AD5-nCOV , trade-named Convidecia , is a single-dose viral vector vaccine for COVID-19 that is also used as an inhaled booster. It was developed by CanSino Biologics , with Phase III trials conducted in Argentina , Chile , Mexico , Pakistan , Russia , and Saudi Arabia with 40,000 participants.
106-629: In February 2021, global data from Phase III trials and 101 COVID cases showed that the intramuscular version of the vaccine had a 65.7% efficacy in preventing moderate symptoms of COVID-19 , and 91% efficacy in preventing severe disease. It has similar efficacy to the Janssen vaccine , another one-shot adenovirus vector vaccine with 66% efficacy in a global trial. Convidecia is similar to other viral vector vaccines like AZD1222 , Gam-COVID-Vac , and Ad26.COV2.S . Its single-dose regimen and normal refrigerator storage requirement (2° to 8 °C) could make it
212-580: A metastudy by Mandeep R. Mehra of the Harvard Medical School and Sapan S. Desai of Surgisphere Corporation, which concluded that the malaria drugs hydroxychloroquine and chloroquine did not improve the condition of COVID-19 patients, and may have harmed some of them. In response to concerns raised by members of the scientific community and the media about the veracity of the data and analyses, The Lancet decided to launch an independent third party investigation of Surgisphere and
318-494: A strain of coronavirus known as "severe acute respiratory syndrome coronavirus 2" ( SARS-CoV-2 ). COVID-19 is mainly transmitted when people breathe in air contaminated by droplets / aerosols and small airborne particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing. Transmission is more likely the closer people are. However, infection can occur over longer distances, particularly indoors. The transmission of
424-552: A systemic inflammatory response syndrome . Among healthy adults not exposed to SARS-CoV-2, about 35% have CD4 T cells that recognise the SARS-CoV-2 S protein (particularly the S2 subunit) and about 50% react to other proteins of the virus, suggesting cross-reactivity from previous common colds caused by other coronaviruses. The Lancet The Lancet is a weekly peer-reviewed general medical journal and one of
530-628: A Phase I trial in China with 144 adults to determine safety and immunogenicity when inhaled through the mouth with nebulizer rather than intramuscular injection, with results published in 2021. On June 3, 2021, expansion of clinical trials was approved by the NMPA and the nasal spray applied for Emergency Use Listing. In July 2021, results published in The Lancet showed two doses of the inhaled version resulted in neutralising antibody responses similar to
636-474: A ban on tobacco in the United Kingdom in 2003, expressed support for Gaza during the 2014 Israel-Gaza conflict , and issued an apology for sexist language. A December 2003 editorial by the journal, titled "How do you sleep at night, Mr Blair ?", called for tobacco use to be completely banned in the United Kingdom. The Royal College of Physicians rejected their argument. John Britton, chairman of
742-419: A certain critical size, generally thought to be <100μm diameter, evaporate faster than they settle; due to that fact, they form respiratory aerosol particles that remain airborne for a long period of time over extensive distances. Infectivity can begin four to five days before the onset of symptoms. Infected people can spread the disease even if they are pre-symptomatic or asymptomatic . Most commonly,
848-505: A chilling effect on scientific research and the scientific community by implying that scientists who "bring up the lab-leak theory... are doing the work of conspiracy theorists"; the statement was deemed to have "effectively ended the debate over COVID-19's origins before it began". Further criticism of the letter was focused on the fact that, according to emails obtained through the Freedom of Information Act , members involved in producing
954-629: A deal to distribute the vaccine in Brazil, which included producing the vaccine domestically. In March, Chile signed a deal for 1.8 million doses for delivery between May and June, for which emergency use approval was granted in April. In June, Ecuador approved emergency use and ordered 6 million doses for delivery between June and August 2021. In October 2020, Indonesia reached an agreement with CanSino to deliver 100,000 doses in November 2020, with
1060-466: A dose of Sputnik V followed by a dose of Convidecia. This would address a supply shortage of Sputnik V, which has had difficulties in supplying the second dose in sufficient quantities compared to the first dose. On 25 June 2020, China approved the vaccine for limited use by the military. In February 2021, China approved the vaccine for general use. In February 2021, Mexico approved the vaccine for emergency use. In February 2021, Pakistan approved
1166-566: A drug that they would not be able to get." The deputy editor of The Lancet responded to the criticism by arguing that no other measures besides a total ban would likely be able to reduce tobacco use. The smokers' rights group FOREST stated that the editorial gave them "amusement and disbelief". Director Simon Clark called the journal " fascist " and argued that it is hypocritical to ban tobacco while allowing unhealthy junk foods , alcohol consumption , and participation in extreme sports . Health Secretary John Reid reiterated that his government
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#17327808898171272-867: A favorable vaccine option for many countries. It is currently under evaluation for emergency use listing by the WHO . On May 19 2022, WHO issued EUL for the vaccine. A Phase I study published in The Lancet showed two doses of a nebulised version of Convidecia (inhaled through the mouth) resulted in neutralising antibody responses similar to the existing one-dose injection. Convidecia and the Pakistani version called PakVac are approved for use by some countries in Asia, Europe, and Latin America. Production capacity for Ad5-NCov should reach 500 million doses in 2021. Manufacturing will take place in China, with filling and finishing of
