How long does Lancet Infectious Diseases take to review?

Lancet Infectious Diseases typically takes 2-4 weeks to first decision. The full review process involves 6 main stages: consider a presubmission inquiry, prepare manuscript to lancet specifications, and peer review.

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Lancet Infectious Diseases Impact Factor 29.5: Publishing Guide

Q: What is the impact factor of Lancet Infectious Diseases?

Lancet Infectious Diseases has an impact factor of 29.5 (2024). This places it among the top-tier journals in its field with Lancet Infectious Diseases publishes high-impact original research, reviews, and commentary across all infectious diseases, but there's a clear hierarchy in what editors prioritize.

Q: What is the acceptance rate of Lancet Infectious Diseases?

Lancet Infectious Diseases has an acceptance rate of ~12%. A common reason for rejection is submitting laboratory or basic science studies without human data. Lancet Infectious Diseases is a clinical and epidemiological journal first. They've redirected countless papers to EBioMedicine or Lancet Microbe because authors didn't understand this distinction. If you've characterized a new resistance mechanism in vitro but don't have patient isolates or clinical outcome data, this isn't your journal. Even in silico modeling needs to be validated against real-world epidemiological data to have a chance here. The bench-to-bedside pipeline matters, but they want papers from the bedside end.

Q: Is Lancet Infectious Diseases peer reviewed?

Yes, Lancet Infectious Diseases is fully peer reviewed. All submissions undergo rigorous peer review by External reviewers have 14-21 days to submit reports. Lancet reviewers are instructed to assess methodology rigorously and comment on clinical significance. Statistical review is standard for trials and complex observational studies. The editorial team synthesizes reviews before making a decision..

Q: What does Lancet Infectious Diseases look for in submissions?

Global health significance with policy teeth: Your findings need to matter beyond your study population. Editors want research that WHO officials, national health ministries, or guideline committees will read and act on. A single-center study from a teaching hospital in a wealthy country won't cut it unless the findings are truly exceptional. They're particularly interested in data from regions underrepresented in the literature, especially sub-Saharan Africa, Southeast Asia, and Latin America, where disease burden is highest but evidence is thinnest.

The Lancet's flagship specialty journal for infectious diseases, with an impact factor of 29.5. If you've got clinical data that changes treatment guidelines or epidemiological findings with global health implications, this is where it belongs.

29.5

Impact Factor (2024)

~12%

Acceptance Rate

2-4 weeks to first decision

Time to First Decision

What Lancet Infectious Diseases Publishes

Lancet Infectious Diseases publishes high-impact original research, reviews, and commentary across all infectious diseases, but there's a clear hierarchy in what editors prioritize. They're looking for work that directly informs clinical practice or public health policy, not bench science with theoretical clinical applications five years down the road. Pandemic preparedness, emerging pathogens, antimicrobial resistance, and vaccine effectiveness studies sit at the top of the priority list. The journal won't touch basic mechanistic studies unless they've got immediate translational implications with human data to back them up. If your paper could plausibly be cited in a WHO guideline or change how doctors prescribe antimicrobials, you're in the right place.

Clinical trials of new antimicrobials, antivirals, and vaccines with outcomes data that could shift treatment protocols or public health recommendations within 12 months of publication.
Large-scale epidemiological studies tracking disease burden, transmission processes, or risk factors across populations, particularly those from low and middle-income countries where data gaps exist.
Antimicrobial resistance surveillance data with clear policy implications, including studies documenting emergence of resistance patterns or evaluating stewardship interventions.
Outbreak investigations and pandemic response research where findings need rapid dissemination to influence ongoing public health responses.
Health systems research examining implementation of infectious disease interventions, diagnostic rollouts, or vaccine delivery programs at scale.

Editor Insight

“I see thousands of submissions a year, and the pattern of rejections is predictable. Researchers send us excellent basic science that belongs in a microbiology journal because they've heard of The Lancet brand. We're not looking for mechanistic discoveries unless you can show me what it means for patients. Clinical trials need to move beyond demonstrating statistical significance to addressing whether the effect size matters for practice. I reject a lot of well-conducted research simply because the authors haven't thought about implementation. Who's going to use this treatment? Can they afford it? Does the health system infrastructure exist to deliver it? These aren't afterthoughts for us. We also fast-track papers during outbreaks, and I mean genuinely fast, sometimes peer review in 48 hours when data is urgent. But don't mistake speed for lower standards. The bar stays the same; we just move faster. If you're sitting on outbreak data, contact us before submitting. We can advise on how to prioritize your analyses and what we most need to see.”

What Lancet Infectious Diseases Editors Look For

Global health significance with policy teeth

Your findings need to matter beyond your study population. Editors want research that WHO officials, national health ministries, or guideline committees will read and act on. A single-center study from a teaching hospital in a wealthy country won't cut it unless the findings are truly exceptional. They're particularly interested in data from regions underrepresented in the literature, especially sub-Saharan Africa, Southeast Asia, and Latin America, where disease burden is highest but evidence is thinnest.

