The Lancet

Deepti Gurdasani,Nisreen A Alwan,Trisha Greenhalgh,Zoë Hyde,Luke Johnson,Martin McKee,Susan Michie,Kimberly A Prather,Sarah D Rasmussen,Stephen Reicher,Paul Roderick,Hisham Ziauddeen

doi : 10.1016/S0140-6736(21)00622-X

CORRESPONDENCE| VOLUME 397, ISSUE 10280, P1177-1178, MARCH 27, 2021

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Effect of previous SARS-CoV-2 infection on humoral and T-cell responses to single-dose BNT162b2 vaccine

Maria Prendecki,Candice Clarke,Jonathan Brown,Alison Cox,Sarah Gleeson,Mary Guckian,Paul Randell,Alessia Dalla Pria,Liz Lightstone,Xiao-Ning Xu,Wendy Barclay,Stephen P McAdoo,Peter Kelleher,Michelle Willicombe

doi : 10.1016/S0140-6736(21)00502-X

CORRESPONDENCE| VOLUME 397, ISSUE 10280, P1178-1181, MARCH 27, 2021

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COVID-19, cults, and the anti-vax movement

Sophie Mylan,Charlotte Hardman

doi : 10.1016/S0140-6736(21)00443-8

CORRESPONDENCE| VOLUME 397, ISSUE 10280, P1181, MARCH 27, 2021

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Health systems in the ACT-A

David B Hipgrave,Aboubacar Kampo,Luwei Pearson

doi : 10.1016/S0140-6736(21)00442-6

CORRESPONDENCE| VOLUME 397, ISSUE 10280, P1181-1182, MARCH 27, 2021

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The crisis of health care in Myanmar

Jean J Bowyer,Susan C Broster,Jay Halbert,San San Oo,Susan PA Rubin

doi : 10.1016/S0140-6736(21)00621-8

CORRESPONDENCE| VOLUME 397, ISSUE 10280, P1182, MARCH 27, 2021

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Department of Error

doi : 10.1016/S0140-6736(21)00669-3

DEPARTMENT OF ERROR| VOLUME 397, ISSUE 10280, P1182, MARCH 27, 2021

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Department of Error

doi : 10.1016/S0140-6736(21)00670-X

DEPARTMENT OF ERROR| VOLUME 397, ISSUE 10280, P1182, MARCH 27, 2021

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Evaluating Progestogens for Preventing Preterm birth International Collaborative (EPPPIC): meta-analysis of individual participant data from randomised controlled trials

The EPPPIC Group

doi : 10.1016/S0140-6736(21)00217-8

ARTICLES| VOLUME 397, ISSUE 10280, P1183-1194, MARCH 27, 2021

Preterm birth is a global health priority. Using a progestogen during high-risk pregnancy could reduce preterm birth and adverse neonatal outcomes.

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Discontinuing ?-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial

Aurélien Dinh,Jacques Ropers,Clara Duran,Benjamin Davido,Laurène Deconinck,Morgan Matt,Olivia Senard,Aurore Lagrange,Sabrina Makhloufi,Guillaume Mellon,Victoire de Lastours,Frédérique Bouchand,Emmanuel Mathieu,Jean-Emmanuel Kahn,Elisabeth Rouveix,Julie Grenet,Jennifer Dumoulin,Thierry Chinet,Marion Pépin,Véronique Delcey,Sylvain Diamantis,Daniel Benhamou,Virginie Vitrat,Marie-Christine Dombret,Bertrand Renaud,Christian Perronne,Yann-Erick Claessens,José Labarère,Jean-Pierre Bedos,Philippe Aegerter,Anne-Claude Crémieuxfor the Pneumonia Short Treatment (PTC) Study Group

doi : 10.1016/S0140-6736(21)00313-5

ARTICLES| VOLUME 397, ISSUE 10280, P1195-1203, MARCH 27, 2021

Shortening the duration of antibiotic therapy for patients admitted to hospital with community-acquired pneumonia should help reduce antibiotic consumption and thus bacterial resistance, adverse events, and related costs. We aimed to assess the need for an additional 5-day course of ?-lactam therapy among patients with community-acquired pneumonia who were stable after 3 days of treatment.