1378-456: A global trial. Convidecia is a viral vector vaccine similar to AstraZeneca 's AZD1222 and Gamaleya 's Gam-COVID-Vac . Ad5-nCOV can be stored in less extreme cold conditions compared to mRNA vaccines . In February, Chen Wei , who lead the development of the vaccine, said annual production capacity for Ad5-NCov could reach 500 million doses in 2021. In February, Mexico received the first batch of active ingredients for Convidecia, which
1484-422: A higher risk of developing severe symptoms. Some complications result in death. Some people continue to experience a range of effects ( long COVID ) for months or years after infection, and damage to organs has been observed. Multi-year studies are underway to further investigate the long-term effects of the disease. COVID‑19 transmission occurs when infectious particles are breathed in or come into contact with
1590-411: A journal initially launched in 2014 by parent publisher Elsevier, since 2015 supported by Cell Press and The Lancet , and eventually (July 2018) incorporated in The Lancet family journals together with its newly incepted sister journal eClinicalMedicine ( clinical research and public health research). In May 2019, The Lancet Digital Health published its first issue. Occasionally, the editors of
1696-447: A letter signed by 27 scientists that stated: "We stand together to strongly condemn conspiracy theories suggesting that COVID-19 does not have a natural origin [...] [Scientists] overwhelmingly conclude that this coronavirus originated in wildlife," adding: "Conspiracy theories do nothing but create fear, rumours, and prejudice that jeopardise our global collaboration in the fight against this virus." The letter has been criticized for having
1802-479: A letter with an estimate of the number of direct and indirect deaths that may be caused in the coming months and years by the Israel–Hamas war . Using other conflicts, where the number of indirect deaths was 3 to 15 times higher than the number of direct deaths, the authors estimated the total number of conflict-related deaths by multiplying the reported deaths by five, and argued that in the coming months and years "it
1908-473: A paper in 1998 in which the authors suggested a link between the MMR vaccine and autism spectrum disorder . In February 2004, The Lancet published a statement by 10 of the paper's 13 coauthors repudiating the possibility that MMR could cause autism. The editor-in-chief, Richard Horton , went on the record to say the paper had "fatal conflicts of interest" because the study's lead author, Andrew Wakefield , had
2014-454: A potentially influential report contributing to further misinformation on such an important topic" and "It's true we've details to understand on the side of natural origins, for example the exact intermediate species involved, but that doesn't mean there's… any basis to the wild speculation that US labs were involved". In October 2023, The Lancet retracted two papers from 2008 and 2014 by surgeon Paolo Macchiarini . These papers, which discussed
2120-423: A range of effects, such as fatigue , for prolonged periods after an initial COVID-19 infection. This is the result of a condition called long COVID , which can be described as a range of persistent symptoms that continue for months or years. Long-term damage to organs has been observed after the onset of COVID-19. Multi-year studies are underway to further investigate the protracted effects of long COVID. Reducing
2226-467: A serious conflict of interest that he had not declared to The Lancet . The journal completely retracted the paper on 2 February 2010, after Wakefield was found to have acted unethically in conducting the research. The Lancet ' s six editors, including the editor-in-chief, were also criticised in 2011 because they had "covered up" the "Wakefield concocted fear of MMR" with an "avalanche of denials" in 2004. The Lancet also published an estimate of
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#17327808898172332-566: A visit and said that he "deeply, deeply regret[ted] the completely unnecessary polarization that publication of the letter by Dr Paola Manduca caused." Mark Pepys , a member of the Jewish Medical Association, criticised the letter as being a "partisan political diatribe" which was inappropriate for a serious publication. In addition, Pepys accused Richard Horton personally for allowing the publication of such political views. On 19 February 2020, The Lancet published
2438-744: Is a novel severe acute respiratory syndrome coronavirus. It was first isolated from three people with pneumonia connected to the cluster of acute respiratory illness cases in Wuhan. All structural features of the novel SARS-CoV-2 virus particle occur in related coronaviruses in nature, particularly in Rhinolophus sinicus (Chinese horseshoe bats). Outside the human body, the virus is destroyed by household soap which bursts its protective bubble . Hospital disinfectants, alcohols, heat, povidone-iodine , and ultraviolet -C (UV-C) irradiation are also effective disinfection methods for surfaces. SARS-CoV-2
2544-571: Is associated with COVID-19 and is reported in as many as 88% of symptomatic cases. Published data on the neuropathological changes related with COVID-19 have been limited and contentious, with neuropathological descriptions ranging from moderate to severe hemorrhagic and hypoxia phenotypes , thrombotic consequences, changes in acute disseminated encephalomyelitis (ADEM-type), encephalitis and meningitis . Many COVID-19 patients with co-morbidities have hypoxia and have been in intensive care for varying lengths of time, confounding interpretation of
2650-433: Is available, guidelines and recommendations for hypertensive patients remain. The effect of the virus on ACE2 cell surfaces leads to leukocytic infiltration, increased blood vessel permeability, alveolar wall permeability, as well as decreased secretion of lung surfactants. These effects cause the majority of the respiratory symptoms. However, the aggravation of local inflammation causes a cytokine storm eventually leading to
2756-402: Is because pregnant women with COVID‑19 appear to be more likely to develop respiratory and obstetric complications that can lead to miscarriage , premature delivery and intrauterine growth restriction . Fungal infections such as aspergillosis , candidiasis , cryptococcosis and mucormycosis have been recorded in patients recovering from COVID‑19. COVID‑19 is caused by infection with
