This research provide a comprehensive examination of the impact of clinical, demographic, and lipid-related factors on the severity and mortality of patients with COVID-19. The findings presented in our study indicate that there are no statistically significant differences between critical and non-critical cases when considering gender. Nevertheless, it is worth noting that there was a discernible pattern linked to age, as older people were overrepresented among patients who experienced severe outcomes or did not survive. These data provide support for the widely accepted scientific consensus that age is a significant risk factor for negative outcomes related to COVID-19, such as hospitalization, admission to critical care units, and death33.
The substantial proportion of the cohort with diabetes and hypertension in this study is consistent with previous research indicating that these comorbidities are associated with worse outcomes in COVID-1934. These conditions are known to exacerbate the inflammatory response and contribute to endothelial dysfunction, which may enhance the severity of SARS-CoV-2 infection. This suggest that COVID-19 patients with comorbidities like diabetes and hypertension may be at higher risk of disease severity and mortality35. Therefore, it is significant to identify and manage these comorbidities in COVID-19 patients to improve their outcomes.
However, variables including sex, diabetes, and obesity, were not significantly associated with survival outcomes. Previous studies have identified these as potential risk factors for severe COVID-19 outcomes36,37, which is unexpected. The absence of an association in the present study may be attributable to the small sample size, necessitating additional research in larger cohorts.
When comparingthe lipid profiles of COVID-19 patientsbetween severity and survival outcome groups, no significant differences in cholesterol levels across severity or outcome groups in COVID-19 patients. The median cholesterol levels were comparable across all groups, with non-critical patients exhibiting slightly higher levels than critical patients. Similarly, the study found no significant differences in high-density lipoprotein cholesterol (HDL-c) levels among severity and outcome groups. The values were closely matched in all groups, with non-critical patients and survivors marginally higher than their counterparts. The study found slightly lower median values of low-density lipoprotein cholesterol (LDL-c) in critical compared to non-critical patients, but this difference was insignificant. This finding is consistent with a study by Zhang et al. that found that LDL-c levels were lower in COVID-19 patients with severe disease than those with mild disease8.
Triglyceride levels showed a statistically significant difference between survival outcome groups, with non-survivors exhibiting higher median levels. This suggests a potential association between elevated triglycerides, reduced HDL-c levels, and increased mortality risk in COVID-19 patients. According to additional studies, high triglyceride levels and low HDL-c levels are predictors of COVID-19 severity and mortality6,10,19,38. Nevertheless, the relationship between lipid profiles and COVID-19 outcomes is not yet fully understood, and additional research is required to identify the precise mechanisms underlying this association. According to the lipid profile changes, elevated triglycerides are associated with COVID-19 severity and mortality; this finding is consistent with a recent meta-analysis that linked elevated triglycerides to COVID-19 severity and mortality10.
Similarly, Masana et al.19 identified low HDL cholesterol and elevated triglycerides as predictors of COVID-19severity. However, the conclusions drawn from previous studies regarding the alterations in serum lipids in COVID-19 patients are inconsistent. For instance, Liu et al. found that dyslipidemia was not associated with COVID-19 severity or mortality39. Different study designs, patient populations, and lipid profile measurements may account for these discrepancies.
The present study also evaluated the ability of lipid profile variables to predict COVID-19 severity and mortality using AUC-ROC curves. The study found that all lipid profile components had moderate discriminatory ability, with AUC values ranging from 0.79 to 0.89. The study also established optimal cut-off points for each lipid variable based on the Youden's index J and found that each lipid variable, except for Tryg, showed a significant association with mortality outcome in logistic regression analysis. The multivariate logistic regression model revealed that the lipid variables had substantial predictive value for severity and mortality outcome, even after adjusting for potential confounders such as age, sex, diabetes, hypertension, and obesity.
These findings are consistent with previous research showing that lipid profile alterations are associated with COVID-19 severity and mortality40. Moreover, the present study's findings suggest that lipid profile variables may be useful in predicting COVID-19 outcomes and could be used as a readily available biological marker to predict the severity and mortality of COVID-19 infection41. However, it is essential to note that lipid profile variables are just one of many factors that may influence COVID-19 outcomes. Other factors, such as treatment adherence on chronic diseases42, albumin levels43, Leukocyte glucose index44, and neutrophillymphocyte ratio41, have also been identified as predictors of COVID-19 outcomes.
Other research indicates that comorbidities may moderate the relationship between lipid profile and COVID-19 outcomes. For instance, Kumari et al.45 found that lipid profiles may be a potential marker for determining the disease prognosis for COVID-19 patients, but they did not examine the impact of comorbidities. The precise mechanisms coupling these comorbidities to worse outcomes are not fully understood, but they could involve a combination of factors, such as chronic inflammation, impaired immune function, and increased susceptibility to viral entry and replication.
