PONE-D-21-02914

Post COVID Syndrome among Symptomatic COVID-19 Patients: A Prospective Study in a Tertiary Care Center in Bangladesh

PLOS ONE

Dear Dr. Mahmud,

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Academic Editor

PLOS ONE

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Comments to the Author

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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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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: No

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5. Review Comments to the Author

Reviewer #1: Post COVID Syndrome among Symptomatic COVID-19 Patients: A Prospective Study

in a Tertiary Care Center in Bangladesh. This study presents a detailed description of incidence and risk factors of Post Covid sequelae. This is an interesting study, providing useful information for clinical practice.

Some points need to be clarified:

General:

The manuscript should go through a linguistic editing, as well as revision in accordance with academic writing guidelines

Abstract:

- Post COVID features are significantly higher among the female [RR, 95% CI, p 1.2, (1.02-1.48), 0.03], those who suffered for longer period (p= 0.00) and those who had prolonged positivity [RR, 95% CI, p; 1.09, (1.00-1.19), 0.00] for Covid 19. Please explain, it is not clear. The definitions seem to overlap, which is why p = 0.00

- Severity of the COVID had also positive association (p value=0.02). Please explain, it is not clear.

Main text:

- “the virus is dominating the life of every people of this universe.” please refer to our World only or add a reference about Covid people infection in other worlds.

- “To address this health problem and plan for future action.” This is very interesting but, this health problem has been already considered: in literature there are reviews about the Covid sequelae and rehabilitation of patients post-covid-19 infection. Please address this aspect in your article describing the status of art in this field. What do you mean for future action?

- Post COVID features are significantly higher among the female [RR, 95% CI, phi, p 1.2, (1.02-1.48), 0.12, 0.03], those who suffered for longer period (partial eta squared p value 0.18, 0.00), and those who had prolonged positivity [RR, 95% CI, phi, p; 1.09, (1.00-1.19), 0.11, 0.0] for COVID 19. The same as above. The definitions seem to overlap, which is why p = 0.00

- “It seems that they were the patient who required log time to recover to meet WHO criteria for recovery.” Not clear.

- “a new symptoms”. Correct this.

- “So the suffering of the COVID patients does not end with apparent clinical recovery. It also leaves long term sequels and sufferings for nearly half of the patients which also need to be addressed with proper attention.” Add a reference.

- “Mental agony related to having COVID infection might have a role.” What do you mean with mental agony?

- “More over intensive care unit patient may develop symptoms unrelated to COVID, due to post intensive care syndrome.” Which are these symptoms and how can you differentiate them from COVID symptoms, considering that covid is the cause of intensive care admission?

- “Those two study failed to identify the scenario as a whole.” Please don’t use the verb fail to.

- “COVID- 19 affected patients require long-term follow up even after recovery for observation and managing their ailments.” COVID-19 affected patients need a rehabilitation program during hospitalization and most of all at discharge. Please consider this aspect.

Reviewer #2: PONE-D-21-02914

Mahmud et al. report the prevalence of post-COVID-19 syndrome among relatively young patients in Bangladesh. Although this study was limited by single-centered design, fairly early time for evaluation, and more than 10% of loss-to-follow, it is still surprising to see a high prevalence of post-COVID-19 syndrome among young patients and its potential social impact in post-COVID-19 era. I would like to point out the following concerns:

Major comments:

1. While this study appears to be sound, the manuscript requires extensive elaboration on language to achieve clarity. In addition to the grammatical editing, the use of subheadings in the Methods and Results section will help to organize and improve the flow and readability of the manuscript.

2. For new symptom onset after the COVID-19, the data were not stratified further to determine if the symptoms were persistent following initial COVID-19, worsened after COVID-19 recovery, or occurred post-recovery. It would be valuable if the authors could delineate the prevalence more concisely.

3. The overall values of coefficient are low; thus, their interpretation is not clear. In contrast, Table 3 provides clear data, and this alone may be sufficient to report.

Minor comments:

1. In Table 3, if the purpose of the authors were to emphasize the independent risk factors for post-COVID-19 syndrome, it is more intuitive to use the mild group as a reference group fir severity.

2. What is the X axis of Figure 2? Is it the percentage of each symptoms among patients who developed the post-COVID-19 syndrome all COVID-19 patients?

3. I have trouble finding figure legends. Please include them in the revision.

4. Please edit Figure 1 as appropriate because eligible patients seem to increase from 352 to 355.

5. Please make sure to mention all the statistical methods used in the Methods section. For example, Mann-Whitney test is used in the results but does not appear in the Methods.

6. Please spell out RBS, SGPT considering the broad spectrum of the readers of this journal.

7. Please define “respiratory distress” in the Methods.

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Reviewer #1: No

Reviewer #2: No

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Post-COVID-19 syndrome among symptomatic COVID-19 patients: A prospective cohort study in a tertiary care center of Bangladesh

PONE-D-21-02914R1

Dear Dr. Mahmud,

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,

Aleksandar R. Zivkovic

Academic Editor

PLOS ONE