2862-577: Is being filled and finished in Querétaro by Drugmex. In Malaysia, filling and finishing of the vaccine for distribution would be completed by Solution Biologics. In May, Pakistan began filling and finishing 3 million doses a month at the National Institute of Health, which would be branded as PakVac for domestic distribution. If the vaccine is approved in Russia, Petrovax said it has
2968-522: Is closely related to the original SARS-CoV . It is thought to have an animal ( zoonotic ) origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus Betacoronavirus , in subgenus Sarbecovirus (lineage B) together with two bat-derived strains. It is 96% identical at the whole genome level to other bat coronavirus samples (BatCov RaTG13 ). The structural proteins of SARS-CoV-2 include membrane glycoprotein (M), envelope protein (E), nucleocapsid protein (N), and
3074-700: Is complete. If the vaccine trials were successful, then the National Research Council would work with CanSino to produce and distribute the vaccine in Canada. In August 2020, the National Research Council disclosed the vaccine had not been approved by Chinese customs to ship to Canada, after which the collaboration between CanSino and the Canadian Center for Vaccinology was abandoned. In September 2020, CanSino began
3180-453: Is not implausible to estimate that up to 186,000 or even more deaths could be attributable to the current conflict in Gaza". The estimate quickly gained traction in both international and regional media, with some of the outlets misrepresenting the 186,000 figure as the actual number of deaths, rather than long-term cumulative estimate. As a result, three days after the publication, one of
3286-595: Is the cause of the bud release and the formation of the viral envelope. The N and E protein are accessory proteins that interfere with the host's immune response. Human angiotensin converting enzyme 2 (hACE2) is the host factor that SARS-CoV-2 virus targets causing COVID‑19. Theoretically, the usage of angiotensin receptor blockers (ARB) and ACE inhibitors upregulating ACE2 expression might increase morbidity with COVID‑19, though animal data suggest some potential protective effect of ARB; however no clinical studies have proven susceptibility or outcomes. Until further data
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3392-469: Is the viral component that attaches to the host receptor via the ACE2 receptors. It includes two subunits: S1 and S2. Studies have shown that S1 domain induced IgG and IgA antibody levels at a much higher capacity. It is the focus spike proteins expression that are involved in many effective COVID‑19 vaccines. The M protein is the viral protein responsible for the transmembrane transport of nutrients. It
3498-567: The Journal Citation Reports , The Lancet Oncology has a 2021 impact factor of 54.433, The Lancet Neurology has 59.935, and The Lancet Infectious Diseases has 71.421. There is also an online website for students entitled The Lancet Student in blog format, launched in 2007. Since July 2018, The Lancet has also published two open access journals as part of The Lancet Discovery Science , dedicated to essential early evidence: eBioMedicine ( translational research ),
3604-879: The Journal Citation Reports , the journal has a 2023 impact factor of 98.4, ranking it first above The New England Journal of Medicine in the category "Medicine, General & Internal". According to BMJ Open , The Lancet is more frequently cited in general newspapers around the world than The BMJ , NEJM and JAMA . The Lancet also publishes several specialty journals: The Lancet Neurology ( neurology ), The Lancet Oncology ( oncology ), The Lancet Infectious Diseases ( infectious diseases ), The Lancet Respiratory Medicine ( respiratory medicine ), The Lancet Psychiatry ( psychiatry ), The Lancet Diabetes and Endocrinology ( endocrinology ), and The Lancet Gastroenterology & Hepatology ( gastroenterology ) all of which publish original research and reviews. In 2013, The Lancet Global Health ( global health ) became
3710-885: The Alpha variant (B.1.1.7, formerly called the UK variant), first found in London and Kent, the Beta variant (B.1.351, formerly called the South Africa variant), the Gamma variant (P.1, formerly called the Brazil variant), the Delta variant (B.1.617.2, formerly called the India variant), and the Omicron variant (B.1.1.529), which had spread to 57 countries as of 7 December. On December 19, 2023,
3816-755: The COVID-19 pandemic . The symptoms of COVID‑19 are variable but often include fever, fatigue, cough, breathing difficulties , loss of smell , and loss of taste . Symptoms may begin one to fourteen days after exposure to the virus. At least a third of people who are infected do not develop noticeable symptoms . Of those who develop symptoms noticeable enough to be classified as patients, most (81%) develop mild to moderate symptoms (up to mild pneumonia ), while 14% develop severe symptoms ( dyspnea , hypoxia , or more than 50% lung involvement on imaging), and 5% develop critical symptoms ( respiratory failure , shock , or multiorgan dysfunction ). Older people are at
3922-644: The Convidecia Air , an inhaled version of the Convidecia vaccine, to be used as a booster dose. In December 2020, Mexico 's Foreign Minister Marcelo Ebrard signed an agreement for 35 million doses. Mexico received active ingredients for 2 million doses with a total of 6 million doses expected to arrive in February. In June 2021, Argentina approved emergency use of the vaccine and ordered 5.4 million doses. In October 2021, Brazil 's Bionn SA signed
4028-569: The Iraq War 's Iraqi death toll—around 100,000—in 2004. In 2006, a follow-up study by the same team suggested that the violent death rate in Iraq was not only consistent with the earlier estimate, but had increased considerably in the intervening period (see Lancet surveys of casualties of the Iraq War ). The second survey estimated that there had been 654,965 excess Iraqi deaths as a consequence of
4134-588: The Spanish flu , Middle East respiratory syndrome , and Zika virus . In January 2020, the World Health Organization (WHO) recommended 2019-nCoV and 2019-nCoV acute respiratory disease as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations or groups of people in disease and virus names to prevent social stigma . The official names COVID‑19 and SARS-CoV-2 were issued by
