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Wick and colleagues1 recently recommended strategies to enhance clinical trial designs in acute respiratory distress syndrome (ARDS). Recognising ARDS as a heterogeneous syndrome with distinct phenotypes, the authors emphasise the use of point-of-care biomarker assays and airspace sampling to allow trial participants to be distinguished from one another. Additionally, the authors advocate for increased recruitment of under-represented populations and propose an expansion of the definition of ARDS to enhance the external validity of future trials.

Vaccines are a primary component of the COVID-19 pandemic response. Up until August, 2022, all available COVID-19 vaccines targeted only the ancestral strain of SARS-CoV-2. Emergence of the highly transmissible omicron (B.1.1.529) variant in November, 2021, has been associated with reduced effectiveness of first-generation COVID-19 vaccines against infection.1 Omicron and other variants of concern pose substantial challenges to optimising COVID-19 vaccination strategies. Thankfully, a growing body of literature shows that a COVID-19 vaccine booster dose protects against symptomatic omicron inf...

The COVID-19 pandemic destabilised health-care systems and led to millions of excess deaths worldwide.1 Disproportionate inflammatory response and thromboembolic events denoted the clinical spectrum of patients with severe disease phenotypes and poor outcomes. In early 2020, when SARS-CoV-2 vaccines and antivirals such as nirmatrelvir–ritonavir were not yet available, approved immunomodulatory, immunosuppressive, and antithrombotic agents seemed inexpensive and safe options to treat patients in the community and hospital settings.

At the height of the COVID-19 pandemic, public health restrictions including self-isolation of positive cases and their close contacts were vital to reduce onward transmission of SARS-CoV-2, thus preventing deaths and the potential overwhelming of health-care services. However, the requirement for prolonged and often repeated episodes of self-isolation has had an enormous impact on individuals' psychological, financial, and educational wellbeing, disproportionately affecting those on lower incomes, the self-employed, and those unable to work from home.

The immune evasiveness of SARS-CoV-2 omicron (B.1.1.529) subvariants resulted in large, global waves of infection and raised concerns about vaccine effectiveness against COVID-19-related hospitalisation and death. In The Lancet Respiratory Medicine, Sara Y Tartof and colleagues1 assessed the effectiveness and duration of protection offered by two doses and three doses of BNT162b2 (Pfizer–BioNTech) against hospital and emergency department admission following infection with the omicron BA.1 or BA.2 subvariants.