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Massive scientific productivity accompanied the COVID-19 pandemic. We evaluated the citation impact of COVID-19 publications relative to all scientific work published in 2020 to 2021 and assessed the impact on scientist citation profiles. Using Scopus data until August 1, 2021, COVID-19 items accounted for 4% of papers published, 20% of citations received to papers published in 2020 to 2021, and >30% of citations received in 36 of the 174 disciplines of science (up to 79.3% in general and internal medicine). Across science, 98 of the 100 most-cited papers published in 2020 to 2021 were related to COVID-19; 110 scientists received ≥10,000 citations for COVID-19 work, but none received ≥10,000 citations for non–COVID-19 work published in 2020 to 2021. For many scientists, citations to their COVID-19 work already accounted for more than half of their total career citation count. Overall, these data show a strong covidization of research citations across science, with major impact on shaping the citation elite.
The covariates included within the multivariable models fitted by each paper. This is a data microarray in which the studies run along the Y-axis and the covariates run along the X-axis. Rows and columns are ordered in descending order, based on the total number each covariate was included in the multivariable models fitted by each study. Where patterns were similar between studies or covariates, those studies or covariates were placed next to each other. (PDF 82 kb)
Abstract Background Estimates of community spread and infection fatality rate (IFR) of COVID‐19 have varied across studies. Efforts to synthesize the evidence reach seemingly discrepant conclusions. Methods Systematic evaluations of seroprevalence studies that had no restrictions based on country and which estimated either total number of people infected and/or aggregate IFRs were identified. Information was extracted and compared on eligibility criteria, searches, amount of evidence included, corrections/adjustments of seroprevalence and death counts, quantitative syntheses and handling of heterogeneity, main estimates and global representativeness. Results Six systematic evaluations were eligible. Each combined data from 10 to 338 studies (9‐50 countries), because of different eligibility criteria. Two evaluations had some overt flaws in data, violations of stated eligibility criteria and biased eligibility criteria (eg excluding studies with few deaths) that consistently inflated IFR estimates. Perusal of quantitative synthesis methods also exhibited several challenges and biases. Global representativeness was low with 78%‐100% of the evidence coming from Europe or the Americas; the two most problematic evaluations considered only one study from other continents. Allowing for these caveats, four evaluations largely agreed in their main final estimates for global spread of the pandemic and the other two evaluations would also agree after correcting overt flaws and biases. Conclusions All systematic evaluations of seroprevalence data converge that SARS‐CoV‐2 infection is widely spread globally. Acknowledging residual uncertainties, the available evidence suggests average global IFR of ~0.15% and ~1.5‐2.0 billion infections by February 2021 with substantial differences in IFR and in infection spread across continents, countries and locations.
Evidence on how much medical interventions work may change over time. It is important to determine what fluctuations in the treatment effect reported by randomized trials and their metaanalyses may be expected and whether extreme fluctuations signal future major changes. We applied recursive cumulative metaanalysis of randomized controlled trials to evaluate the relative change in the pooled treatment effect (odds ratio) over time for 60 interventions in two medical fields (pregnancy/perinatal medicine, n = 45 interventions; myocardial infarction, n = 15 interventions). We evaluated the scatter of relative changes for different numbers of total patients in previous trials. Outlier cases were noted with changes greater than 2.5 standard deviations of the expected. With 500 accumulated patients, the pooled odds ratio may change by 0.6- to 1.7-fold in the immediate future. When 2000 patients have already been randomized, the respective figures are between 0.74- and 1.35-fold for pregnancy/perinatal medicine and between 0.83- and 1.21-fold for myocardial infarction studies. Extreme early fluctuations in the treatment effect were observed in three interventions (magnesium in myocardial infarction, calcium and antiplatelet agents for prevention of preeclampsia), where recent mega-trials have contradicted prior metaanalyses, as well as in four other examples where early large treatment effects were dissipated when more data appeared. Past experience may help quantify the uncertainty surrounding the treatment effects reported in early clinical trials and their metaanalyses. Early wide oscillations in the evolution of the treatment effect for specific interventions may sometimes signal further major changes in the future.
Discussion | The recommendation by the ACIP was informed by the Centers for Disease Control and Prevention model, which assumed a high probability of postherpetic neuralgia and 100% adherence. 1In this modeling study, we found that neither ACIP recommendation would be cost-effective, unless adherence to the 2-dose regimen approached 100%.Using a more realistic estimate, we found it cost-effective to begin vaccination at 55 years of age and offer ZVL recipients a booster after 5 years.This discrepancy highlights the cautions required in interpreting costeffectiveness findings and the importance of scrutinizing underlying assumptions.Adherence of 100% is unlikely for several reasons.The coverage of single-dose ZVL was only 30% in 2015, partly owing to cost. 5 At $280 for the series, RZV is now the most expensive adult vaccine.Reimbursement will also be an issue, especially in people 65 years or older, because Medicare covers zoster vaccine under part D with substantial copayments. 6The 2-dose regimen will require an additional office visit, potentially resulting in extra work loss.Finally, the 6% of patients with a severe local reaction after the first dose may be particularly hesitant to return. Conclusions |The new recommendations of the ACIP for RZV do not appear to be cost-effective unless 100% of patients receive both doses.Given our best estimates, vaccination with RZV at 55 years of age and a booster at least 5 years after ZVL would offer better value.Clinicians may consider vaccination earlier for patients who are very likely to comply with a second dose.In all cases, efforts should be made to enhance compliance with the full series.
