Peer Review History

Original SubmissionOctober 27, 2020
Decision Letter - Raffaele Serra, Editor

PONE-D-20-33764

Clinical characteristics and laboratory features of COVID-19 in high altitude areas: A retrospective cohort study

PLOS ONE

Dear Dr. Chen,

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.

The reviewers have commented on your above paper. They have suggested that this manuscript be revised according to the reviewers suggestions and resubmitted.  Provided you address the changes recommended, the manuscript will be accepted for publication.

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We look forward to receiving your revised manuscript.

Kind regards,

Prof. Raffaele Serra, M.D., Ph.D

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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2. We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. For information on unacceptable data access restrictions, please see http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions.

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We will update your Data Availability statement on your behalf to reflect the information you provide.

Additional Editor Comments:

The reviewers have commented on your above paper. They have suggested that this manuscript be revised according to the reviewers suggestions and resubmitted.

[Note: HTML markup is below. Please do not edit.]

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

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

Reviewer #1: 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

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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: No

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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 authors describe the clinical and laboratory characteristics of COVID-19 patients in high altitude areas of Sichuan province, China. According to the results present in this manuscript, the authors do not compare the patients in high and low altitude areas and only described a cohort study. Without the information of patients positive to COVID-19 in-plane area, it is difficult to correlate the symptoms and attribute some aspects with the geographic area. The results are clear and will be contributed to the knowledge of COVID-19 disease.

The manuscript must be reviewed at the grammatical and typographical levels (example: a lack of spaces between the words)

Although some aspects of these results must be improved, I recommend that this manuscript be revised.

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Reviewer #1: No

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While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Revision 1

For Journal Requirements:

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and

https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

Response: We confirm that our manuscript meets PLOS ONE's style requirements.

2. We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. For information on unacceptable data access restrictions, please see http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions.

In your revised cover letter, please address the following prompts:

a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially identifying or sensitive patient information) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent.

b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings as either Supporting Information files or to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. Please see http://www.bmj.com/content/340/bmj.c181.long for guidelines on how to de-identify and prepare clinical data for publication. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories.

We will update your Data Availability statement on your behalf to reflect the information you provide.

Response: There are no restrictions of the data. We have uploaded the data as Supporting Information files.

3. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Response: We added the following references according to revision:

11. Breevoort A, Carosso GA, Mostajo-Radji MA. High-altitude populations need special considerations for COVID-19. Nat Commun. 2020;11(1):3280. Epub 2020/07/03. doi: 10.1038/s41467-020-17131-6. PubMed PMID: 32612128.

17. Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpatrick T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect. 2020;80(6):656-65. Epub 2020/04/14. doi: 10.1016/j.jinf.2020.03.041. PubMed PMID: 32283155; PubMed Central PMCID: PMCPMC7151416.

18. Seclén SN, Nunez-Robles E, Yovera-Aldana M, Arias-Chumpitaz A. Incidence of COVID-19 infection and prevalence of diabetes, obesity and hypertension according to altitude in Peruvian population. Diabetes Res Clin Pract. 2020;169:108463. Epub 2020/09/25. doi: 10.1016/j.diabres.2020.108463. PubMed PMID: 32971150; PubMed Central PMCID: PMCPMC7505740.

20. Qian GQ, Yang NB, Ding F, Ma AHY, Wang ZY, Shen YF, et al. Epidemiologic and clinical characteristics of 91 hospitalized patients with COVID-19 in Zhejiang, China: a retrospective, multi-centre case series. Qjm. 2020;113(7):474-81. Epub 2020/03/18. doi: 10.1093/qjmed/hcaa089. PubMed PMID: 32181807; PubMed Central PMCID: PMCPMC7184349.

We also exclude the following references according to revision:

22. Wu PF, Li RZ, Zhang W, Hu HY, Wang W, Lin Y. Polycystic ovary syndrome is causally associated with estrogen receptor-positive instead of estrogen receptor-negative breast cancer: a Mendelian randomization study. American journal of obstetrics and gynecology. May 13 2020;doi:10.1016/j.ajog.2020.05.016

We updated the following references which were from medRxiv or bioRxiv:

24. Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C, et al. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. J Transl Med. 2020;18(1):206. Epub 2020/05/22. doi: 10.1186/s12967-020-02374-0. PubMed PMID: 32434518; PubMed Central PMCID: PMCPMC7237880.

26. Huang H, Cai S, Li Y, Li Y, Fan Y, Li L, et al. Prognostic Factors for COVID-19 Pneumonia Progression to Severe Symptoms Based on Earlier Clinical Features: A Retrospective Analysis. Front Med (Lausanne). 2020;7:557453. Epub 2020/10/31. doi: 10.3389/fmed.2020.557453. PubMed PMID: 33123541; PubMed Central PMCID: PMCPMC7571455.

________________________________________

Reviewers' Comments to the Author:

Reviewer #1: The authors describe the clinical and laboratory characteristics of COVID-19 patients in high altitude areas of Sichuan province, China. According to the results present in this manuscript, the authors do not compare the patients in high and low altitude areas and only described a cohort study. Without the information of patients positive to COVID-19 in-plane area, it is difficult to correlate the symptoms and attribute some aspects with the geographic area. The results are clear and will be contributed to the knowledge of COVID-19 disease. The manuscript must be reviewed at the grammatical and typographical levels (example: a lack of spaces between the words)

Although some aspects of these results must be improved, I recommend that this manuscript be revised.

Response: First of all, thank you for bring up this important issue. We are well aware of the limitations of our study which were that we were not able to compare the characteristics of COVID-19 patients in high and low altitude areas due to the inability to access the relevant data. Nonetheless, we tried our best to precisely describe all the clinical and laboratory features of COVID-19 in high altitude areas, allowing an adequate comparison with other previously published studies conducted in low altitude areas. Also, we described the similarities and differences in the clinical features of COVID-19 between high and low altitude areas in discussion part of the manuscript in detail.

Moreover, thanks for your suggestion of language editing of the manuscript. We have tried our best to polish the language in the revised manuscript. We believe the language has been improved in the updated version.

Attachments
Attachment
Submitted filename: Response to Reviewers.docx
Decision Letter - Raffaele Serra, Editor

Clinical characteristics and laboratory features of COVID-19 in high altitude areas: A retrospective cohort study

PONE-D-20-33764R1

Dear Dr. Zhang,

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,

Prof. Raffaele Serra, M.D., Ph.D

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

amended manuscript is acceptable

Reviewers' comments:

Formally Accepted
Acceptance Letter - Raffaele Serra, Editor

PONE-D-20-33764R1

Clinical characteristics and laboratory features of COVID-19 in high altitude areas: A retrospective cohort study

Dear Dr. Zhang:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

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Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Prof. Raffaele Serra

Academic Editor

PLOS ONE

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