Rigorous methodology that withstands scrutiny

Lancet journals are famous for their statistical and methodological standards, and the infectious disease editors are no exception. Randomized trials need to follow CONSORT. Observational studies need to address confounding properly, not just acknowledge it exists. Your sample size justification needs to be solid, and your sensitivity analyses need to actually test your assumptions. They've desk-rejected plenty of well-intentioned studies because the methods couldn't support the conclusions the authors wanted to draw.

Clinical relevance that's immediately actionable

Don't make editors work to figure out why your paper matters. The clinical implications should be obvious from the abstract. If you've shown a new diagnostic performs better, what's the number needed to test to catch one additional case? If you've evaluated a treatment, what's the effect size in terms that clinicians understand? They want papers that could change what a doctor does on Monday morning, not papers that might eventually contribute to a field of research.

Timeliness that matches the moment

Infectious disease research is uniquely time-sensitive. A paper on COVID-19 variants that arrives six months after the variant has swept through populations is already outdated. Editors track emerging threats closely and will fast-track papers on current outbreaks, new resistance patterns, or vaccine effectiveness against circulating strains. If your work addresses an active public health emergency, say so explicitly in your cover letter and request expedited review.

Patient and public involvement that's genuine

Like all Lancet journals, there's an expectation that patients and communities have been involved in research design, not just as subjects. This doesn't mean you need a community advisory board for every study, but editors notice when researchers have clearly thought about whether their outcomes matter to patients. For vaccine studies, for instance, acceptability and uptake barriers matter as much as immunogenicity. They'll ask about this in review if you don't address it upfront.

Why Papers Get Rejected

These patterns appear repeatedly in manuscripts that don't make it past Lancet Infectious Diseases's editorial review:

Submitting laboratory or basic science studies without human data

Lancet Infectious Diseases is a clinical and epidemiological journal first. They've redirected countless papers to EBioMedicine or Lancet Microbe because authors didn't understand this distinction. If you've characterized a new resistance mechanism in vitro but don't have patient isolates or clinical outcome data, this isn't your journal. Even in silico modeling needs to be validated against real-world epidemiological data to have a chance here. The bench-to-bedside pipeline matters, but they want papers from the bedside end.

Overstating findings in the abstract

Lancet editors read abstracts with a skeptical eye, and they've seen every flavor of overclaim. Saying your trial shows a treatment is 'highly effective' when the confidence interval crosses clinically meaningful thresholds will get you desk-rejected. Claiming your surveillance data reveals an 'alarming' trend without proper comparator data looks like advocacy dressed up as science. They want precise, measured language that matches what your data actually show, even if that makes for a less exciting abstract.

Ignoring equity and access considerations

A new treatment that costs $50,000 per patient isn't going to get the same reception as one that could be deployed in resource-limited settings. Editors explicitly consider whether findings have implications for global health equity, and they notice when authors don't. If you're evaluating a diagnostic that requires specialized equipment unavailable in most of the world, you need to acknowledge that limitation. If your intervention study was conducted entirely in wealthy countries, discuss generalizability to other settings or it'll come up in review.

Submitting outbreak reports without broader implications

Case series and outbreak investigations need to offer something beyond 'this happened here.' What does your outbreak tell us about transmission that we didn't know? What surveillance or response failures does it reveal? A descriptive account of cases, even from an interesting pathogen, won't make it unless there's a larger lesson. They publish plenty of outbreak research, but it needs to inform future preparedness or response, not just document what occurred.

Weak or missing patient and public involvement statements

All Lancet journals require authors to describe patient and public involvement in their research, and a perfunctory statement will be noticed. Simply writing 'patients were not involved in study design' without explaining why or how you plan to disseminate findings to affected communities signals that you haven't thought about this. Editors view genuine PPI as a marker of research quality, and reviewers increasingly comment on it. If involvement wasn't possible, explain the barriers and describe how you engaged with patient perspectives in other ways.

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Insider Tips from Lancet Infectious Diseases Authors

Use the presubmission inquiry system for anything unconventional

Editors actually read presubmission inquiries and respond within a week. If you're not sure your topic fits, don't waste time formatting a full submission. They'll tell you honestly whether to proceed, and sometimes suggest a more appropriate Lancet journal. This is especially useful for modeling studies or health systems research where the infectious disease angle might not be obvious.

Time your submission around major conferences

Papers with data first presented at CROI, ECCMID, or IDWeek often get submitted in the weeks after these meetings. Editors and reviewers have usually attended and may already be familiar with the work. Submitting immediately after a well-received conference presentation can work in your favor, as long as your manuscript is ready. Don't rush a sloppy paper just to capitalize on buzz.

Include a linked research in context panel from the start

Lancet Infectious Diseases requires authors to summarize existing evidence and what their study adds. Don't treat this as an afterthought, it's actually one of the first things editors read. A weak 'evidence before this study' section suggests you haven't done a proper literature search. Make it specific: cite the systematic reviews, name the gaps, and be precise about what you're adding.

Suggest reviewers strategically but honestly

Your suggested reviewers reveal a lot about how well you know your field. Editors check whether you've suggested obvious competitors, collaborators, or people who genuinely have expertise. Don't suggest senior figures just because they're famous; suggest people who've published on your specific topic. And make sure you've excluded anyone with conflicts, real or perceived, because editors will check.