In addition, the findings of the presented study may have substantial implications for the treatment of COVID-19 patients. Age and hypertension were identified as significant survival predictors in COVID-19 patients, particularly in the context of early identification and management of comorbidities. Findings regarding triglycerides suggest that surveillance and treatment of lipid profile abnormalities may be necessary for enhancing COVID-19 outcomes. In addition, further research is necessary to thoroughly comprehend the mechanisms underlying the association between COVID-19 and lipid profile levels and to develop effective interventions for preventing and treating dyslipidemia caused by COVID-19. Furthermore, this study emphasizes the significance of considering comorbidities such as diabetes and hypertension when assessing the severity and mortality of COVID-19. Age and hypertension were significant survival predictors in both univariate and multivariate Cox proportional hazards regression models. Additionally, the survival analysis for HDL-c levels also revealed interesting findings.
The present study found that COVID-19 patients with higher HDL-c levels may have a greater chance of survival. This finding aligns with previous research suggesting that HDL-c, known for its anti-inflammatory and antioxidant properties, may have a protective role in COVID-19. In this sense, some studies evaluated the HDL-c anti-inflammatory and antioxidant activity, proving that the Serum amyloid A (SAA), Apolipoprotein A-1, Alpha-1 antitrypsin, and paraoxonase 1 (PON-1) (HDL-c associated proteins) are altered in SARS-CoV-2 infection which could be related to decreased functionality of HDL-c in COVID-19 severity23,46.
Moreover, evidence suggests that cholesterol-rich lipid rafts and receptors, such as HDL scavenger receptor B type 1 (SR-B1), which regulate lipid entry into cells can enhance SARS-CoV-2 entry17. HDL-c mobilizes the cholesterol of cholesterol-rich lipid rafts for traffic and re-localizes SARS-CoV-2 receptors, which promote the viral entry into cells17.Because HDL-c has immunomodulatory effects, it could be hypothesized that low HDL-c levels during infection are associated with the regulation of immune cells in COVID-19 severity47,48. A study evaluating lymphocytes, macrophage activation, dendritic cells, inflammatory mediators, cytokines, and their correlation with HDL-c levels during SARS-CoV-2 infection is required to test this hypothesis.
Stadler et al. demonstrated that the cholesterol efflux capacity is associated with mortality, ApoA-I protein, HDL-ApoA-I protein, HDL-c, total ApoA-II protein, HDL-free cholesterol, and HDL phospholipids in patients with COVID-1949. Another study demonstrating the importance of HDL-c during SARS-CoV-2 infection showed that a ratio of triglyceride to HDL-c was related to the risk of severe COVID-1950.
Changes in lipid profile levels could have clinical applicability in providing timely treatment for patients with COVID-19. In this regard, a study of lipid profiletrajectories during the two years before COVID-19 testing revealed that higher antecedent HDL-c levels were associated with a lower SARS-CoV-2 infection risk. These levels, however, declined during viral infection51. On the other hand, Jin et al. reported that the patients infected during the first wave of COVID-19 with high levels of low-density lipoprotein cholesterol (LDL-c), triglyceride, and total cholesterol before infection and on admission had a poor progression of COVID-197. Moreover, HDL-c, LDL-c, total cholesterol, and triglyceride were significantly lower in the patients with COVID-19 during the first wave of COVID-19, demonstrating that lipid profile predicts the severity of SARS-CoV-2 infection52. Al-Zadjali et al. demonstrated that low HDL-c levels areassociated with increase long-term COVID-19 severity in unvaccinated patients infected with SARS-CoV-2 after the first wave of COVID-1953. Regarding vaccination, a study focused on analyzing the lipid profile before and after the two doses of the COVID-19 vaccination in patients without exposure to SARS-CoV-2 infection revealed that triglyceride levels were significantly decreased and cholesterol, HDL-c, and LDL-c levels were significantly increased in patients who received the mRNA-1273 (Moderna) vaccine54. Individuals vaccinated with the BNT162b2 (Pfizer-BioNTech) vaccine had a significant increase in HDL-c, while patients vaccinated with ChAdOx1 nCov-19 (Oxford-AstraZeneca) had no change in lipid profile after follow-up54. Szczerbiski et al. reported an absence of statistically significant correlation between the total cholesterol, HDL-c, and LDL-c levels and anti-SARS-CoV-2 S antibodies concentration at the end-of-observation-19 weeks in patients vaccinated with the second dose of BNT162b2 mRNA COVID-19 vaccine55. On the other hand, in the patients who received the COVID-19 vaccine and were diagnosed with SARS-CoV-2 infection after the first wave of COVID-19, the total cholesterol, HDL-c, and LDL-c were significantly lower in non-survivors and these values were associated with the mortality risk56. Furthermore, patients with low levels of LDL-c, total cholesterol, and anti-SARS-CoV-2 antibodies had the highest mortality rates56. Thus, lipid profile, emerging SARS-CoV-2 variants, and the immune response in COVID-19 vaccine recipients (neutralizing antibodies against SARS-CoV-2) could be strongly related with COVID-19 mortality through a pathophysiological mechanism where the statin therapy would improve the chances of survival57.
