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News24.com | Even if you’re not diabetic, high blood sugar could be fatal with Covid-19

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  • High blood sugar levels in Covid-19 patients are a major red flag, even if they don’t have diabetes.
  • A large Spanish study found this to be especially true when levels are high upon admission to hospital.
  • Hyperglycaemia should be actively monitored and treated in Covid-19 patients to reduce mortality rates.

The deadly impact of Covid-19 on diabetic patients has been well-established during the coronavirus pandemic, but more research is showing that high blood sugar can be fatal, even if you don’t suffer from diabetes.

Earlier research in July first revealed this sinister complication in coronavirus patients, and the latest study from Spain is the largest to date, using data from more than 11 000 patients.

Published in Annals of Medicine, the study took a closer look at the blood sugar levels of Covid-19 patients at the time of their hospital admission, regardless of their diabetic status.

READ | High blood sugar in Covid-19 patients who have never had diabetes can cause death

Early warning sign

The researchers established that high blood sugar – also known as hyperglycaemia – upon non-critical admission is an early warning sign that a Covid-19 patient might need mechanical ventilation and have a higher risk of death. 

In those without diabetes, hyperglycaemia can be triggered by infection, trauma, medications and other chronic conditions.

“Although several studies and meta-analyses have shown that patients with diabetes have a significantly higher risk of severe Covid-19 and increased mortality rates,” write the researchers, “the impact of hyperglycaemia itself, rather than the presence of [diabetes], has not been sufficiently described in non-critical patients hospitalised with Covid-19”.

What is the link between blood sugar and Covid-19?

One theory suggests that the virus’s infection of endocrine pancreas cells can disrupt the body’s insulin management, while another highlights that the inflammation a body endures during an infection can increase insulin resistance.

“One question that remains to be answered is whether hyperglycaemia plays any role in the physiopathology of the disease or if it is just an inflammatory bystander,” the study speculates.

Using data from 11 312 Covid-19 patients from 109 hospitals in Spain, they looked at admission hyperglycaemia in non-critical patients and its link to the length of hospital stay, ICU admission, mechanical ventilation and death.

The study, however, didn’t include patients who developed hyperglycaemia while in the hospital due to treatments and medications.

READ MORE | More evidence shows why Covid mortality rate is higher in men

High glucose levels, higher death rate

The patients were assigned to three groups based on their blood sugar levels – less than 140mg/dL, between 140 and 180 mg/dL, and more than 180mg/dL. Only about 18.9% of the group was classified as diabetic, and those with high levels tended to be older, male and mostly had some history of diabetes, hypertension and other chronic conditions.

Just more than 20% of the patients died in the hospital and, out of the mortalities, 41.1% were in the high blood glucose group, 33% from the middle range and 15.7% below 140mg/dL.

“Indeed, there was a gradual increase in all-cause mortality as admission [blood glucose] levels increased, and there were no differences in mortality rates within each category of [blood glucose] levels between patients with or without a previous history of diabetes,” explain the researchers.

Early monitoring important 

Even compared to other factors like age, gender, hypertension, chronic obstructive pulmonary disease and anaemia, high blood sugar levels still stood out as a predictor for mortality from Covid-19.

Those with elevated levels also tended to stay in hospital for longer and were more likely to be admitted to ICU and go on a ventilator.

The results from the study highlight the importance of blood glucose monitoring in Covid-19 patients, even if they don’t have diabetes, especially in the early stages of infection and hospitalisation.

“Early correction of hyperglycaemia in the course of Covid-19 could result in a decrease in the release of inflammatory cytokines and a reduction in the virus’s ACE binding capacity, consequently resulting in better outcomes,” the researchers concluded.

READ | Covid-19: An extensive study of the outbreak in Spain found most people did not develop immunity

Image credit: Unsplash

News24.com | Five serendipitous medical discoveries – starting with the Oxford vaccine dose

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You might assume that all great medical discoveries are the result of deliberate action on the part of scientists. But you’d be wrong. Many great discoveries are the result of accidents, mistakes and chance. Here are five of the best, starting with the most recent.

1. Oxford vaccine dose

If the Oxford-AstraZeneca vaccine had been given at the specified dose, the effectiveness of the vaccine at stopping Covid-19 would have been a slightly disappointing 62%. (And I say “slightly disappointing” guardedly because it’s a good result, but next to Pfizer and Moderna’s 95% efficacy, it doesn’t look champagne-poppingly brilliant.)