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Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study

Christian Holm Hansen,Daniela Michlmayr,Sophie Madeleine Gubbels,K?re M?lbak,Steen Ethelberg

doi : 10.1016/S0140-6736(21)00575-4

ARTICLES| VOLUME 397, ISSUE 10280, P1204-1212, MARCH 27, 2021

The degree to which infection with SARS-CoV-2 confers protection towards subsequent reinfection is not well described. In 2020, as part of Denmark's extensive, free-of-charge PCR-testing strategy, approximately 4 million individuals (69% of the population) underwent 10·6 million tests. Using these national PCR-test data from 2020, we estimated protection towards repeat infection with SARS-CoV-2.

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Metagenomic next-generation sequencing clinches diagnosis of leishmaniasis

Chong Wang,Ang Li,Qingmiao Shi,Zujiang Yu

doi : 10.1016/S0140-6736(21)00352-4

CLINICAL PICTURE| VOLUME 397, ISSUE 10280, P1213, MARCH 27, 2021

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Guillain-Barré syndrome

Nortina Shahrizaila,Helmar C Lehmann,Satoshi Kuwabara

doi : 10.1016/S0140-6736(21)00517-1

SEMINAR| VOLUME 397, ISSUE 10280, P1214-1228, MARCH 27, 2021

Guillain-Barré syndrome is the most common cause of acute flaccid paralysis worldwide. Most patients present with an antecedent illness, most commonly upper respiratory tract infection, before the onset of progressive motor weakness. Several microorganisms have been associated with Guillain-Barré syndrome, most notably Campylobacter jejuni, Zika virus, and in 2020, the severe acute respiratory syndrome coronavirus 2. In C jejuni-related Guillain-Barré syndrome, there is good evidence to support an autoantibody-mediated immune process that is triggered by molecular mimicry between structural components of peripheral nerves and the microorganism. Making a diagnosis of so-called classical Guillain-Barré syndrome is straightforward; however, the existing diagnostic criteria have limitations and can result in some variants of the syndrome being missed. Most patients with Guillain-Barré syndrome do well with immunotherapy, but a substantial proportion are left with disability, and death can occur. Results from the International Guillain-Barré Syndrome Outcome Study suggest that geographical variations exist in Guillain-Barré syndrome, including insufficient access to immunotherapy in low-income countries. There is a need to provide improved access to treatment for all patients with Guillain-Barré syndrome, and to develop effective disease-modifying therapies that can limit the extent of nerve injury. Clinical trials are currently underway to investigate some of the potential therapeutic candidates, including complement inhibitors, which, together with emerging data from large international collaborative studies on the syndrome, will contribute substantially to understanding the many facets of this disease.

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Urgent lessons from COVID 19: why the world needs a standing, coordinated system and sustainable financing for global research and development

Nicole Lurie,Gerald T Keusch,Victor J Dzau

doi : 10.1016/S0140-6736(21)00503-1

HEALTH POLICY| VOLUME 397, ISSUE 10280, P1229-1236, MARCH 27, 2021

The research and development (R&D) ecosystem has evolved over the past decade to include pandemic infectious diseases, building on experience from multiple recent outbreaks. Outcomes of this evolution have been particularly evident during the COVID-19 pandemic with accelerated development of vaccines and monoclonal antibodies, as well as novel clinical trial designs. These products were developed, trialled, manufactured, and authorised for use in several countries within a year of the pandemic's onset. Many gaps remain, however, that must be bridged to establish a truly efficient and effective end-to-end R&D preparedness and response ecosystem. Foremost among them is a global financing system. In addition, important changes are required for multiple aspects of enabling sciences and product development. For each of these elements we identify priorities for improved and faster functionality. There will be no better time than now to seriously address these needs, however difficult, as the ravages of COVID-19 continue to accelerate with devastating health, social, and economic consequences for the entire community of nations.

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