Despite the emergence of new SARS-CoV-2 variants, our findings remain clinically relevant, offering insights into the prognostic value of lipid profiles in COVID-19 patients. These insights are pivotal for risk stratification and the development of management strategies that are adaptable to the evolving pandemic landscape. Furthermore, this study elucidates the critical associations between lipid profile abnormalities and COVID-19 severity and mortality, thereby contributing significantly to existing literature. However, the study is not without limitations. The retrospective design, small sample size, and absence of control groups introduce potential biases and limit the generalizability of our findings. Additionally, uncontrolled confounding variables and population heterogeneity further constrain the study's applicability. Despite these constraints, this researchmakes a significant contribution to the field. Future investigations should adopt a prospective methodology, incorporate larger and more diverse cohorts, and include control groups. Employing advanced statistical techniques to control confounders and conducting mechanistic studies will refine our understanding and facilitate targeted interventions, thereby enhancing the study's global scientific impact.
Our findings suggest that patients with comorbidities should be classified with caution based on their lipid profile values when assessing the prognosis of COVID-19 patients. In addition, the relationship between lipid profile, disease outcome, and comorbidities must be understood to guide adequate risk stratification and treatment planning for COVID-19 patients. Similarly, the underlying mechanisms and potential interventions for dyslipidemia in COVID-19 patients require additional research. Despite its moderate AUC, the logistic regression model suggests a limited yet non-negligible ability to discriminate between patient outcomes based on lipid profiles. While the model exhibits high sensitivity, its specificity is notably low, indicating a propensity for false positive predictions, which could limit its clinical utility. In contrast, the Cox model's incorporation of time-to-event data provides a more granular analysis of risk factors, reinforcing the prognostic significance of age and hypertension. These results are consistent with existing literature that highlights the exacerbation of COVID-19 severity by underlying health conditions. Our findings corroborate previous studies that have identified age and hypertension as critical determinants of COVID-19 prognosis. However, the unique contribution of this study lies in its analytical approach, combining logistic regression with Cox proportional hazards modeling to enhance the depth of prognostic assessments. This study's primary limitations stem from its reliance on available clinical data, which may not capture all potential confounders. Future research should explore the inclusion of additional variables, such as genetic markers and patient lifestyle factors, which could further refine the predictive models presented herein. However, this study advances knowledge by shedding light on the prognostic significance of the lipid profile of COVID-19 infection. It also highlights the significance of considering lipid metabolism in treating and staging the disease.
When understanding the usefulness of lipid profiles in the prognosis of COVID-19, the classification of patients based on clinical guidelines or other clinical parameters should be considered. Our study classified the patients according to the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia, issued by the Chinese Centers for Disease Control and Prevention. Other studies that validated a clinical risk score or analyzed intermediates of cholesterol biosynthesis and their association with the clinical outcomes of SARS-CoV-2 infection classified the severity of COVID-19 based on the American Thoracic Society guidelines and the National Institutes of Health recommendations, respectively58,59. Hence, these and other classifications should be considered when comparing study results to avoid errors in interpreting severity and mortality predictors for COVID-19.
A comprehensive understanding of the effect of lipid profiles on COVID-19 outcomes may lead to improved clinical decision-making and patient care. In conclusion, this study advances our understanding of the factors influencing COVID-19 outcomes, emphasizing the role of systemic health issues such as hypertension. The dual analytical approach utilized herein not only highlights significant predictors but also underscores the complexity of prognostic modeling in infectious diseases.
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WASHINGTON The Select Subcommittee on the Coronavirus Pandemic held a hearing titled A Hearing with the National Institute of Allergy and Infectious Diseases Senior Scientific Advisor, Dr. David Morens. Evidence obtained by the Select Subcommittee prior to the hearing showed that Dr. Morens a former top advisor to Dr. Anthony Fauci at the National Institute of Allergy and Infectious Diseases (NIAID) deliberately obstructed the Select Subcommittees investigation into the origins of COVID-19 to protect Dr. Fauci, unlawfully deleted federal COVID-19 records, and shared nonpublic information about National Institutes of Health (NIH) grant processes with his best-friend EcoHealth Alliance President Dr. Peter Daszak. Dr. Morenss testimony confirmed these discoveries and proved that he clearly believes the laws of the federal government do not apply to him. Members used Dr. Morenss own emails as evidence of his misconduct and pressed Dr. Morens to explain why he displayed such contempt for the American people while serving as a senior official at the National Institutes of Health (NIH) during the COVID-19 pandemic. Dr. Morens admitted to using his personal email account to conduct official business, feigned ignorance about the NIHs record retention policy, and offered half-hearted apologies for his self-admitted misogynistic comments. Both majority and minority members held Dr. Morens accountable for his failure to serve the American people with the honesty, respect, and integrity that they deserve from public health officials.