In Brazil and South Africa, the Oxford vaccine was given at the correct initial dose, and the second dose a month later. But in the UK, the trial participants were incorrectly given half a dose in the first round and a full dose later. And, serendipitously, this resulted in 90% efficacy. Not only that, but the “wrong” dose also resulted in milder side-effects.

2. Penicillin

Perhaps the most famous serendipitous discovery in medicine is Alexander Fleming’s chance discovery of penicillin in 1928. Growing Staphylococcus bacteria that had been left on a bench, he noted on returning from holiday, that one of the plates he was culturing had no bacterial growth around a fungal colony that had started in the plate.

Fleming made his cultures of this fungus – penicillin – available far and wide. It would be one of his former students who first used it to treat a bacterial infection in 1930.

And it would be more than ten years later that penicillin was being produced in mass quantities to test its clinical effectiveness on patients, following groundbreaking work from Oxford University.

3. Culturing bacteria

The discovery and study of bacteriology by Robert Koch was a significant scientific advance. Before his work, bacteria were notoriously difficult to isolate from each other and were often grown in a nutrient broth that supports many species.

In 1872, Koch noted the growth of distinct colonies on a potato slice and this would be the catalyst for the use of agar, which is now the standard substance used to grow bacteria in a petri dish.

This discovery would allow scientists to isolate which bacteria were making a patient ill.

Koch’s work led to him discover the first causative bacteria of a named disease: Bacillus anthracis, which causes anthrax.

4. X-rays

The application of X-rays revolutionised medicine in the late 19th and early 20th century. Wilhelm Röntgen became aware of these new rays, which he called “X” because of their unknown origin, while studying cathode rays (streams of electrodes in vacuum tubes).

He noticed that the X-rays could penetrate cardboard, and he quickly used them to show they penetrated human tissues, too, using his wife’s hand to do so.

The application of these rays for looking inside the human body soon became widespread. There was little understanding of the damage they were doing. Many cases of symptoms typical of radiation sickness and exposure were documented, including famous scientists such as Thomas Edison.

5. Stomach ulcers

Over 4 billion people are estimated to be infected with H pylori, a bacterium that lives in the stomach and can cause ulcers. It was the tireless efforts of two researchers – Barry Marshall and J. Robin Warren – and a longer than usual growing period, that led to the discovery of the bacteria.

Before this, stress and certain foods were thought to cause stomach ulcers. While these factors can make ulcers worse, they don’t cause them.

In 1982, Marshall and Warren were studying the stomach lining and contents of several patients with varying gastric symptoms. The fortuitous positioning of the Easter weekend meant that cultures from patients were left alone in the lab longer than usual. This resulted in the identification of a slow-growing novel bacteria that was causing these symptoms.

Sadly, the reluctance of the scientific community to accept the findings of the scientists led to Marshall infecting himself with H pylori by consuming a live culture of bacteria, becoming symptomatic and then treating himself with antibiotics.The Conversation

Adam Taylor, Professor and Director of the Clinical Anatomy Learning Centre, Lancaster University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

News24.com | Top tunes to put the pep in runners’ step

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  • Listening to music improves one’s workout experience in more ways than one
  • An online clothing store has shared Spotify’s global top ten runners’ songs 
  • The number of beats per minute of these songs is one of the reasons why they’re so popular 

Listening to music while working out has been proven to up our enjoyment of exercise – while also improving the quality of our workout.

An analysis by SportShoes.com revealed the top ten songs on runners’ playlists around the world. This is based on data from the music streaming service Spotify. Some of the top genres include EDM (not surprisingly due to its movement-inducing beat), hip hop and pop.

The 10 most popular running songs on Spotify are:

1. Work B**ch – Britney Spears 

2. Blinding Lights – The Weeknd

3. Roses (Imanbek Remix) – SAINt JHN 

4. Eye of the Tiger – Survivor

5.Titanium (feat. Sia) – David Guetta 

6. Can’t Hold Us – (feat. Ray Dalton) – Macklemore & Ryan Lewis

7. Can’t Stop The Feeling! – Justin Timberlake

8. Uptown Funk (feat. Bruno Mars) – Mark Ronson

9. This Is What You Came For (feat. Rihanna) – Calvin Harris 

10. Lose Yourself – Eminem

SportsShoes.com attributes the “inspirational lyrics and driving beat” of “Work B**ch” By Britney Spears to being number one on the list. The number of beats per minute of each song was also included as a reason for the songs topping the list.