4240-579: The University of La Frontera . In December 2020, Argentina's Fundación Huésped began Phase III trials in 11 health centers in the metropolitan area of Buenos Aires and Mar del Plata . In April 2021, a new trial was registered in Jiangsu involving one dose of Convidecia followed by a dose of ZF2001 28 or 56 days later using different technologies as a way to further boost efficacy. In July, 2021, Cansino said it would begin combination trials with
4346-538: The Vagina Museum . The journal's cover displayed a quotation from the review that referred to women as "bodies with vaginas". The quotation drew strong criticism on Twitter from medical professionals and feminists accusing The Lancet of sexism , arguing that this language was "dehumanising" and an "unhelpful" attempt at inclusivity. Horton later issued an apology on the journal's website. On July 5, 2024, The Lancet published in its Correspondence section
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4452-482: The small intestine . The virus can cause acute myocardial injury and chronic damage to the cardiovascular system . An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China, and is more frequent in severe disease. Rates of cardiovascular symptoms are high, owing to the systemic inflammatory response and immune system disorders during disease progression, but acute myocardial injuries may also be related to ACE2 receptors in
4558-710: The spike protein (S). The M protein of SARS-CoV-2 is about 98% similar to the M protein of bat SARS-CoV, maintains around 98% homology with pangolin SARS-CoV, and has 90% homology with the M protein of SARS-CoV; whereas, the similarity is only around 38% with the M protein of MERS-CoV . The many thousands of SARS-CoV-2 variants are grouped into either clades or lineages . The WHO, in collaboration with partners, expert networks, national authorities, institutions and researchers, have established nomenclature systems for naming and tracking SARS-CoV-2 genetic lineages by GISAID , Nextstrain and Pango . The expert group convened by
4664-548: The B.1 lineage. Several notable variants of SARS-CoV-2 emerged throughout 2020. Cluster 5 emerged among minks and mink farmers in Denmark . After strict quarantines and the slaughter of all the country's mink , the cluster was assessed to no longer be circulating among humans in Denmark as of 1 February 2021. As of December 2021 , there are five dominant variants of SARS-CoV-2 spreading among global populations:
4770-542: The CNS, possibly within an infected white blood cell. Research conducted when Alpha was the dominant variant has suggested COVID-19 may cause brain damage. Later research showed that all variants studied (including Omicron) killed brain cells, but the exact cells killed varied by variant. It is unknown if such damage is temporary or permanent. Observed individuals infected with COVID-19 (most with mild cases) experienced an additional 0.2% to 2% of brain tissue lost in regions of
4876-562: The COVID-19 infection may have different symptoms, and their symptoms may change over time. Three common clusters of symptoms have been identified: a respiratory symptom cluster with cough, sputum , shortness of breath , and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; and a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhea. In people without prior ear, nose, or throat disorders, loss of taste combined with loss of smell
4982-574: The Chinese state media, the team registered an experimental COVID-19 vaccine for Phase I trial in China on 17 March 2020, to test its safety. The trial was conducted on 108 healthy adults aged 18 to 60 in two medical facilities in Wuhan , Hubei province. In April, Ad5-nCoV became the first COVID-19 vaccine candidate in the world to begin Phase II trials. The Phase II trial results were published in
5088-474: The Director-General of WHO, characterized letter's methods as "take one unreliable number and multiply by another unreliable number to get a bigger unreliable number”. Consequently, American Jewish Committee called The Lancet to "remove the letter from its website and, moving forward, exercise greater caution in selecting the claims it amplifies". The Lancet was criticised after it published
5194-555: The National Institutes of Health has 'resisted disclosing details' of its work." Virologist Angela Rasmussen commented that this may have been "one of The Lancet's most shameful moments regarding its role as a steward and leader in communicating crucial findings about science and medicine". David Robertson from the University of Glasgow's Centre for Virus Research said that "It's really disappointing to see such
5300-475: The WHO declared that another distinctive variant, JN.1, had emerged as a "variant of interest". Though the WHO expected an increase in cases globally, particularly for countries entering winter, the overall global health risk was considered low. The SARS-CoV-2 virus can infect a wide range of cells and systems of the body. COVID‑19 is most known for affecting the upper respiratory tract (sinuses, nose, and throat) and
5406-759: The WHO on 11 February 2020 with COVID-19 being shorthand for "coronavirus disease 2019". The WHO additionally uses "the COVID‑19 virus" and "the virus responsible for COVID‑19" in public communications. The symptoms of COVID-19 are variable depending on the type of variant contracted, ranging from mild symptoms to a potentially fatal illness. Common symptoms include coughing , fever , loss of smell (anosmia) and taste (ageusia), with less common ones including headaches , nasal congestion and runny nose , muscle pain , sore throat , diarrhea , eye irritation , and toes swelling or turning purple, and in moderate to severe cases, breathing difficulties . People with
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#17327808898175512-551: The WHO recommended the labelling of variants using letters of the Greek alphabet , for example, Alpha , Beta , Delta , and Gamma , giving the justification that they "will be easier and more practical to discussed by non-scientific audiences". Nextstrain divides the variants into five clades (19A, 19B, 20A, 20B, and 20C), while GISAID divides them into seven (L, O, V, S, G, GH, and GR). The Pango tool groups variants into lineages , with many circulating lineages being classed under