Key Hearing Takeaways
Select Subcommittee on the Coronavirus Pandemic Chairman Brad Wenstrup (R-Ohio), D.P.M, called out Dr. Morenss ignorance and grilled him for seemingly false testimony related to his deletion of federal COVID-19 records.
Chairman Wenstrup: I have nonofficial emails on a separate phone that are fused, or I can separate them, but not my official ones. And that doesnt account for telling people that youre doing official business with that they should contact you on your Gmail.
Dr. Morens: Thats true.
Chairman Wenstrup: And especially to avoid FOIA and to be able to potentially delete things you dont want in The New York Times, which was your comment. On January 18 [2024], you testified no when asked if you ever deleted anything from your official account that could be considered a federal record. Dr. Morens, are you aware that the destruction or attempted destruction of federal records carries a potential punishment of both imprisonment and a fine?
Dr. Morens: I was not aware of that, and I was not aware that anything I deleted like emails was a federal record because we have federal records training periodically and the training, you know, that I recall we received, defined a federal record in a very different way than you may be thinking of it. None of it defined it as an email.
Chairman Wenstrup: Well, that may be something to look into, is what your training looks like when it comes to federal records, because its far different from mine.
Committee on Oversight and Accountability Chairman James Comer (R-Ky.) revealed Dr. Faucis intimate knowledge of and respect for the recently suspended and soon-to-be debarred EcoHealth Alliance President Dr. Peter Daszak. Chairman Comer also solicited an admission from Dr. Morens that he deletes a lot of emails that could be classified as federal records.
Chairman Comer: On January 18 [2024], you testified that you did not have any conversations with Dr. Fauci regarding EcoHealth. On October 25, 2021, you wrote Peter, from Tonys numerous recent comments to me, theyre trying to protect you. You meaning EcoHealth and Dr. Daszak. Dr. Morens, did you ever have any conversations with Dr. Fauci regarding EcoHealth.
Dr. Morens: Well the ones you just mentioned, I dont have any recollection of that.
Chairman Comer: No recollection?
Dr. Morens: No recollection, nowhat I do remember is one time in a face-to-face meeting. He referred or alluded to some stuff that was in the press. I dont think he even said what it was. But I assumed it was about Peters grants and press reports about it and the ending of the grant. And I said to him, sort of out of the blue, guessing what he was really thinking, I said to him, Tony I know you would have never been involved in getting rid of that grant. He didnt respond. He just sort of looked at me.
Chairman Comer: So Dr. Fauci was always a big defender of EcoHealth and their right to receive federal funding.
Dr. Morens: I think he had great respect for them. And when the grant problems came about, I think he was troubled by it.At some point, somebody, it may not have been Tony, but it might have been Hugh Auchincloss, somebody said to me Peter is his own worst enemy because he made some mistakes on that grant.
Chairman Comer: I would say thats a factual statement.
Chairman Comer: Did you ever delete any official records?
Dr. Morens: we are at the issue of defining whats a federal record. I deleted a lot of emails. I do it every day.
Rep. Mariannette Miller-Meeks (R-Iowa), M.D., blasted Dr. Morens for his misogynistic comments about female public health leaders during the COVID-19 pandemic. The Select Subcommittees recent staff report revealed email evidence of Dr. Morens engaging in inappropriate and disrespectful behavior that is unbecoming of U.S. Government official.
Rep. Miller-Meeks: Why in 2021, I would have expected it when I was in medical school in 1982, but why in 2021 that you would have commented in an email. Dr. Fauci got Rochelle Walensky her job as CDC Director by lobbying for her to Ron Klain. Well, she does wear a skirt. I poured a little cold water on her, but he was undeterred in thinking that she is the cats pajama. So let me just say, am I the cats pajama?
Dr. Morens: I uh
Rep. Miller-Meeks: Do you know how many women sit on this Subcommittee? Do you know what it takes for any of these women to get elected to Congress? Because I find your comments to be disgusting. You had an illustrious career and an amazing track to get to where you are. Youre trusted with one of the highest positions in government to combat public health crises and instead of doing your job, youre too busy worrying about avoiding FOIAs and challenging someones position because they happen to wear a skirt. The American people deserve a whole lot better in their public servants. We dont need to worry about your trying to avoid FOIAs or what the quality of your mattress is, quite frankly, sir. You should be ashamed of your character and embarrassed. Im glad that you are. And you should, in fact, apologize to this subcommittee, to Congress, and to our nation.
Rep. Nicole Malliotakis (R-N.Y.) pressed Dr. Morens towards an admission of guilt that he shouldnt have done that and thats wrong when asked about his use of personal email to undermine the operations of the U.S. Government.
Rep. Malliotakis: It is government business if you are advising him [Dr. Peter Daszak], youre advocating on his behalf, youre editing things, letters that he wanted to send to NIH. You did all that on personal e-mail, correct?
