PONE-D-20-38031

Role of ivermectin in the prevention of COVID-19 infection among healthcare workers in India: A matched case-control study

PLOS ONE

Dear Dr. Batmanabane,

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: Partly

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: Priyamadhaba Behera et al. conducted an interesting study about the role of ivermectin in SARS-CoV-2 prophylaxis.

General comment

In the manuscript, the authors wrote "COVID-19 infection" (title included), but it is a disease. Please modify it with "SARS-CoV-2 infection".

Abbreviations should be written entirely in the first apparition in the text (e.g., COVID-19). Please, recheck the manuscript and fix it.

Some sentences are hard to follow. Some typos are present. I suggest re-reading the manuscript and fix it.

Introduction

The authors wrote, "The SARS-CoV-2 pandemic has claimed over 1,101,298 lives and affected over 39,196,259 persons worldwide". While I am writing the revision, the number of infected persons is 88,024,536, and deaths are 1,899,015. Please update these numbers, adding the date.

I believe it is important for the reader to write a sentence to present COVID-19 disease, particularly clinical presentation, describing both major (fever, cough, and dyspnea) and minor symptoms (alteration of the smell and taste, gastrointestinal symptoms, headache, and cutaneous manifestations). You could read and use these articles: https://doi.org/10.1002/hed.26269, https://doi.org/10.1002/hed.26204, https://doi.org/10.26355/eurrev_202007_22291, https://doi.org/10.1016/S1473-3099(20)30402-3, https://doi.org/10.1097/IPC.0000000000000952 https://doi.org/10.1111/eci.13427.

Methods

I believe that an important confounder is the typology of wards where HCWs were working. For example, people who work in intensive care units have an increased risk that people who work in low-intensity wards are plausible that the first are exposed to high SARS-CoV-2 viral load during some procedure (e.g., Tracheal intubation, Broncho-Alveolar Lavage). On the contrary, I do not believe that the profession has a role in infection risk. Please comment.

Furthermore, I would like to know if all participants used the same personal protective equipment, or maybe some wards used different PPE.

Besides, I would like to know if each HCW were free to choose to start a prophylactic treatment and which treatment. Another bias could be that people who decided to start a prophylactic treatment were more careful during the hospital's permanence and everyday life.

Result

Have the authors analysed if positive people who took ivermectin had a mild disease than positive people who have not taken ivermectin?

I suggest specifying that the number between brackets are odd ratios.

Tables

In all tables, the authors should add an explanation of the abbreviation used.

Table 1. It is not clear the meaning of "Whether you had COVID-19 duties in the hospital?". It is not clear if the "Duration of physical activity" is daily.

Reviewer #2: The paper entitled "Role of ivermectin in the prevention of COVID-19 infection among healthcare workers in India: A matched case-control study".The study was aimed to explore the association between ivermectin prophylaxis and development of COVID-19 infection among healthcare workers.

I suggest minor revisions in particular its important detail Table 3 because it is not clear; the conclusion have to be revised and clarify the bibliography "24".

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Reviewer #1: No

Reviewer #2: No

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Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study

PONE-D-20-38031R1

Dear Dr. Batmanabane,

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):

All queries have been answered

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: Yes

**********

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

**********

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: I have carefully re-read the revised manuscript "Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study". The authors have satisfactorily replied to the previous issues.

Reviewer #2: Dear Author ,

I read the revised manuscript and I 'm in agreement about the response to my comments

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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