Data sharing statements are scrutinized closely

Lancet takes data sharing seriously, and 'data available upon reasonable request' doesn't cut it anymore for most study types. You need to explain what data will be shared, where, and under what conditions. For trials, individual participant data sharing is expected. Editors view strong data sharing commitments as a signal of research integrity, and reviewers are asked to comment on whether your statement is adequate.

The Lancet Infectious Diseases Submission Process

Consider a presubmission inquiry

1 week

For papers where fit is uncertain, submit a structured abstract and brief cover letter explaining significance. Editors respond within 5-7 days with clear guidance. This step is optional but saves time for borderline submissions or unusual formats.

Prepare manuscript to Lancet specifications

1-2 weeks

Format according to Lancet guidelines: structured abstract up to 300 words, research in context panel, ICMJE disclosure forms for all authors. The word limit is 4,500 words excluding abstract, references, and tables. Follow EQUATOR guidelines for your study type religiously.

Submit through Editorial Manager

1-2 days

Complete all author declarations, suggest and exclude reviewers, and upload supplementary materials. The cover letter should explain why this journal specifically, not just why the work is important. Mention any time sensitivity if relevant to an ongoing outbreak.

Initial editorial assessment

1-2 weeks

A handling editor reviews your submission against scope and quality thresholds. About 50-60% of papers are rejected at this stage without external review. You'll hear back quickly if it's a desk rejection. Papers that proceed go to 2-3 external reviewers.

Peer review

3-6 weeks

External reviewers have 14-21 days to submit reports. Lancet reviewers are instructed to assess methodology rigorously and comment on clinical significance. Statistical review is standard for trials and complex observational studies. The editorial team synthesizes reviews before making a decision.

Decision and revision

6-12 weeks total

Most papers that aren't rejected outright receive major revision requests. You'll have 4-6 weeks to respond with detailed rebuttals. Revised papers often return to original reviewers. Accept after minor revision is the best realistic outcome for first submissions. Final decisions come from the editorial team in London.

Lancet Infectious Diseases by the Numbers

Impact Factor (2024)(Consistently in the top 3 infectious disease journals by citation metrics)	29.5
Acceptance Rate(Varies by article type; original research is more competitive than reviews)	~12%
Time to First Decision(Faster for outbreak-related submissions; desk rejections come within days)	2-4 weeks
Time to Publication(Online First available within weeks of acceptance; can be expedited for urgent findings)	6-9 months
Submission Volume(Spikes during pandemics and major outbreak events)	~2,500/year
Open Access Option(Gold OA available; APC approximately $6,000; many funders cover costs)	Available

Before you submit

Lancet Infectious Diseases accepts a small fraction of submissions. Make your attempt count.

The pre-submission diagnostic runs a live literature search, scores your manuscript section by section, and gives you a prioritized fix list calibrated to Lancet Infectious Diseases. ~30 minutes.

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Article Types

Original Research (Article)

4,500 words

Primary research reports including clinical trials, observational studies, and epidemiological investigations. This is the main article type and the most competitive. Must include structured abstract and research in context panel.

Review

5,000 words

Authoritative summaries of clinical management or epidemiology topics. Usually commissioned, but strong unsolicited proposals are considered. Must be evidence-based and clinically focused, not just literature summaries.

Series

Variable

Groups of linked papers on a major topic, typically 3-5 papers published together. Always commissioned by editors following a proposal. Often focus on disease areas or public health themes needing updated synthesis.

Comment

1,200 words

Expert opinion pieces on current issues in infectious diseases, often linked to papers in the same issue. Most are commissioned, but editors consider timely submissions on emerging threats or policy debates.

Correspondence

400 words

Short communications including preliminary data, case reports with broader lessons, and responses to published articles. Lower bar for acceptance but must offer something new or correct an important misconception.

Personal View

1,500 words

Opinion pieces on controversial or neglected topics in infectious diseases. Strong voice and clear argument required. Not for self-promotion; must engage with genuine debates in the field.

Landmark Lancet Infectious Diseases Papers

Papers that defined fields and changed science:

Horby et al., 2021 - RECOVERY trial demonstrating dexamethasone reduces mortality in severe COVID-19, changing global treatment protocols
Pan et al., 2020 - First detailed characterization of SARS-CoV-2 viral load in clinical samples from China
Cao et al., 2020 - First randomized trial of lopinavir-ritonavir for COVID-19 showing no benefit, guiding treatment decisions early in the pandemic
Baeten et al., 2016 - Partners Demonstration Project showing PrEP delivery is feasible in African populations at high HIV risk
Zhu et al., 2020 - First clinical trial results of a COVID-19 vaccine candidate, establishing safety and immunogenicity

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Primary Fields

HIV/AIDS treatment and preventionTuberculosis diagnosis and managementAntimicrobial resistance surveillance and stewardshipVaccine effectiveness and implementationEmerging infectious diseases and outbreak responseMalaria and neglected tropical diseasesRespiratory infections including influenza and COVID-19Healthcare-associated infectionsViral hepatitisGlobal health security and pandemic preparedness

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