However, when it came to the top artist featured on running playlists, Calvin Harris came in first place. Other top artists include Eminem at number two, David Guetta at number three, Drake coming in fourth place followed by Kanye West, Lady Gaga, Rihanna, Avicii, Ed Sheeran and Pitbull at number ten. 

These songs also have high bpm (beats per minute) which range between 109 and 171 bpm. This could be another factor contributing to why they are a part of running routines around the world. 

According to a study in the Frontiers in Psychology, journal, music with higher tempos improves the quality of exercise. The Italian researchers stated: “We found that listening to high-tempo music while exercising resulted in the highest heart rate and lowest perceived exertion compared with not listening to music. This means that the exercise seemed like less effort, but it was more beneficial in terms of enhancing physical fitness.”

Interestingly, there is also a top ten list of Disney running songs. Number one on the Disney top ten list for runners is “When Will My Life Begin” from the 2010 movie “Tangled”. SportsShoes.com describes the track as being “the perfect warm-up track”.

The list compiled by SportsShoes.com is as follows:

1. When Will My Life Begin? – Mandy Moore – Tangled

2. Let It Go – Idina Menzel – Frozen

3. How Far I’ll Go – Auli’i Cravalho – Moana

4. You’re Welcome – Dwayne Johnson – Moana

5. Circle of Life – Carmen Twillie – The Lion King

6. Try Everything – Shakira – Zootopia

7. Go The Distance – Roger Bart – Hercules

8. Life is a Highway – Rascal Flatts – Cars

9. Be Our Guest – Angela Lansbury – Beauty & The Beast

10. I’ll Make a Man Out of You – Donny Osmond – Mulan

With research suggesting that working out with music has multiple benefits, it should be well worth giving some of these tracks a try for motivation and making workouts more fun. For advice on running and appropriate gear, visit SportsShoes.com

News24.com | Major measles outbreak predicted to occur in 2021 in wake of Covid-19 pandemic

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  • The Covid-19 pandemic has made previously routine vaccinations against other infectious diseases, such as measles, a challenge
  • This is because many vaccination campaigns were paused for months in 2020
  • These factors may result in severe measles outbreaks in 2021, and governments need to urgently address the situation

Measles, a highly contagious respiratory disease, claimed over 207 500 lives in 2019, according to the World Health Organization – a 50% increase from 2016.

While vaccination efforts may have reduced the number of deaths from 2000 to 2018, the Covid-19 pandemic is impacting efforts to control and treat other diseases, including measles.

The disease, caused by a virus in the paramyxovirus family, affects mainly unvaccinated young children and unvaccinated pregnant women. However, any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected, notes the WHO.

A recently-published article in The Lancet has therefore called for urgent international action to prevent potentially devastating measles epidemics in the years to come.

As a result of resources and attention shifting to the pandemic, many children have missed out on measles vaccination this year, making future measles outbreaks inevitable, said lead author Professor Kim Mulholland, from the Murdoch Children’s Research Institute and Chair of the WHO’s SAGE Working Group on measles and rubella vaccines.

Economic impact of lockdown, malnutrition, and measles

The year 2020 has been a quiet year for measles, thanks to travel reductions and national Covid-19 control measures implemented globally. However, the resulting economic impact could have a direct effect on the proliferation of the disease, especially against the background of childhood malnutrition.

The severity of measles can be worsened through malnutrition, the authors wrote, leading to poorer outcomes and more deaths, especially in low- and middle-income countries. (Measles is particularly common in parts of Africa and Asia, where the majority – more than 95% – of measles deaths occur in countries with low per capita incomes and weak health infrastructures.)

“Children who die from measles are often malnourished, but acute measles pushes many surviving children into malnutrition,” Mulholland said.

“Malnutrition, along with measles-associated immune suppression, leads to delayed mortality, while co-existing vitamin A deficiency can also lead to measles-associated blindness.

“The coming months are likely to see increasing numbers of unimmunised children who are susceptible to measles. Many live in poor, remote communities where health systems are less resilient, and malnutrition and vitamin A deficiency are already increasing.”

Vaccination campaigns also halted during pandemic

Mulholland also expressed concern about the negative effect the Covid-19 pandemic has had on the control of vaccine-preventable diseases, as a result of vaccination campaigns being paused during some months in 2020, and routine immunisation services disrupted in many countries.

By the end of October 2020, the WHO estimated that delayed vaccination campaigns in 26 countries led to 94 million children missing scheduled measles vaccine doses.

“All these factors create the environment for severe measles outbreaks in 2021, accompanied by increased death rates and the serious consequences of measles that were common decades ago,” Mulholland said.

“This is despite the fact that we have a highly cost-effective way to prevent this disease through measles vaccination.”

The return of measles in 2019

Before Covid-19 swept the globe, there was already a dramatic return of measles – more than at any time in the past 20 years, the researchers stated.

According to WHO data, there were 9.8 million measles cases and 207 000 deaths in 2019, a staggering 50% more than in 2016.

Where have most cases occurred?

Africa has seen the large majority of measles-related deaths, with major outbreaks happening in Madagascar and the Democratic Republic of Congo. The disease also re-emerged in South America, especially among indigenous communities.

Mulholland explained that the inadequate vaccination that led to the 2019 measles outbreaks has still not been adequately addressed, adding that the situation has been exacerbated by service disruptions during the Covid-19 pandemic where high-risk, unimmunised children were clustered together in unreached communities.

The way forward: Proposed solutions

The authors proposed three pillars for immediate action:

  • Help countries reach unimmunised children through catch-up immunisation and campaigns.
  • Better prepare countries for expected outbreaks – the WHO and partners have developed a Strategic Response Plan to assist with measles outbreak prevention, preparedness and response.
  • Maintain measles and rubella elimination targets. WHO’s new Measles Rubella Strategic Framework 2021–2030, aligned with the Immunization Agenda 2030 provides a plan for strengthening routine immunisation and surveillance.

“Without concerted efforts now, it is likely that the coming years will see an increase in measles and its severe, frequently fatal, complications,” Mulholland said, commenting that the proposed solutions might help end the outbreaks of the past decade.

READ | How measles complications can affect every organ

READ | Measles leaves people more vulnerable to future infections

READ | Vaccinations halted in several poor countries due to coronavirus fears

Image: Katja Fuhlert from Pixabay 

News24.com | OPINION | South African researchers are looking at medicinal plants for possible Covid-19 treatments

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South Africa has a long tradition of using plants for medicinal purposes. Some of these, such as Aloe ferox, Sutherlandia frutescens and Kiggelaria africana, have been studied as sources of useful compounds. But most still need to be scientifically validated as treatments for particular diseases.

Medicinal plants are gradually gaining prominence in scientists’ search for potential treatment agents for Covid-19. Currently there is no specific antiviral drug to treat this new respiratory disease. Most treatment strategies focus on managing symptoms and supportive therapy such as supplementary oxygen and mechanical ventilation.

My colleagues and I from the Durban University of Technology and the University of KwaZulu-Natal in South Africa are among the researchers looking for potential Covid-19 treatments from plants. We recently completed the first phase of our project, which ultimately seeks to develop a novel SARS-CoV-2 therapeutic.

Our aim in the first phase was to identify bioactive compounds in plants that are indigenous to South Africa which could be effective against SARS-CoV-2, the virus that causes Covid-19. We looked for potential Covid-19 therapeutic agents from a list of 29 bioactive compounds.

The species chosen were based on their use for the common cold, flu, other respiratory conditions, antimalarial, antiviral and antioxidant activity.

Our initial findings show that some compounds had the potential to inhibit SARS-CoV-2. We are now in the second phase of our study, which will test the compounds rigorously in the laboratory. This is a starting point in the search for a novel SARS-CoV-2 therapeutic.

From plant extract to therapeutic

In the initial stage of this project we worked with collaborators from the University of KwaZulu-Natal, Bio-computational and drug design laboratory. The team screened potential bioactive compounds isolated from commonly used South African medicinal plants using molecular docking.

Molecular docking is the study of how two or more molecular structures (for example, a drug and an enzyme or protein) fit together. Protein-binding may affect drug activity in one of two ways: either by changing the effective concentration of the drug at its site of action or by changing the rate at which the drug is eliminated, thus affecting the length of time for which effective concentrations are maintained.

We performed molecular docking of the plant compounds against SARS-CoV-2, using biocomputational analysis.

Some of the plant compounds showed potential. These were from Acacia senegal, Sutherlandia frutescens, Hypoxis hemerocallidea, Xysmalobium undulatum and Aspalathus linearis (commonly known as rooibos).

They exhibited favourable binding orientations and were identified as potential inhibitors of the SARS-CoV-2 receptor binding domain and SARS-CoV-2 RNA-dependent polymerase.

Four compounds exhibited extremely good binding to the virus, meaning that these compounds may prevent the virus from replicating.

These compounds could serve as a starting point for the discovery of a novel SARS-CoV-2 therapeutic.

Next steps

For the next stage we will infect animal cells with the virus. Then we’ll administer the compounds (cytotoxicity screening) to see what effect they have. If this in vitro study shows promising results, further analysis will be conducted using an animal model. The effects of the compounds on infected rats will be monitored.

Our end goal is to finally have a successful treatment for this virus. Infections can still occur even when a safe and effective vaccine is available. This is why it’s important to ensure effective treatments are also part of the efforts to end Covid-19.

No traditional African medicine has been scientifically validated yet as a treatment for SARS-CoV-2.

We are now in the second phase of our study, which will test the compounds rigorously in the laboratory if funding can be found. This depends on a lot of different factors.

We will be working with collaborators from the University of KwaZulu-Natal’s Department of Virology, where the analysis will take place.The Conversation

Depika Dwarka, Post doctoral Fellow, Durban University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Health24.com | Heavy birth weight may increase risk of heart problems

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  • There is a risk of atrial fibrillation in adulthood for babies who were born with a higher body weight 
  • Maintaining a healthy weight and a healthy lifestyle early on can, however, prevent the onset of AF later in life
  • Pregnant mothers should also pay more attention to diet control and have regular check-ups

Research presented at the 31st Great Wall International Congress of Cardiology (GW-ICC) indicates that elevated birth weight can be associated with atrial fibrillation (irregular heart rate) in adulthood. 

Previous studies have indicated that a high BMI during pregnancy is linked to atrial fibrillation in offspring, and advised that preventing maternal obesity can lessen the likelihood of the condition.

Now a study authored by Dr Songzan Chen of Zhejiang University suggests  that there is a risk of atrial fibrillation in adulthood for babies who were born with a higher body weight (over 4 000 grams). Researchers conducted a trial using data from 321 223 individuals “to identify 132 genetic variants associated with birth weight”.

The relationship between birth weight and atrial fibrillation

Dr Chen found that there is a causal relationship between birth weight and atrial fibrillation. Also, birth weight presents an indication of adult height, and the risk of atrial fibrillation is higher in tall people.

However, maintaining a healthy weight and a healthy lifestyle early on can prevent the onset of AF later in life.

Elevated birth weight preventable

According to Professor Guosheng Fu of Sir Run Run Shaw Hospital, ”reducing the number of newborns with elevated birth weight is probably considered as a feasible prevention to ease the burden of atrial fibrillation. Therefore, pregnant women should pay more attention to diet control and regular check-ups, especially for those with obesity or diabetes.”

People who were born with higher weight should also try to avoid other triggers of AF, such as drinking alcohol, obesity, smoking and drinking caffeinated drinks, as these increase the risk. Dr Chen emphasised that these individuals should adopt a healthy lifestyle to lower their chances of developing AF.

Image credit: Unsplash

Compiled by Virginia Van Wyk

Health24.com | Another Covid vaccine candidate reports promising results – what we know

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  • Results from the Oxford University Covid-19 vaccine trial shows promising results, with up to 90% efficacy reported
  • The vaccine will now await regulatory approval from independent regulator, the MHRA 
  • The UK government has pre-ordered 100 million doses, and AstraZeneca stated that it will seek an Emergency Use Listing from WHO for vaccine availability in low-income countries

Positive data from an interim analysis of the University of Oxford’s Covid-19 vaccine trial in the UK and Brazil shows that it protects 70% of people from developing Covid symptoms, Oxford’s manufacturing partner, AstraZeneca announced on Monday.

The data is from the COV002 Phase 2/3 trial in the UK and COV003 Phase 3 trial in Brazil, which involves more than 23 000 participants. No hospitalisations or severe cases of the disease were reported in volunteers who received the vaccine, named AZD1222.

A total of 30 cases of Covid-19 were found in participants who received two jabs of the vaccine, and 101 cases in people who received a saline injection. According to the researchers, it translates to 70% protection.

Additional data from the large-scale trial also suggests that perfecting the dose could increase protection up to 90%. This was seen for one course of dosing, where volunteers received a half dose of the vaccine, followed by a full dose at least one month after.

When participants were given two “high” doses, it resulted in 62% protection. However, this increased to 90% when participants received a “low” dose followed by a high one. 

Chief investigator pleased with results

Professor Andrew Pollard, the trial’s lead investigator said: “Excitingly, we’ve found that one of our dosing regimens may be around 90% effective and if this dosing regime is used, more people could be vaccinated with planned vaccine supply.”

The researchers stated that it’s not clear why there is a difference, although Pollard told the BBC that the team is “really pleased with these results”.

There were also lower levels of asymptomatic infection in the low followed by high dose group which “means we might be able to halt the virus in its tracks,” Pollard said.

Vaccine’s architect Professor Sarah Gilbert also commented: “The announcement today takes us another step closer to the time when we can use vaccines to bring an end to the devastation caused by [the virus].”

The vaccine uses an adenovirus, which causes the common cold in chimpanzees, that has been genetically engineered so that it’s unable to replicate and cause disease in humans. 

How does the Oxford vaccine fare, compared to Pfizer and Moderna’s vaccines?

This news follows shortly after the positive results announced by Pfizer/BioNTech and Moderna, whose vaccines showed 95% and 94.5% protection respectively. Both companies have applied to regulatory authorities for approval.

While 70% may seem like a disappointing result in comparison to these two vaccines, the Food and Drug Administration (FDA) requires a Covid-19 vaccine to prevent disease in 50% of volunteers in order to gain approval.

Logistics less complex

Logistics of storing and transporting the Oxford vaccine will be far less complex than the Pfizer and Moderna vaccines, as it can be stored at fridge temperature, making it more favourable to distribute worldwide.

The Pfizer/BioNTech vaccine needs to be stored below freezing temperatures (minus 70 degrees Celsius), while Moderna’s vaccine needs to be shipped and transported at minus 20 degrees Celsius.

Reporting by Bhekisisa earlier this month notes that despite its promise, cold chain requirements mean these jabs wouldn’t be the first choice for countries like South Africa.

In addition to the above, the Oxford vaccine is also much cheaper than the Pfizer and Moderna vaccines.

This means that it will play a significant role in fighting the spread of the virus pandemic, if it is approved by regulators, which is due to take place in the next couple of weeks.

“I’m really very pleased, I really welcome these figures – this data – that show that the vaccine in the right dosage can be up to 90% effective,” Health Secretary Matt Hancock told Sky News.

“Of course, it’s vital that the independent regulator – the MHRA (Medicines and Healthcare products Regulatory Agency) – will need to look at the data, will need to check to make sure that it’s effective and safe.” 

Comments on results by lead investigator of SA’s trial

Clinical trials are also being carried out in the US, Japan, Russia, South Africa, Kenya and Latin America. Planned trials are due to take place in other European and Asian countries. A total of 60 000 participants are expected to be enrolled globally.

This vaccine candidate was also the first of Covid-19 vaccines to be trialled in South Africa. Named the Ox1Cov-19 Vaccine VIDA trial, it is done in collaboration with Oxford University. The SA trial is being led by Professor in Vaccinology at Wits University, Shabir Madhi.

Commenting on the results, Madhi said in a press release by the university:

“The results from this study add further hope that accessing vaccines to fight the Covid-19 pandemic are fast becoming a reality.

“The results from this study are intriguing, in that a dose-sparing regimen may inadvertently end up being more protective. This has implications not only for the cost of the vaccine, but also how many more people could possibly be vaccinated in the near future when vaccine supply is likely to be constrained.

“Also, the ability to scale up production of this vaccine, and it only needing to be stored at 2-8 degrees Celcius, would greatly assist in the deployment of the vaccine in low- and middle-income countries. The cost of this vaccine is also anticipated to be much cheaper than other Covid-19 vaccines that have recently been shown to be efficacious.”

Madhi emphasised the importance of testing the vaccine in diverse populations, such as South Africa:

“The results of the study from South Africa remain of global interest, and to inform recommendations on Covid-19 vaccine in Africa, as the Covid-19 experience in South Africa has been very different to the UK.

“As for many other vaccines, genetic factors and local conditions could also affect the performance of the vaccine in different populations. The results of the pooled analysis from UK and Brazil creates optimism that we will also show protection against Covid-19 in the South African study, where participants are still being followed-up.”

Who’s first in line to receive the vaccine?

According to the BBC, AstraZeneca is preparing to produce three billion doses worldwide.

The UK government has already pre-ordered 100 million doses, enough to immunise 50 million people. If approved, four million is expected to roll out by the end of the year.

Earlier this year, Madhi explained that AstraZeneca, however, doesn’t have any direct involvement with SA’s vaccine trial as the agreement to do the trial here preceded Oxford’s agreement with AstraZeneca for further clinical development and manufacturing of the vaccine.

But spokesman for the Department of Health, Popo Maja, confirmed to Spotlight this month that although SA had not concluded any vaccine deal, negotiations with manufacturers and COVAX (an initiative co-lead by the World Health Organization that aims to ensure developing countries get access to Covid-19 vaccines) are underway.

AstraZeneca’s press release notes that “it will now immediately prepare regulatory submission of the data to authorities around the world that have a framework in place for conditional or early approval.

“The Company will seek an Emergency Use Listing from the World Health Organization for an accelerated pathway to vaccine availability in low-income countries. In parallel, the full analysis of the interim results is being submitted for publication in a peer-reviewed journal,” they stated.

READ | Covid-19: Two of the vaccine front runners have already reported promising evidence – so what now?

READ | Cold truth: South Africa won’t be able to store these Covid vaccines. Here’s why.

READ | The latest news on a leading Covid vaccine candidate is promising, but how optimistic should we be?

Image: Getty/zhangshuang

Zakiyah Ebrahim

Health24.com | Breaking the two-hour barrier: Scientists looked at what it takes to be an elite marathon runner

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  • Running a marathon requires specific abilities
  • Scientists have long debated the requirements of being an elite marathon runner
  • Data collected from the Breaking2 project reveal that oxygen and the way it is used play an important role

Running at a “two-hour marathon pace” requires specific physiological abilities. While these requirements have always been a great topic of debate, the actual demands had not been determined – until recently, that is. 

A recent study conducted by Professor Andrew Jones and a team of researchers revealed exactly what it takes – physiologically – for elite marathon runners to tackle a sub-two-hour marathon. The study was based on tests done on athletes participating in the Breaking2 project.

Higher oxygen intake

Breaking2 was a project initiated by Nike to break the two-hour barrier. Findings revealed that runners must possess a perfectly balanced rate of oxygen uptake (known as VO2 max), master moving efficiently and have a high lactate turnpoint. 

To test for these factors, 16 male distance runners took part in a detailed examination while running on a treadmill at a constant speed of 21.1km/h.

According to Professor Jones, “To run for two hours at this speed, athletes must maintain what we call ‘steady-state’ VO2. This means they meet their entire energy needs aerobically (from oxygen).”

Interestingly, 15 of the 16 runners from the study are from East Africa. It was also discovered that while running a marathon, elite runners take in twice as much oxygen as a normal person while sprinting.

Professor Jones expressed that a standout factor that differentiates these elite runners is that they show remarkable fatigue resistance.

This is because seem to know what their “critical speed” is and run just below this speed, thereby avoiding fatigue.

Eliud Kipchoge is an example of a runner with great fatigue resistance and was one of the participants of the study who ended up winning the marathon and breaking the two-hour barrier. 

Image credit: iStock

Compiled by Virginia Van Wyk

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News24.com | Breaking the two-hour barrier: Scientists looked at what it takes to be an elite marathon runner

You Need Posted on by
  • Running a marathon requires specific abilities
  • Scientists have long debated the requirements of being an elite marathon runner
  • Data collected from the Breaking2 project reveal that oxygen and the way it is used play an important role

Running at a “two-hour marathon pace” requires specific physiological abilities. While these requirements have always been a great topic of debate, the actual demands had not been determined – until recently, that is. 

A recent study conducted by Professor Andrew Jones and a team of researchers revealed exactly what it takes – physiologically – for elite marathon runners to tackle a sub-two-hour marathon. The study was based on tests done on athletes participating in the Breaking2 project.

Higher oxygen intake

Breaking2 was a project initiated by Nike to break the two-hour barrier. Findings revealed that runners must possess a perfectly balanced rate of oxygen uptake (known as VO2 max), master moving efficiently and have a high lactate turnpoint. 

To test for these factors, 16 male distance runners took part in a detailed examination while running on a treadmill at a constant speed of 21.1km/h.

According to Professor Jones, “To run for two hours at this speed, athletes must maintain what we call ‘steady-state’ VO2. This means they meet their entire energy needs aerobically (from oxygen).”

Interestingly, 15 of the 16 runners from the study are from East Africa. It was also discovered that while running a marathon, elite runners take in twice as much oxygen as a normal person while sprinting.

Professor Jones expressed that a standout factor that differentiates these elite runners is that they show remarkable fatigue resistance.

This is because seem to know what their “critical speed” is and run just below this speed, thereby avoiding fatigue.

Eliud Kipchoge is an example of a runner with great fatigue resistance and was one of the participants of the study who ended up winning the marathon and breaking the two-hour barrier. 

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Health24.com | Study highlights heart-health issues for adults who were preemies

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  • Before the 1970s, the survival rate of extremely preterm babies was below 10%
  • A new study studied changes during adult years in individuals who were born very preterm
  • It was found that the extremely premature group tended to develop more heart issues as adults

Erin Wegener was a tiny baby facing enormous challenges.

Born at 29 weeks’ gestation, she weighed only 1 pound, 14 ounces (0.5kg). Her first three months were lived in the neonatal intensive care unit. Family photos show her covered in gauze, sustained by too many tubes to count. Her entire hand just about fit inside her father’s wedding ring.

Her parents were warned she could face a lifetime of mental and physical challenges. But today, she’s working as a music therapist in the same hospital system in Grand Rapids, Michigan, where she was born.

The doctors’ most dire warnings didn’t come true, and her premature birth has never been much of a factor in her adult life. “I feel very thankful that I have not had a lot of health issues growing up,” she said.

Cardiovascular health score

Wegener was born in 1985, just a few years before breakthroughs in treatment allowed many more extremely low birth weight babies to survive. As that wave of children enters adulthood, a new study is revealing details about possible risks to their heart health.

Research published in the American Heart Association journal Hypertension compared cardiovascular health among two groups of Australians born in 1991 and 1992, as they turned 25 years old. The 165 participants in the first group were born extremely preterm (earlier than 28 weeks’ gestation) or with an extremely low birth weight (below 2.2 pounds). The 127 participants in the second group were born at term and at normal weights.

Researchers looked at several factors related to heart health and calculated a cardiovascular health score for each person. Overall, the extremely premature/low birth weight group had a less favourable rating than the term-born group, specifically for blood pressure, exercise capacity, fasting blood glucose (a marker of diabetes) and visceral abdominal fat (“belly fat”, which has been linked to heart disease, cancer and more).

It was known that people born early are prone to such problems, said the study’s lead author Dr Jeanie Cheong, a professor at the Royal Women’s Hospital in Melbourne, Australia. But the new research sought to tie the risks together for an overall view, she said. “We looked at all these factors cumulatively, rather than individually, thus providing a holistic view to health.”

Her work is part of the ongoing Victorian Infant Collaborative Study, which has been monitoring a group of Australians since their birth in 1991 or 1992. That’s the era when some treatments became widespread – such as corticosteroids for at-risk pregnant women to accelerate lung growth of babies in utero or using wetting-like agents called surfactants to treat immature lungs in premature babies.

Gender differences

Those treatments led to what Cheong called an exponential rise in survival over a short period for preemies. Before the 1970s, the survival rate of extremely preterm babies was below 10%, she said. By the early 1990s, that rate had soared to nearly 70%. It’s now at 87%, according to a separate study published recently in BMJ Open that Cheong led.

But the new study confirms other investigations about preemies’ long-term cardiovascular risk and adds details, said Dr Anne Monique Nuyt, a professor of paediatrics at the University of Montreal and head of neonatology at CHU Sainte-Justine hospital in Montreal. She was not involved in the new research.

“It’s one of the very first reports showing changes during adult years in individuals who were born very preterm.” Because they evaluated the participants at age 18, researchers discovered, for example, that the preterm group gained more weight between 18 and 25 than the normal birth weight group.

Nuyt, co-leader of a separate long-term study of premature infants, said the new work also confirmed earlier findings of gender differences in preemies’ future heart risks. Males scored worse for blood pressure, exercise tolerance and belly fat.

Cheong said the findings shouldn’t worry individuals born early. But “it is even more important for them to have close health surveillance and adopt healthy lifestyle choices, something that we all should do regardless,” she said.

Miracle of survival

The new study also showed the rate of smoking among former preemies is as high as in the general population, which Nuyt called worrisome. After all, many required oxygen right up until their parents took them home.

“We know smoking is very bad for the lungs. And it’s very bad for the heart, and it’s very bad for blood pressure. So if there’s one group that should not at all smoke, it’s these extremely low birth weight or extremely preterm individuals,” said Nuyt, who co-wrote a review paper published recently in Hypertension that called for greater awareness of the links between premature birth and heart problems.

“All physicians, all health care providers should be asking their patients, ‘Do you know your birth weight? Do you know whether you were born very tiny or very premature?'” she said.

Wegener, now 35, isn’t aware of any heart issues. And as the mother of three – with another baby due in April – she’s grateful for what she considers the miracle of her survival and long-term health. “I feel very fortunate.”

American Heart Association Newscovers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. 

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Michael Merschel