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PONE-D-20-22853

Physiological and Socioeconomic Characteristics Predict COVID-19 Mortality and Resource Utilization in Brazil

PLOS ONE

Dear Dr. Paschalidis,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Muhammad Adrish

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: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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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: I read with great interest this manuscript

I find it well wrote and wiht high research quality from a country that need also scientific attention

Only some suggestions:

1. Introduction: update data of COVID cases in Brazil at revision's day

2. Methods and results: very well wrote

3.Discussion: discuss better the role of cardiovascolar risk factor on outcome (see and cite https://doi.org/10.1016/j.numecd.2020.07.031) and future perspective from your data (see and cite doi:10.3390/ijerph17082690)

Conclusion: They are coherent with the manuscript

I appreciate your manuscript and find tables and statistical analisys very well done

Reviewer #2: The manuscript entitled “Physiological and Socioeconomic Characteristics Predict COVID-19 Mortality and Resource Utilization in Brazil” by Wollenstein-Betech et al, performed statistical analysis on publicly available data of 113,214 patients, including 50,387 deceased. Authors built 5 different classifiers, LR, sparse version of LR, SVM, RF and XGBoost to predict mortality and the need for mechanical ventilators for a COVID-19 patient using demographics, comorbidities, symptoms, and some clinical information. They construct SVM and LR classifiers and compare their performance with RF and XGBoost and found that LR and SVM achieve comparable performance. The manuscript is well designed and provides lots of useful information. However, the result section needs improvement.

The study shows that the death from COVID-19 was strongly associated with demographics, socioeconomic factors, and comorbidities. It is well known that mortality in the case of COVID-19 condition is strongly associated with comorbidities. The new information provided by this study is its association with demographics and the socioeconomic factors. However, authors have not put the details in the result section or discussion. The result section can be strengthen. Lots of data have been provided in the tables/ figures which are not mentioned in the result section. For better understanding of the manuscript by the readers, authors need to include these data in the result section.

Although mentioned in the tables and figures, authors need to discuss more about the educational level and access to private hospital in the discussion section. Ultimate aim of the manuscript is to predict mortality and the need for mechanical ventilators for a COVID-19 patient using demographics, comorbidities, symptoms, and some clinical information. Authors should provide their suggestions about “how these parameters can be used by the healthcare professionals”.

One of the major cause for the mortality could be longer access to the healthcare and late reporting of the case. Can authors provide any data (if possible) and mention it in the result/ discussion section.

Table 1: Why in the demographics section schooling and region are not equating to 100%

Line 214: check the sentence

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Reviewer #1: Yes: Francesco Di Gennaro

Reviewer #2: No

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Physiological and Socioeconomic Characteristics Predict COVID-19 Mortality and Resource Utilization in Brazil

PONE-D-20-22853R1

Dear Dr. Paschalidis,

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,

Muhammad Adrish

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: All comments have been addressed

Reviewer #2: All comments have been addressed

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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: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: I Don't Know

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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: Yes

Reviewer #2: Yes

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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: Yes

Reviewer #2: Yes

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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 improve their manuscript and I find it well done

Tha article, in my opinion, now can be pubblish

Reviewer #2: All the queries raised are satisfactorily answered by the authors. The manuscript may be considered for publication.

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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: No

Reviewer #2: No