PONE-D-20-28716

Variation in outcome of invasive mechanical ventilation between different countries for patients with severe COVID-19: a systematic review and meta-analysis

PLOS ONE

Dear Dr. Elsayed,

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 manuscript deals with quite a hot topic in everyday clinical practice. We suggest to discuss mortality rates (in respect to ventilatory strategy) of other disease states in respect to COVID disease. 

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Chiara Lazzeri

Academic Editor

PLOS ONE

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3. We noticed you have some minor occurrence of overlapping text with the following previous publications, which needs to be addressed:

- https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.15201

- https://www.atsjournals.org/doi/pdf/10.1164/rccm.202004-1385ED

- https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-020-00692-6

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Reviewers' comments:

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Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: Yes

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5. Review Comments to the Author

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Reviewer #1: This is a very important topic for which a systematic review provides information that is of vital importance for clinical work and healthcare policy.

I would suggest editing the introduction so to make it current: it should definitely be mentioned that vaccination has begun as a vaccine has been approved and more will follow. A reference to an extremely recent meta-analysis titled Case Fatality Rates for Patients with COVID-19 Requiring Invasive Mechanical Ventilation. A Meta-analysis by Zheng Jie Lim et al. as well as discussion of its implications is warranted in the introduction section; if you wish to elaborate and contrast your findings with it, you could do so in the discussion.

It would be helpful to mention mortality rates after the initiation of mechanical ventilation for other conditions treated in the ICU other than the previous coronavirus diseases (eg. sepsis, pancreatitis, bacterial pneumonia, other viral pneumonias, COPD exacerbations) in the discussion. It is important to know whether the mortality of COVID19 when treated with mechanical ventilation is similar to other diseases which may be treated similarly in the ICU.

I would also suggest doing a sensitivity analysis by including the 6 studies which included only patients with a definitive outcome. Another sensitivity analysis that could be attempted is the exclusion of studies with a small number (eg. less than 100) of patients with a definitive outcome. This may lead to a result with lower heterogeinty.

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Reviewer #1: No

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Variation in outcome of invasive mechanical ventilation between different countries for patients with severe COVID-19: a systematic review and meta-analysis

PONE-D-20-28716R1

Dear Dr. Elsayed,

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.

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Kind regards,

Chiara Lazzeri

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: