Study explores why Covid-19 disproportionately affects older people

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A “unique” study is tracking the effects of Covid-19 in people aged over 70, in a bid to help develop a bespoke vaccine for older people.

The University College London (UCL) project involves more than 600 older people who have signed up to the study, which aims to find out why the virus disproportionately affects this age group.

“We know that outcomes from Covid-19 are particularly bad for the elderly”

Daniel Davis

Those involved were already part of the ongoing ‘Long-term Information and Knowledge for Ageing – Camden’ (LINKAGE) study.

It is tracking the health and wellbeing of those aged over 70, to help understand how older people recover from infection and illness.

To help better understand the impact of coronavirus on older people, LINKAGE has now developed the Covid-19 sub-study.

Lead researcher Dr Daniel Davis, UCL population science and experimental medicine,  said: “The original design of the LINKAGE study has meant we are in the perfect position to follow participants at all stages of infection: from being well, into early infection and throughout the course of the illness.

“We know that outcomes from Covid-19 are particularly bad for the elderly and what is unique about our group was that these were older people we already knew quite a lot about,” he said.

“When the epidemic was rolling out, we realised the value of that. If you are going to develop a vaccine, you need to know what the immune system of an older person was like before they got it.”

Existing LINKAGE study participants received a letter in March, asking if they would be willing to volunteer to the sub-study and those who agreed are visited once by healthcare workers for swab and blood samples to be taken. They then receive follow-up health assessment by way of a phone call.

Scientists at UCL are working with experts at Imperial College London to analyse these samples to determine the person’s antibody levels and find any indicators that might suggest whether the patient would develop mild or severe symptoms if exposed to Covid-19.

Dr Davis, who is also a consultant in geriatric medicine at University College London Hospital, said an “important goal” within the study was to “determine pre-infection antibody levels against other coronaviruses”.

“There are no other samples that are tracking pre-infection in older people specifically”

Daniel Davis

“One theory of why Covid-19 affects elderly people more severely is that the older you get, the more other strains of coronavirus you have previously been exposed to, which leads to the immune system reacting in an exaggerated fashion,” he said.

“This of course has implications for whether a vaccine is the answer, and if it is the answer, how a vaccine should be developed.”

The Covid-19 sub-study was signed off by the Health Research Authority on March 16 and the first samples were collected on 19 March.

“Our study is unique because there are no other samples that are tracking pre-infection in older people specifically. Our results will be widely used and will be widely needed,” added Dr Davis.

He said: “We think we can find predictive markers: a signal in your blood today that will predict how you might fare if you get infected with Covid-19 – will your immune system be able to clear it or not?”

LINKAGE Camden is led by UCL, in partnership with the NHS, Camden Clinical Commissioning Group, and the Wellcome and the Medical Research Council.

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