Dr. Morens: I shouldnt have done that. Thats wrong.
Rep. Malliotakis: It is wrong and that is why were asking the question because you were using it for official business. And thats what were trying to understand. Why were you trying to hide this from members of Congress, from the government, from the public?
Rep. Debbie Lesko (R-Ariz.) elicited a wholly indefensible and incoherent answer from Dr. Morens as to why he broke federal record keeping laws. Dr. Morens claimed that he did not believe he was breaking FOIA laws, so therefore, he could not have broken the law.
Rep. Lesko: Sir, I believe you have lied here today to us, to Congress. When you say, oh, I didnt know this, I didnt intentionally use my Gmail. Are you kidding me? Dr. Morens, do you want to change your testimony?
Dr. Morens: No, I dont the context is that this Gmail communication thing was set up purely to deal with personal things that were not government business.
Rep. Lesko: With all due respect, how can you say that when you clearly, in all these emails, were intentionally avoiding FOIA? You said it in your own words, sir.
Dr. Morens: Lets talk about what you mean by intentionally avoiding FOIA. I dont consider that telling them dont send me things because they could get FOIAd as intentionally avoiding FOIA
Rep. Lesko: Did you use, in most of these emails, your official signature? It said David M Morens, O.D., NIAID, NIH. These were official.
Dr. Morens: Well
Rep. Lesko: And you forwarded from your NIH email to your personal email, and you said it right in your email.
Dr. Morens: I realized if a Gmail or an NIH email came to me and I replied to it, for some reason, there was a default where the signature I had on Gmail, which said David Morens of Bethesda, Maryland or something didnt go out. But the NIH email went out. I dont know how that happened. I didnt do it consciously.
Rep. Lesko: Im sorry. I just dont believe you.
Rep. Rich McCormick (R-Ga.), M.D., revealed conflicting statements that prove Dr. David Morens either lied to the Select Subcommittee during his public hearing or during his transcribed interview about deleting federal records.
Rep. McCormick: We have statements concerning the NIH, NIAID FOIA officer instruction on how to avoid documents production through intentional misspellings of keywords to avoid triggering hits on automated search queries in response to FOIA requests and congressional oversight inquiries. That you had these secret backchannel ways to get a hold of Fauci that you were trying to avoid queries by misspellings and other things. Thats what we have come to the conclusion on. Do you deny that?
Dr. Morens: The secret backchannel, joking terminology, to my knowledge, was never about FOIAs.
Rep. McCormick: So youre going to joke about backchannels to Fauci and about misspellings on queries. Thats a joke. Not very funny to me.
Dr. Morens: I had no backchannel. You know, I could walk into Tonys office and talk to him anytime I wanted. Theres no need to have a backchannel. I had face to face meetings with him all the time.
Rep. McCormick: So you deny it?
Dr. Morens: I guess I do.
Rep. McCormick: Dr. Morens, we have your previous statement on FOIA documents here. Chairman, I request unanimous consent to submit these documents for the record. Based on your answer, you either lied to Congress during your transcribed interview or you are lying here today.
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COVID-19 brought an unprecedented shift in the approach to breast cancer screening and treatment in Australia.
A retrospective clinical analysis of data from patients at Sydney Adventist Hospital (SAH) in New South Wales has linked an increase in cases of advanced breast cancer since the pandemic to breast screening suspensions which occurred due to COVID-19 restrictions.
Researchers from the Australian National University looked at new cases of female breast cancer diagnosed at SAH between July 2019 and June 2022, and categorised them into pre-pandemic, pandemic, and post-pandemic groups.
They found an increase in patients with advanced breast cancer (stage 3 or 4) in the pandemic and post-pandemic group (8.5% and 7%), compared to the pre-pandemic group (4.6%).
The research is published in the ANZ Journal of Surgery. Previous reports have found little evidence that COVID-19 delays created worse health outcomes for women being screened for breast cancer.
Breast cancer specialist and radiation oncologist at the Australian National University College of Health & Medicine, John Boyages says the SAH study showed some worrying trends for patients with more aggressive cancers.
Aggressive cancers are known to grow more quickly. For example, for oestrogen receptor-negative tumours, the rate of node-positivity doubled, increasing from 33% to 66% from the pre- to post-pandemic periods, says Boyages who was lead author of the research.
Node-positive breast cancer means that cells from the tumour have metastasised and been found in the lymph nodes in the armpit area.
The increased probability of having cancer spread to a patients lymph nodes and delayed diagnosis is likely to translate into poorer patient outcomes in the longer term, says Boyages.
Our study clearly shows government and health authorities need to prioritise cancer screening in future pandemics.
Breast cancer is the most common cancer affecting women in Australia, accounting for an estimated 12.7% of all new cancer diagnoses and 6.4% of all cancer deaths in 2022. The national BreastScreen Australia program offers free breast screening for women aged over 40.