5618-526: The ability to fill and finish 4 million doses per month to start with, eventually reaching a target of 10 million doses a month in 2021. The company eventually hopes to build a plant within 3 years to manufacture Convidecia in Russia. In early 2020, Chen Wei led a joint team of the Institute of Biotechnology, the Academy of Military Medical Sciences , and CanSino Biologics to develop AD5-nCOV. According to
5724-435: The article, which was done on June 3, 2020. As a step to increase quality control, the editors of The Lancet Group announced changes to the editorial policy in a comment titled "Learning from a retraction" which was published on September 22, 2020. In September 2022, The Lancet published the report of their "Covid-19 Commission" which was headed by Jeffrey Sachs , an economist with no medical background, who has pushed
5830-515: The brain connected to the sense of smell compared with uninfected individuals, and the overall effect on the brain was equivalent on average to at least one extra year of normal ageing; infected individuals also scored lower on several cognitive tests. All effects were more pronounced among older ages. The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the glandular cells of gastric , duodenal and rectal epithelium as well as endothelial cells and enterocytes of
5936-591: The brain found as complications leading to death in people infected with COVID‑19. Infection may initiate a chain of vasoconstrictive responses within the body, including pulmonary vasoconstriction – a possible mechanism in which oxygenation decreases during pneumonia. Furthermore, damage of arterioles and capillaries was found in brain tissue samples of people who died from COVID‑19. COVID‑19 may also cause substantial structural changes to blood cells , sometimes persisting for months after hospital discharge. A low level of blood lymphocytess may result from
6042-428: The brains of those who have died from COVID‑19, but these results need to be confirmed. While virus has been detected in cerebrospinal fluid of autopsies, the exact mechanism by which it invades the CNS remains unclear and may first involve invasion of peripheral nerves given the low levels of ACE2 in the brain. The virus may also enter the bloodstream from the lungs and cross the blood–brain barrier to gain access to
6148-565: The cities of Riyadh, Dammam, and Mecca. In October 2020, Mexico began Phase III trials on 15,000 volunteers. In September 2020, Russia began Phase III trials on 500 volunteers, which Petrovax later received approval from the government to expand to 8,000 more volunteers. In September 2020, Pakistan began Phase III trials on 40,000 volunteers as part of a global multi-center study. As of December, about 13,000 volunteers have participated in trials of Ad5-nCoV. In November 2020, Chile began Phase III trials on 5,200 volunteers to be managed by
6254-409: The clear jelly liquid found in lung autopsies of people who died of COVID-19. One possibility addressed in medical research is that hyuralonic acid (HA) could be the leading factor for this observation of the clear jelly liquid found in the lungs, in what could be hyuralonic storm, in conjunction with cytokine storm . One common symptom, loss of smell, results from infection of the support cells of
6360-448: The college's tobacco advisory group, praised the journal for discussing the health problem, but he concluded that a "ban on tobacco would be a nightmare." Amanda Sandford, spokesperson for the anti-tobacco group Action on Smoking and Health , stated that criminalising a behaviour 26% of the population commit "is ludicrous." She also said: "We can't turn the clock back. If tobacco were banned we would have 13 million people desperately craving
6466-465: The conspiracy theory that Covid came from a US "biotechnology" lab. Before the report's release, Sachs appeared on the podcast of Robert F. Kennedy Jr. , who has previously spread vaccine conspiracy theories. On the podcast episode, Sachs claimed that "Government officials such as Anthony Fauci "are not being honest" about the virus's origins". The published report included claims that "'independent researchers have not yet investigated' US labs, and said
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#17327808898176572-583: The country's first COVID-19 vaccine patent to CanSino. On 16 May 2020, Canadian Prime Minister Justin Trudeau announced Health Canada had approved Phase II trials to be conducted by the Canadian Center for Vaccinology (CCfV) on the COVID-19 vaccine produced by CanSino. Scott Halperin , director of the CCfV, said the vaccine would not be the only one going into clinical trials in Canada, and any potential vaccine would not be publicly available until after Phase 3
6678-406: The data. Of people who show symptoms, 81% develop only mild to moderate symptoms (up to mild pneumonia ), while 14% develop severe symptoms ( dyspnea , hypoxia , or more than 50% lung involvement on imaging) that require hospitalization, and 5% of patients develop critical symptoms ( respiratory failure , septic shock , or multiorgan dysfunction ) requiring ICU admission. At least a third of
6784-491: The doctors responded by saying that the letter was a legitimate exercise in freedom of expression, while a second one stated that he had no knowledge about David Duke or the Ku Klux Klan. The editor of The Lancet , Richard Horton , said: "I have no plans to retract the letter, and I would not retract the letter even if it was found to be substantiated." However, Horton subsequently came to Israel's Rambam Hospital for
6890-596: The existing one-dose injection and recommended the efficacy and cost-effectiveness of the nasal vaccine to be evaluated in Phase II/III studies. In September 2022, CanSino announced that Convidecia Air had been approved as a booster Covid-19 vaccine in China. Rollout of inhaled boosters was underway in October. In August 2020, Saudi Arabia confirmed it would begin Phase III trials on 5,000 people for Ad5-nCoV in
6996-399: The expectation that an additional 15 to 20 million doses would be delivered in 2021. In February 2021, Malaysia 's Solution Biologics agreed to supply 3.5 million Convidecia doses to the government. The doses would be delivered starting in April with 500,000 complete doses, with the rest in bulk to be finished by Solution Biologics. In February 2021, Pakistan purchased 20 million doses of
