleagues had similar results in a related retrospective cohort study in the United States that was published online December 2, 2019, in JAMA Network Open.
He and his colleagues analyzed National Health and Nutrition Examination Survey (NHANES) data from more than 31,000 participants.
Zidar told Medscape Medical News the Danish work “is a terrific confirmatory observation. It is very helpful when independent groups publish using different databases and different patient populations and come to the same general agreement.”
The NHANES data are meant to represent the diversity of the United States, and his study controlled for factors that included race and ethnicity, but neither study should be considered definitive, and the conclusions should be tested in other populations, he continued.
“It’s increasingly clear that immune function plays a role in a number of different disease arenas,” he added.
Zidar is from the Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, in Ohio.
The importance of lymphocyte counts has been underrecognized in medicine; however, “It is more closely linked to mortality than a lot of things we look at,” he noted.
Findings from the Danish study and others can help with a precision medicine approach to immune therapies, Zidar said.
“Long term, it’s important to dissect which populations of patients might respond preferentially to immune therapies or intensification of preventive therapies. We’ve lacked an ability to risk-stratify people based upon their immune function,” he explained.
The Danish study authors note that in a previous study that involved the same cohort, they determined that lymphopenia was linked with a 1.4-fold higher risk of being admitted to a hospital and a 1.7-fold higher risk for infection-related death.
The project received funding from the European Union’s Horizon 2020 research and innovation program. The authors and Zidar have disclosed no relevant financial relationships.
CMAJ. Published online January 13, 2020. Full text
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
All orders are protected by SSL encryption – the highest industry standard for online security from trusted vendors.
Bizarre Sunlight Loophole Melts Belly Fat Fast! is backed with a 60 Day No Questions Asked Money Back Guarantee. If within the first 60 days of receipt you are not satisfied with Wake Up Lean™, you can request a refund by sending an email to the address given inside the product and we will immediately refund your entire purchase price, with no questions asked.