However, according to the authors: in the initial stages of the pandemic, COVID-19 impacted breast screening and general healthcare attendance, with many women cancelling or postponing their appointments and adhering to the stay-at-home message put forward by the Government.
A report by the Australian Institution of Health and Welfare in 2022 said breast screening was delayed or postponed during the COVID-19 outbreak in 2020.
To protect clients, staff, and the community from the risk of COVID-19, BreastScreen Australia services were suspended nationwide from 25 March 2020. The suspension was lifted around a month later for most services, but a staged approach was introduced with longer appointment times and precautionary measures to ensure the safety of clients and staff. The rate at which BreastScreen services could resume was affected by jurisdictional social distancing and infection control guidelines and requirements. Most BreastScreen services stayed open, with these additional precautionary measures, for the remainder of the year despite additional lockdowns and increasing numbers of cases of COVID-19.
The program also faced further suspensions in the latter half of 2021.
A report in late 2022 looked at the impact of the breast screening delays in 2020, and concluded that in NSW the impact was small.
Researchers from Cancer Institute NSW say a retrospective analyses demonstrated no evidence of a substantial change in the size of tumours diagnosed by BreastScreen NSW in clients whose breast cancer screening was delayed by the suspension of service due to the COVID-19 pandemic.
But they said the findings may not reflect all Australian states and territories, due to variations in COVID restrictions and lockdowns.
The SAH study found that patients with symptomatic breast cancer at diagnosis increased from 42.3% in the pre-pandemic, to 53.1% in the pandemic and 57% in the post-pandemic.
But Boyages says it was not all bad news.
During the same period, there was an increased use of shorter courses of radiation, and we became more experienced in radiation courses as short as one week, he says.
We also increased the use of more chemotherapy before surgery to work out if a cancer is sensitive to the planned chemotherapy leading to a shift in less mastectomy rates: 33% pre-pandemic versus 24% post-pandemic.
The authors caution that the population this study was conducted on may not be representative of nationwide populations.
Patients in this catchment are likely to have greater healthcare access, and therefore higher attendance for screening and subsequent treatment, they write.
Further studies involving multi-centre analysis may be beneficial in establishing trends in breast cancer during the pandemic.
The World Health Organization (WHO) published a new report suggesting the COVID-19 pandemic undid a decade of life expectancy at birth and healthy life expectancy gains (HALE), with global expectancy levels now matching those last seen in 2012.
"Not only has the pandemic set back healthy longevity worldwide by years, it also reversed the previous trends of shifting disease burden to noncommunicable diseases," the report said.
Not only has the pandemic set back healthy longevity worldwide by years, it also reversed the previous trends of shifting disease burden to noncommunicable diseases.
The Americas and South-East Asia regions each lost about 3 years of life expectancy at birth between 2019 and 2021, the report said, as SARS-CoV-2 caused communicable diseases to be the cause of 23.0% of all deaths in 2020 and 28.1% in 2021 a return to 2005 levels.
In 2020 and 2021, COVID-19 was the top cause of death for the region of the Americas. In 2019, communicable diseases only accounted for three of the top ten causes of death worldwide, a trend swiftly reversed by the novel coronavirus.
Between 2000 and 2019, steady gains were made with life expectancy. In 2000, life expectancy was 66.8 years (95% uncertainty interval [UI], 66.2 to 67.3 years) and rose to 73.1 (UI, 72.6 to 73.7) years in 2019.
Women gained an average of 6.5 years from 2000 to 2019, and men 6.2 years.
When the pandemic began in 2020, expectancy rates began to drop almost immediately. Global life expectancy at birth dropped by 0.7 years to 72.5 (UI, 71.9 to 73.1) years in 2020 (back to the 2016 level), and by a further 1.1 years to 71.4 (UI, 70.8 to 72.0) years in 2021 (the 2012 level).
The effects of the pandemic were seen most strongly in middle and high-income countries.
"By World Bank income groups, life expectancy was cut by 0.6 years in low-income countries and by 2.4 years in lower-middle-income countries, and HALE cut by 0.6 years and 2.0 years, respectively, between 2019 and 2021," the authors said.
In 2019, seven of the 10 leading causes of death were non-communicable diseases (NCDs), and in upper-middle-income and high-income countries, NCDs accounted for nine out of 10 top causes of death, with only lower respiratory infections ranking.
By 2021, however, COVID-19 became the third and second leading causes, respectively, claiming 4.1 million and 8.8 million lives globally
"In all but two WHO regions (the African and Western Pacific regions), COVID-19 ranked among the top five causes of deaths in 2020 and 2021, responsible for the largest number of deaths in both years in the Region of the Americas, in 2021 in the South-East Asia Region and the second largest number of deaths in both years in the European and the Eastern Mediterranean regions," the WHO said.
Ian Hamilton has returned to the Yankees bullpen, as the team took him off of the COVID-19 injured list before facing the Angels on Tuesday.
Hamilton initially went on the list on May 20 after getting sent home the day before. Prior to the designation, the Yankees had not used the COVID-19 IL since 2022.