7102-721: The expression of ACE-2, thereby facilitating the SARS-Cov2 virus to enter cells and to replicate. A competition of negative feedback loops (via protective effects of interferon alpha) and positive feedback loops (via upregulation of ACE-2) is assumed to determine the fate of patients suffering from COVID-19. Additionally, people with COVID‑19 and acute respiratory distress syndrome (ARDS) have classical serum biomarkers of CRS, including elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer , and ferritin . Systemic inflammation results in vasodilation , allowing inflammatory lymphocytic and monocytic infiltration of
7208-428: The eyes, nose, or mouth. The risk is highest when people are in close proximity, but small airborne particles containing the virus can remain suspended in the air and travel over longer distances, particularly indoors. Transmission can also occur when people touch their eyes, nose or mouth after touching surfaces or objects that have been contaminated by the virus. People remain contagious for up to 20 days and can spread
7314-474: The face. While drugs have been developed to inhibit the virus, the primary treatment is still symptomatic , managing the disease through supportive care , isolation , and experimental measures . During the initial outbreak in Wuhan , the virus and disease were commonly referred to as "coronavirus" and "Wuhan coronavirus", with the disease sometimes called "Wuhan pneumonia". In the past, many diseases have been named after geographical locations, such as
7420-473: The group's first fully open access journal . In 2014, The Lancet Haematology ( haematology ) and The Lancet HIV ( infectious diseases ) were launched, both as online only research titles. The Lancet Child & Adolescent Health ( paediatrics ) launched in 2017. The three established speciality journals ( The Lancet Neurology , The Lancet Oncology , and The Lancet Infectious Diseases ) have built up strong reputations in their medical speciality. According to
7526-523: The heart. ACE2 receptors are highly expressed in the heart and are involved in heart function. A high incidence of thrombosis and venous thromboembolism occurs in people transferred to intensive care units with COVID‑19 infections, and may be related to poor prognosis. Blood vessel dysfunction and clot formation (as suggested by high D-dimer levels caused by blood clots) may have a significant role in mortality, incidents of clots leading to pulmonary embolisms , and ischaemic events (strokes) within
7632-414: The high levels of antibodies suggested the shots may provide immunity for an extended period of time, although Phase III results were still required. On September 24, CanSino began Phase IIb trials on 481 participants to evaluate the safety and immunogenicity of Ad5-nCoV for children ages 6–17 and elderly individuals ages 56 and above. In August, China's National Intellectual Property Administration issued
7738-503: The host cell. Following viral entry, COVID‑19 infects the ciliated epithelium of the nasopharynx and upper airways. Autopsies of people who died of COVID‑19 have found diffuse alveolar damage , and lymphocyte-containing inflammatory infiltrates within the lung. From the CT scans of COVID-19 infected lungs, white patches were observed containing fluid known as ground-glass opacity (GGO) or simply ground glass. This tended to correlate with
7844-528: The infection, children may develop paediatric multisystem inflammatory syndrome , which has symptoms similar to Kawasaki disease , which can be fatal. In very rare cases, acute encephalopathy can occur, and it can be considered in those who have been diagnosed with COVID‑19 and have an altered mental status. According to the US Centers for Disease Control and Prevention , pregnant women are at increased risk of becoming seriously ill from COVID‑19. This
7950-429: The letter as a "u-turn". In June of 2024, The Lancet wrote an op-ed stating that "SARS-CoV-2 is a natural virus that found its way into humans through mundane contact with infected wildlife" and that "doubling down on flawed assumptions in the face of growing evidence calls motivations into question." The 25 September 2021 edition of The Lancet included a review of an exhibition about the history of menstruation at
8056-640: The letter concealed their involvement "to creat[e] the impression of scientific unanimity" and failed to disclose conflicts of interest. After having published letters supporting only the natural origins theory , The Lancet published a letter in September 2021 from a group of 16 virologists, biologists and biosecurity specialists saying that "Research-related hypotheses are not misinformation or conjecture" and that "Scientific journals should open their columns to in-depth analyses of all hypotheses." The Times of India described The Lancet 's decision to publish
8162-573: The letter was Paola Manduca, Professor of Genetics at the University of Genoa in Italy. As reported in The Daily Telegraph , the letter "condemned Israel in the strongest possible terms, but strikingly made no mention of Hamas ' atrocities." According to Haaretz , the authors of the letter include doctors who "are apparently sympathetic to the views of David Duke , a white supremacist and former Ku Klux Klan Grand Wizard ." One of
8268-540: The letter's authors, Prof. Martin McKee , wrote that the letter “has been greatly misquoted and misinterpreted” and clarified that the 186,000 figure was “purely illustrative”. The letter has been criticized by the experts, such as the Chair of "Every Casualty Counts" network Prof. Michael Spagat , who wrote that the estimate "lacks a solid foundation and is implausible". Prof. Peter A. Singer , former Special Adviser to
8374-454: The lower respiratory tract (windpipe and lungs). The lungs are the organs most affected by COVID‑19 because the virus accesses host cells via the receptor for the enzyme angiotensin-converting enzyme 2 (ACE2), which is most abundant on the surface of type II alveolar cells of the lungs. The virus uses a special surface glycoprotein called a " spike " to connect to the ACE2 receptor and enter
