PONE-D-20-14345

SARS-CoV-2 detection in setting of viral swabs scarcity: are MRSA swabs and viral swabs equivalent?

PLOS ONE

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Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: N/A

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The manuscript entitled SARS-CoV-2 detection in setting of viral swab scarcity: are MRSA swabs and viral swabs equivalent? describes the use of MRSA swabs with Amies media and Viral swab with universal transport media for sample collection from SARS-CoV-2 infected patients. Authors indicated that the MRSA swabs yields the comparable results as that of viral swabs. However, this manuscript failed to address the following;

1. Sample size is less

2. Sampling was done at only one center; sampling in different screening center by different technicians will require to exclude personal variation in sample collection.

3. As the Amies media is not known as medium of choice for sample collection for viral diagnosis and it is expected that the sample will be stored for varying time period at room temperature prior to transport to lab to store at -20C; the duration of stability of RNA in the Amies media must be tested prior to recommending them for SARS-CoV-2 sample collection.

4. References not included for several sentences in the introduction; For example- "The spectrum of disease severity ranges from asymptomatic disease to severe pulmonary disease including acute respiratory distress syndrome, multisystem organ failure, and death. Genetic sequencing performed early in the course of the outbreak led to the

development of diagnostic testing".....include references.

5. The following sentence is not clear and need to be re-written : We sampled 81 unique patients, of which the viral swabs were positive on the DiaSorin test in 19.

6. It is needless to mention "Additionally, while our study was conducted only in Veterans, we do not believe there

should be a difference in test results between Veterans and non-Veterans for the positive or

negative predictive value of testing for SARS-CoV-2 infection"

7. Under methods, the sentence "virals wabs (BD H192(07) flexible mini-tip flocked " need to be written as "viral swabs (BD H192(07) flexible mini-tip flocked"

8. The very short and incomplete sentences [ for example "The viral swab specimens were nasopharyngeal" needs to be merged with neighboring sentence or can be re-written appropriately.

Reviewer #2: The tremendous need for swab test justifies the work by Daniel et.al. and this would for sure be helpful in terms of increasing the capacity to test. The manuscript is technically sound and the data support the conclusions. Although the sample number is small, the importance of work makes it acceptable.

Percentage correlation of the positive and negative test of two different swabs together with results from Cepheid Xpert Xpress ® SARS-CoV-2 assay justify the conclusions with appropriate control.

Minor revisions: The authors should describe the primers used for the amplification of CoV2 RNA with details of the amplification conditions in the method section.

The manuscript is well written and acceptable with minor reversions.

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Reviewer #1: No

Reviewer #2: Yes: Alok Choudhary

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SARS-CoV-2 detection in setting of viral swabs scarcity: are MRSA swabs and viral swabs equivalent?

PONE-D-20-14345R1

Dear Dr. Federman,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Selvakumar Subbian, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: (No Response)

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: (No Response)

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: (No Response)

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Authors have addressed all the comments.

However, due to the small sample size tested for the evaluation of MRSA swabs, it will be more appropriate if the title of manuscript changed as "Pilot study on the applicability of MRSA swabs for SARS-CoV-2 sampling in setting of viral swabs scarcity".

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Santhamani Ramasamy