The Yankees initially planned on activating Hamilton before Sundays loss to the Padres. However, they ultimately decided to wait until after Mondays off day.
Hamilton had been a bit off prior to getting sick, as he allowed three earned runs in his last five games. However, the right-hander has established himself as one of the Yankees top relievers; he has a 3.18 ERA over 22.2 total innings in his second season with the team.
A multi-inning weapon, Hamilton has recorded more than three outs in eight of his 19 appearances this season.
To make room for Hamilton, the Yankees optioned Yoendrys Gmez to Triple-A on Sunday.
Gerrit Coles next live batting practice session has been scheduled.
Aaron Boone said the Yankees ace, recovering from elbow inflammation, will throw again in Tampa on Thursday, according to MLB.coms Bryan Hoch. It will be Coles third time facing hitters since getting shut down midway through spring training.
Cole most recently threw two innings on Saturday. He totaled 30 pitches.
As expected, utilityman Jon Berti is going to miss a significant amount of time after suffering a high-grade calf strain over the weekend in San Diego.
Doctors told Berti that he will be on the shelf for 6-8 weeks, according to the New York Posts Greg Joyce. Berti received a PRP injection on Tuesday.
WASHTENAW COUNTY, MI -- In an elementary school of roughly 500 students, Principal Mary Aldridge tries to remember each of her students names. Students flock to her room for lunch and stop to wave or hug her as she walks through the halls.
This is her ninth and last year at the elementary school, as Aldridge is retiring after nearly 30 years of working in Lincoln Consolidated Schools.
I like making sure that people have what they need, Aldridge said about her role as principal. Whether its children, parents, or especially teachers.
She began in the district as a student at 12 years-old. After graduating from high school, she ventured off to Welch College, a private college in Tennessee. She didnt always want to be a teacher but said she fell into it. and quickly fell in love with the idea of teaching kids.
Aldridge returned to Lincoln schools, first as a substitute and media specialist, and became a teacher there in 1995. She taught kindergarten to third grade for nearly a decade before moving on to administrative roles in 2008. She served as assistant principal at Brick Elementary School and principal of Model Elementary School.
Aldridge has loved her time in each of the elementary schools, she said, but the years were not without challenges.
I tried to have fun wherever Im going, wherever Im at, she said. We like to joke around and have fun. And I think you have to really enjoy your job because its so hard. I think teaching is one of the hardest jobs, other than being a parent, that you could ever do.
Through budget cuts and the COVID-19 pandemic, she led teachers through what she said is an increasingly difficult profession.
Its harder now being a teacher than when I started, Aldridge said. The challenges are greater because families are going through more, whether its social emotional issues, or whether its economic issues, or whether its split families, broken families. Theyre going through a lot and our staff goes through a lot and so their jobs are harder and harder.
In recent years, the school has brought in new, younger teachers, Aldridge said. Shes had fun mentoring the new generation.
The Lincoln School Board said goodbye to Aldridge at its May 13 meeting, thanking her for her years of service.
Its always a pleasure to come into your building and see bright, engaged, smiling kids and adults who are excited about learning, Board President Jennifer Czachorski said. We wish you all the best in your retirement.
Taking her place is Laura Maurer, who is coming from Allen Park Public Schools, where she was assistant principal at Lindemann Elementary School. Introducing herself at the board meeting, she said she is very excited to joining the community and it will be a new challenge.
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WATERTOWN A memorial was unveiled Tuesday morning in Thompson Park near the Rotary Pavilion in remembrance of those who lost their lives during the COVID-19 pandemic.
Allison Gorham, chair of the COVID-19 Memorial Committee, also decorates the South Massey Street Island near Clinton Street. She put up a temporary memorial for members of the community who died from the pandemic.
Gorham said she was then asked if she knew if the city was planning to put up a permanent monument.
Fast forward to today, three years later, and we finally have a proper memorial in place. This isnt a happy occasion; honoring people who have died, whether from wars or accidents or some other unexpected tragedy is never joyous. It is a somber moment, she said.
Rewinding back to March 2020, when many people mark the pandemic starting in the United States, little was known, Gorham said.
There was so much uncertainty about the disease, except that it was killing thousands and thousands of people, and ultimately, millions, she said.
The monument has waves on the black base as a representation of the water that surrounds the north country, a blue sphere which represents the world, and Remembering those who have died from Covid-19 in white writing.
This memorial stands as a reminder, even if we didnt know anyone who passed away or was infected by the virus, but in that period, every single one of us was affected. It stands as a reminder and a place of peace and comfort to all in our community who lost someone to COVID and didnt have the opportunity to formally mourn their passing because of the restrictions that were in place, Gorham said.
Gorham thanked current and former members of Watertown City Council and city staff for their help along with the Northern New York Community Foundation, BCA Architects, Jeff Weldon, Acquiring Monuments, and T.F. Wright & Sons Granite.