8480-409: The lung and the heart. In particular, pathogenic GM-CSF-secreting T cells were shown to correlate with the recruitment of inflammatory IL-6-secreting monocytes and severe lung pathology in people with COVID‑19. Lymphocytic infiltrates have also been reported at autopsy. Multiple viral and host factors affect the pathogenesis of the virus. The S-protein , otherwise known as the spike protein,
8586-433: The metastudy. Specifically, The Lancet editors wanted to "evaluate the origination of the database elements, to confirm the completeness of the database, and to replicate the analyses presented in the paper." The independent peer reviewers in charge of the investigation notified The Lancet that Surgisphere would not provide the requested data and documentation. The authors of the metastudy then asked The Lancet to retract
8692-447: The moment a person first becomes infected and the appearance of the first symptoms. The median delay for COVID-19 is four to five days possibly being infectious on 1–4 of those days. Most symptomatic people experience symptoms within two to seven days after exposure, and almost all will experience at least one symptom within 12 days. Most people recover from the acute phase of the disease. However, some people continue to experience
8798-635: The oldest of its kind. It is also one of the world's highest-impact academic journals. It was founded in England in 1823. The journal publishes original research articles, review articles ("seminars" and "reviews"), editorials , book reviews , correspondence, as well as news features and case reports . The Lancet has been owned by Elsevier since 1991, and its editor-in-chief since 1995 has been Richard Horton . The journal has editorial offices in London , New York City , and Beijing . The Lancet
8904-480: The olfactory epithelium , with subsequent damage to the olfactory neurons . The involvement of both the central and peripheral nervous system in COVID‑19 has been reported in many medical publications. It is clear that many people with COVID-19 exhibit neurological or mental health issues . The virus is not detected in the central nervous system (CNS) of the majority of COVID-19 patients with neurological issues . However, SARS-CoV-2 has been detected at low levels in
9010-488: The peak viral load in upper respiratory tract samples occurs close to the time of symptom onset and declines after the first week after symptoms begin. Current evidence suggests a duration of viral shedding and the period of infectiousness of up to ten days following symptom onset for people with mild to moderate COVID-19, and up to 20 days for persons with severe COVID-19, including immunocompromised people. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
9116-586: The peer-reviewed journal The Lancet in August 2020, and noted neutralizing antibody and T cell responses based on statistical analyses of data involving 508 eligible participants. In September, Zeng Guang, chief scientist of the Chinese Center for Disease Control and Prevention , said the amount of COVID-19 antibodies in subjects from the Phase I trials remained high six months after the first shot. Zeng said
9222-411: The people who are infected with the virus do not develop noticeable symptoms at any point in time. These asymptomatic carriers tend not to get tested and can still spread the disease. Other infected people will develop symptoms later (called "pre-symptomatic") or have very mild symptoms and can also spread the virus. As is common with infections, there is a delay, or incubation period , between
9328-416: The respiratory tract, people with severe COVID‑19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated IL‑2 , IL‑6 , IL‑7 , as well as the following suggest an underlying immunopathology: Interferon alpha plays a complex, Janus-faced role in the pathogenesis of COVID-19. Although it promotes the elimination of virus-infected cells, it also upregulates
9434-525: The rest in volume ii . In 1990, the journal moved to a sequential volume numbering scheme, with two volumes per year. Volumes were retro-actively assigned to the years prior to 1990, with the first issue of 1990 being assigned volume 335, and the last issue of 1989 assigned volume 334. The table of contents listing on ScienceDirect uses this new numbering scheme. The Lancet includes editorial content and letters in addition to scientific papers, which have at times been controversial. For example, it called for
9540-859: The risk of long COVID includes staying up to date on the most recent COVID-19 vaccine, practicing good hygiene, maintaining clean indoor air, and physical distancing from people infected with a respiratory virus. Complications may include pneumonia , acute respiratory distress syndrome (ARDS), multi-organ failure , septic shock , and death. Cardiovascular complications may include heart failure, arrhythmias (including atrial fibrillation ), heart inflammation , thrombosis , particularly venous thromboembolism , and endothelial cell injury and dysfunction. Approximately 20–30% of people who present with COVID‑19 have elevated liver enzymes , reflecting liver injury. Neurologic manifestations include seizure , stroke, encephalitis , and Guillain–Barré syndrome (which includes loss of motor functions ). Following
9646-533: The single-dose vaccine for communities living in remote areas including the Orang Asli as well as the homeless and undocumented individuals. Priority states for the CanSino vaccine included Sabah , Johor , Kedah , Kelantan , Perak , Sabah , and Terengganu . COVID-19 Coronavirus disease 2019 ( COVID-19 ) is a contagious disease caused by the coronavirus SARS-CoV-2 . The first known case
9752-623: The specialty journals will feel it incumbent upon themselves to name commissions about a certain particular issue of concern to a wide sub-audience of their readers. One example of this type of commission is the Lancet Infectious Diseases Commission on "Preparedness for emerging epidemic threats", which reported on its mandate in January 2020. Prior to 1990, The Lancet had volume numbering that reset every year. Issues in January to June were in volume i , with
9858-419: The trial and called the critics: "a fairly small, but highly organized, very vocal and very damaging group of individuals who have, I would say, actually hijacked this agenda and distorted the debate so that it actually harms the overwhelming majority of patients." Starting in 2011, critics of the studies filed Freedom of Information Act requests to get access to the authors' primary data, in order to learn what
