News & numbers
“The health and well-being of patients is directly tied to the health and well-being of clinicians and the health system at large.”
Juan Celedón, president, American Thoracic Society Blood clot link threatens roll-out
Countries around the world have restricted or recommended alternatives to using the Oxford-AstraZeneca Covid-19 vaccine in younger people due to its association with rare cerebral venous sinus thrombosis with low blood platelets. Investigations by EU and UK regulators have concluded that these blood clots are a ‘possible’ and ‘extremely rare’ side effect, although no causal relation has yet been established. According to the UK’s MHRA, 79 UK cases have been identified, out of a total of more than 20 million vaccine doses administered, and 19 people have died.
This equates to around one case per 250,000 people vaccinated, and one death in a million.
Regulators in the US, who have not approved the Oxford-AstraZeneca vaccine, have also suspended use of the single-dose Johnson & Johnson vaccine due to reports of six cases of the same blood clots, leading to one death. Concern is mounting that neither product will be
able to recover from the reputational damage, which is particularly concerning given that both are vital to distribution in low and middle-income countries. Speaking about the decision in the UK to offer under-30s an alternate vaccine, which was made on a risk-benefit calculation comparing intensive care admissions with the risk of blood clots in that population, Anthony Harnden, deputy chair of the Joint Committee on Vaccination and Immunisation, emphasised that both the European Medicines Agency and the MHRA had found the Oxford-AstraZeneca vaccine to be “very safe and effective”. “There will be countries in the world where the AstraZeneca vaccine is the only choice, and there would be countries in the world where the life expectancy of the population is very, very low indeed,” added Harnden. “Therefore, the risk- benefit equation for the younger age groups in those other countries in the world will be different than in the UK.”
Covid connected to
psychiatric illness One in three Covid-19 survivors were diagnosed with a neurological or psychiatric condition within six months of infection, according to the largest study into the virus’s impacts on mental health, published in The Lancet Psychiatry. The survey of 236,379 electronic health records of patients, primarily in the US, found that anxiety (17%) and mood disorders (14%) were the most common diagnoses, but neurological conditions were not uncommon in those admitted to intensive care, of whom 7% had a stroke and almost 2% were diagnosed with dementia. The researchers from the University of Oxford and TriNetX health records network also noted that these diagnoses were higher in Covid-19 patients than in those who had flu or respiratory tract infections over the same time period, suggesting a specific link to Covid-19.
Although researchers acknowledge the limits of electronic health records, they and other commentators have emphasised the need to plan health provision around these impacts and to conduct further research.
Reduction of PPE Blood test for depression
Building on previous research into using blood biomarkers to track suicidality, pain, post-traumatic stress disorder and Alzheimer’s disease, researchers at Indiana University School of Medicine have published a study on the development of a blood test that can distinguish the severity of a |patient’s depression.
The test, which uses RNA biomarkers, can also show the risks of depression worsening in the future, and of bipolar disorder, as well as enabling doctors to tailor medication to their patients. In the four-year study programme, the research team observed more than 300 participants in both high and low mood states, and recorded changes in their blood biomarkers.
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“We have pioneered the area of precision medicine in psychiatry over the last two decades, particularly over the last ten years,” said lead author Alexander Niculescu, professor of psychiatry at the university. “This is part of our effort to bring psychiatry from the 19th century into the 21st century. Ultimately, the mission is to save and improve lives.”
He continued, “Blood biomarkers are emerging as important tools in disorders where subjective self-report by an individual, or a clinical impression of a healthcare professional, are not always reliable. These blood tests can open the door to precise, personalised matching with medications, and objective monitoring of response to treatment.”
pressure injuries A ‘care bundle’ of baby wipes, moisturising balm and protective tape has been shown to protect front-line workers from their own PPE. When tested at a large acute care hospital in Ireland, the care bundle made staff almost five times less likely to develop a facial pressure injury. The study, led by researchers from RCSI University of Medicine and Health Sciences Skin Wounds and Trauma (SWaT) Research Centre, is published in the Journal of Wound Care.
34%
Covid-19 survivors diagnosed with a neurological or psychiatric condition six months after infection. The Lancet Psychiatry
Practical Patient Care /
www.practical-patient-care.com
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