The three-year project started when Gorham looked up memorials and found one she liked from a company in Washington State. She then changed the design and the company from Washington worked alongside T.F. Wright & Sons Granite in Carthage.
The memorial cost between $43,000 and $45,000 and the money was raised through a matching grant with the Northern New York Community Foundation.
We lost people, and we needed to have some way to remember that, Gorham said.
Gorham hopes that when people who were affected by the pandemic walk past the monument they know that were not going to forget them.
OPINION:
Last week, a House committee revealed emails from David Morens, who worked under Dr. Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases. The emails further indicate a cover-up as to the origins of COVID-19 (a Chinese lab). Dr. Fauci was the federalgovernments primary architect in response to and spokesperson in the COVID-19 pandemic.
There is considerable evidence that Dr. Fauci and his colleagues were wrong in assessing the disease and the correct response to it. They also engaged in an active campaign to smear the reputations of distinguished scientists who, as we now know, were correct in explaining the errors, misstatements and responses to the pandemic.
The result of the COVID-19 misinformation campaign was to destroy millions of jobs and businesses, unnecessarily shut down schools, and damage future generations. It also caused undue panic among young people who had little chance of contracting fatal infections from the disease and many excess deaths because of undertreatment of those most at risk while misallocating resources to those at little risk.
The public, including many government officials and Presidents Donald Trump and Biden, understandably had little knowledge of exotic viruses. All turned to the experts. Dr. Fauci had the title and experience. Yet few were aware of how little he knew. Fame and power went to his head. He conned millions at a terrible cost by failing to admit what he did not know and pretending to know things he did not know.
When an issue requires specialized knowledge or experience, people naturally seek out the experts. The experts shape public policy, business strategies and societal expectations. Yet history is replete with examples where the experts in science, political and military affairs, economics, demography, history, and the environment have failed to provide accurate information, leading to incorrect actions and predictions.
Economists are often regarded as the oracles of financial markets and national economies. Their predictions, however, often go awry, sometimes with catastrophic consequences. Most recently, President Bidens economic advisers, including the treasury secretary and the chairman of the Federal Reserve, missed the inflation of the last three years. Many economists had warned that the big increase in the monetary supply as a response to the pandemic would cause inflation but were ignored by the Biden administrations experts.
Many economists worldwide believed that Japans rapid economic expansion before 1990 would continue indefinitely, dubbing it the Japanese Economic Miracle. But the asset bubble burst in the early 1990s, leading to the Lost Decade of stagnation. This misjudgment stemmed from a failure to account for underlying structural issues within the Japanese economy, such as demographic challenges and rigid corporate practices.
Back in 1968, biologist Paul Ehrlich wrote a book, The Population Bomb, warning that the world would soon run out of resources because of the rapidly rising overpopulation. His mankind was doomed thesis was soon accepted as the conventional wisdom by the global elite. But a funny thing happened on the way to overpopulation doomsday population growth started slowing to the point where most countries are now below replacement levels that is, women, on average, are having fewer children (less than two) than needed for a stable population.
In the last few months, there have been articles in major media about the coming depopulation disaster leading to an underpopulation doomsday. Decades ago, China initiated a one child per household policy, which it has been unable to reverse despite a now-falling population. A rising tide of the elderly and a fall in productive workers is not sustainable.
In the 1960s and 1970s, influential scientists and media outlets warned of an impending ice age because of observed temperature declines in the preceding decades. This hypothesis, however, was soon overtaken by a new consensus on global warming, a phenomenon driven by anthropogenic greenhouse gas emissions.
But the beat goes on.
We dont have 12 years to save the climate. We have 14 months, the now-defunct news website ThinkProgress predicted 55 months ago.
Gordon Brown said in 2009, when he was Britains prime minister, that we had fewer than fifty days to save the planet from catastrophe. In that same year, former Vice President Al Gore announced that there is a 75% chance that the entire north polar ice cap, during the summer months, could be completely ice free within the next five to seven years (15 years ago and the ice cap is still there).
In 1989, a U.N. report predicted that entire nations could be wiped off the face of the earth by rising sea levels if the global warming trend is not reversed by the year 2000. Thirty-five years after the report, no nation (or inhabited island) has disappeared because of rising sea levels.
There are almost countless environmental disaster forecasts whose expiration date has come and gone yet new forecasts (with only a change in the doomsday date) keep appearing, often by the same experts who have been wrong.
Western analysts in the 1980s believed that the Soviet Union was a permanent geopolitical fixture that would endure. Indeed, he rapid collapse of the Soviet Union in 1991 caught most experts by surprise. Much of this miscalculation was because of an overestimation of the Soviet economy, an underestimation of political corruption, and growing public discontent within the Soviet bloc.
Expert opinions and predictions that have failed underscore the need for humility and caution when making and relying on experts.
Richard W. Rahn is chairman of the Institute for Global Economic Growth and MCon LLC.
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