The Lancet peer reviewers and the COVID-19 pandemic

IntroductionPeer review is paramount to the scholarly article paradigm, helping to ensure the integrity and credibility of research. The Lancet played a crucial role in disseminating key information on the COVID-19 pandemic, publishing early clinical descriptions, risk factors for death, and effectiveness of measures like physical distancing and masks. Notably, The Lancet was the worlds most cited journal for COVID-19 research, emphasising its significant impact on disseminating critical findings during the pandemic. MethodsGeographic data for The Lancets peer reviewers in 2019 (pre-pandemic) and 2020 (pandemic) were analysed at the country level, ranking reviewer countries. A test of proportions compared reviewer numbers between the years. ResultsIn 2020, China emerged as one of the top ten reviewer countries for the first time, with a significant increase from 1% (25 of 1843) in 2019 to 3% (54 of 1850), p=0.001. Italy also entered the top five reviewer countries, rising from 4% (67) to 5% (90), p=0.065. Reviewers from Africa 43 (2%) and South America 31 (2%) represented their continents in 2020. The top ten reviewer nations for The Lancet in 2020 largely mirrored the top ten countries in global COVID-19 research output. ConclusionDuring the COVID-19 pandemics acute phase in 2020, The Lancet, the worlds most cited journal for COVID-19 research, featured peer reviewers who were largely representative of global COVID-19 research output. Notably, reviewers from China, the first country affected by COVID-19, increased significantly. However, underrepresentation of some continents persisted. To foster global idea exchange and enhance pandemic preparedness, research capacity worldwide must expand, broadening the reviewer pool--a vital step given uncertainties in future pandemic geographic origin.