9964-592: The trial's results would have been under the original protocol. In 2016, some of the data was released, which allowed calculation of results based on the original protocol and found that additional treatment led to no significant improvement in recovery rates over the control group. The results from the PACE trial have been used to promote graded exercise therapy ; however, these recommendations are now viewed by most public health bodies as outdated and highly harmful to ME/CFS patients. In May 2020, The Lancet published
10070-536: The vaccine additionally also taking place in Malaysia, Mexico, and Pakistan. In February 2021, data released from an interim analysis of Phase III trials with 30,000 participants and 101 COVID cases showed that globally, the vaccine administered as an intramuscular injection had an efficacy of 65.7% at preventing moderate cases of COVID-19 and 90.98% efficacy at preventing severe cases. In the Pakistan trial subset,
10176-572: The vaccine for emergency use. In March, Hungary approved the vaccine for emergency use. In March, Moldova authorized use of the vaccine. On 15 June 2021, Malaysia’s National Pharmaceutical Regulatory Agency (NPRA) has issued conditional registration for emergency use of the vaccine. On 7 September 2021, National Agency of Drug and Food Control (BPOM) has issued emergency use authorization in Indonesia. On 4 September 2022, China's National Medical Products Administration granted approval for
10282-510: The vaccine had an efficacy of 74.8% at preventing symptomatic cases, and 100% for preventing severe disease. While the efficacy rates were lower than the Pfizer–BioNTech and Moderna vaccines, its single-dose regimen and normal refrigerator storage requirement (2 to 8 °C) could make it a favorable option for many countries. It has similar efficacy to the Janssen vaccine , another one-shot adenovirus vaccine found to be 66% effective in
10388-484: The vaccine of which the first 3 million doses were to arrive in May. In June 2021, Malaysia's coordinating minister for COVID-19 Immunisation, Khairy Jamaluddin , confirmed refugee communities in Malaysia would receive the vaccine; with the first shipment due to arrive in late July. By 19 September 2021, more than 70,000 people in Malaysia had received the Convidecia vaccine. The COVID-19 Immunisation Task Force has prioritised
10494-464: The virus acting through ACE2-related entry into lymphocytes. Another common cause of death is complications related to the kidneys . Early reports show that up to 30% of hospitalised patients both in China and in New York have experienced some injury to their kidneys, including some persons with no previous kidney problems. Although SARS-CoV-2 has a tropism for ACE2-expressing epithelial cells of
10600-752: The virus even if they do not develop symptoms. Testing methods for COVID-19 to detect the virus's nucleic acid include real-time reverse transcription polymerase chain reaction (RT‑PCR), transcription-mediated amplification , and reverse transcription loop-mediated isothermal amplification (RT‑LAMP) from a nasopharyngeal swab . Several COVID-19 vaccines have been approved and distributed in various countries, many of which have initiated mass vaccination campaigns . Other preventive measures include physical or social distancing , quarantining , ventilation of indoor spaces, use of face masks or coverings in public, covering coughs and sneezes, hand washing , and keeping unwashed hands away from
10706-509: The virus is carried out through virus-laden fluid particles, or droplets, which are created in the respiratory tract, and they are expelled by the mouth and the nose. There are three types of transmission: "droplet" and "contact", which are associated with large droplets, and "airborne", which is associated with small droplets. If the droplets are above a certain critical size, they settle faster than they evaporate , and therefore they contaminate surfaces surrounding them. Droplets that are below
10812-615: The war. The 95% confidence interval was 392,979 to 942,636. 1,849 households that contained 12,801 people were surveyed. In 2011, The Lancet published a study by the UK-based "PACE trial management group", which reported success with graded exercise therapy and cognitive behavioural therapy for ME/CFS ; a follow-up study was published in Lancet Psychiatry in 2015. The studies attracted criticism from some patients and researchers, especially with regard to data analysis that
10918-500: Was different from that described in the original protocol . In a 2015 Slate article, biostatistician Bruce Levin of Columbia University was quoted saying "The Lancet needs to stop circling the wagons and be open", and that "one of the tenets of good science is transparency"; while Ronald Davis of Stanford University said: "the Lancet should step up to the plate and pull that paper". Horton defended The Lancet' s publication of
11024-604: Was identified in Wuhan , China, in December 2019. Most scientists believe the SARS-CoV-2 virus entered into human populations through natural zoonosis , similar to the SARS-CoV-1 and MERS-CoV outbreaks, and consistent with other pandemics in human history. Social and environmental factors including climate change , natural ecosystem destruction and wildlife trade increased the likelihood of such zoonotic spillover . The disease quickly spread worldwide, resulting in
11130-470: Was committed to helping people give up smoking. He added: "Despite the fact that this is a serious problem, it is a little bit extreme for us in Britain to start locking people up because they have an ounce of tobacco somewhere." In August 2014 and during the 2014 Israel–Gaza conflict , The Lancet published an "Open letter for the people of Gaza " in their correspondence section. The principal author of
11236-507: Was founded in 1823 by Thomas Wakley , an English surgeon who named it after the surgical instrument called a lancet (scalpel). According to BBC, the journal was initially considered to be radical following its founding. Members of the Wakley family retained editorship of the journal until 1908. In 1921, The Lancet was acquired by Hodder & Stoughton . Elsevier acquired The Lancet from Hodder & Stoughton in 1991. According to
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