The impact of the SARS-COV2 infection on the disorder of consciousness rehabilitation unit

Silvia Marino; Rosella Ciurleo; Antonino Todaro; Antonella Alagna; Anna Lisa Logiudice; Francesco Corallo; Caterina Formica; Carmela Rifici; Patrizia Pollicino; Fabrizia Caminiti; Elisabetta Morini; Placido Bramanti

doi:10.1371/journal.pone.0253958

Peer Review History

Original SubmissionAugust 26, 2020
25 Sep 2020 Decision Letter - Muhammad Adrish, Editor PONE-D-20-26757 The impact of the SARS-COV2 infection on the Disorder of Consciousness Rehabilitation Unit PLOS ONE Dear Dr. Ciurleo, 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. ============================== ACADEMIC EDITOR: Please see comments by the reviewers below. In your revised manuscript, kindly provide point by point response to their queries. I look forward to reviewing your revised manuscript ============================== Please submit your revised manuscript by due date. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Muhammad Adrish Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional 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 [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 Reviewer #2: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: I Don't Know Reviewer #2: Yes ****** 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 ****** 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 Reviewer #2: No ****** 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 thank the authors for their challenging work. However, the paper needs lexical review, for example the choice of the words “ cardiopathic “ in page 5, “ always “ in page 6 and “ typology “ in page 8 is less familiar as the usual scientific lexicon. Reviewer #2: - Overall, the research question is interesting however, major comments should be addressed and clarified. - The readability and syntax of the manuscript will be substantially improved if it is reviewed by a formal translation agency or by a colleague whose first language is English. Abstract: - Short background on the DOC. - Define VS and MCS. - The design of the study should be described in the methods. - The criteria of the subjects should be demonstrated e.g. age, genders. - Did the author make two classifications in this study? VS and MCS, then severe and non-severe. Please, clarify - Methods need more information. - The size is very small to provide a conclusion. - Change 16/18 to 16 and 2/18 to 2. - Important differential results with p-values should be demonstrated. - The conclusion should more concise to be related to the objective of the study. Introduction: - The introduction needs to be analyzed and rewritten. - More information should be clarified about the DOC and its relation to SARS-CoV-2. - The objective of the study is very important however the importance of the study still need more clarification in the introduction section. - What was the hypothesis of the study. Methods: - What is the design of the study? - What were the inclusion and exclusion of the study to select the participants? - Did the author calculate the sample size and power of the study? - Methods section is very poor and needs more information and description. - Statistical analysis: What is the statistical method used to assess the normal distribution of the collected data. "The significance threshold" is inadequate expression. Please, change it to "the level of significance". Results: - Results need to provide answers to the questions raised/researchable problem. - Results need to follow accuracy, brevity, and clarity. - Kindly frame it along the following elements of results. Discussions: - The introductory paragraph should demonstrate the main findings of the study. - The findings should be compared with previous or related studies. - Implications of the study should be explained. - The main limitation of the study design was not demonstrated. - Briefly, the discussion section need major revisions. ****** 6. 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: Yes: MM Reviewer #2: Yes:** Walid Kamal Abdelbasset [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] 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. https://doi.org/10.1371/journal.pone.0253958.r001
Revision 1
4 Mar 2021 Author Response Reviewer #1: We thank the reviewer for the kind and appreciative words. We revised the paper, as suggested. Reviewer #2: We thank the reviewer for the time spent to revise the manuscript. We revised the paper, as suggested. 1) We improved English language English. 2) Abstract: - We performed a short background on the DOC. - We defined VS and MCS. - We described the design of the study in the methods. - We demonstrated the criteria of the subjects. - We clarified the two classifications: VS and MCS, then severe and non-severe. -We improved “Methods section”. - Unfortunately, the sample population cannot be expanded, but 18 DOC patients, affected by SARS-COV2, are a considerable number and never reported in the literature. - We changed Change 16/18 to 16 and 2/18 to 2. - We reported the most important differential results with p-values. - We revised the conclusion, as suggested. 3) Introduction: - We revised the introduction, as suggested. - No data, to date, were reported about DOC and relation to SARS-CoV-2: this is the first study. In addition this is a retrospective, longitudinal, observational study, that showed the impact, in a descriptive way, of a sudden SARS-COV2 infection. No power analysis was performed, because all patients of DOC Unit, were consecutively enrolled. - We revised the report of objective of the in the introduction section. - We better explained the hypothesis of the study. 4) Methods: - Design of the study: this is a retrospective, longitudinal, descriptive, observational study. It was reported. - We included in the study all patients admitted to our DOC rehabilitative unit, at the time the SARS-COV2 outbreak broke out. For this reason, no particular inclusion and/or exclusion were applied. - The response is very similar to the previous point: we included in the study all patients admitted to our DOC rehabilitative unit, at the time the SARS-COV2 outbreak broke out. For this reason, no sample size and power of the study were calculated. - We better described “methods section”. - We better described “statistical analysis section”. 5) Results: - We better described “results section”. 6) Discussions: - We revised the introductory paragraph, as suggested. - To date, no data about SARS-COV2 and DOC, were reported. - We explained implications of the study. - We better explained limitation of the study design. https://doi.org/10.1371/journal.pone.0253958.r002
30 Mar 2021 Decision Letter - Muhammad Adrish, Editor PONE-D-20-26757R1 The impact of the SARS-COV2 infection on the Disorder of Consciousness Rehabilitation Unit PLOS ONE Dear Dr. Ciurleo, 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. ============================== ACADEMIC EDITOR: I have received the comments of the reviewers on your manuscript. The specific comments of the reviewers are included below. Please provide point by point response in your revised manuscript. ============================== Please submit your revised manuscript by April 30th, 2021. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Muhammad Adrish, MD, MBA, FCCP, FCCM 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. [Note: HTML markup is below. Please do not edit.] 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: (No Response) ******** 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: Partly ****** 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 ****** 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: Thank you for this longitudinal small-scale study. I would like the inclusion of the following in the retrospective paper: the steroid regimen use and dose regimen in the 18 patients, the body mass index for the 18 patient as it has been proven that an increased BMI contributes to increased mortality related to COVI-19 chest infection, and finally the inclusion of the metabolic profile including glycemic state control, electrolytes and BP control as all these could contribute to the encephalopathy cycle state of the patients. Reviewer #2: Appreciating the authors for address the required corrections. However, some minor corrections should be addressed: - I suggest authors add "pilot" to the design of the study in accordance with the small sample size. - The methods section should be re-framed and re-arranged as the following: a. Study design, setting b. Participants c. Intervention/issue of interest (exposure) d. Comparison e. Ethics and endpoint f. Statistical analysis - Clarify what the statistical method used to assess the data normality. - Cite the Statistical Software used in data analysis. ****** 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: Yes: MM Reviewer #2: Yes:** Walid Kamal Abdelbasset [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] 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. https://doi.org/10.1371/journal.pone.0253958.r003
Revision 2
22 Apr 2021 Author Response Dear Editor, detailed responses to the reviewers’ questions appear below: Reviewer #1: We thank the reviewer for the kind and appreciative words. We revised the paper, as suggested. - we included steroid regimen use; - we included BMI; - we included metabolic profile. Reviewer #2: We thank the reviewer for the time spent to revise the manuscript. We revised the paper, as suggested. Statistical section, already reports what was requested by the reviewer: - statistical method used: "Mean and standard deviations (SD) were used for normally distributed data and median and range for data that were not normally distributed. Continuous variables were compared by using Wilcoxon rank sum test. Proportions for categorical variables were compared using χ2 test. Because of the small sample size, ordinal, interval and ratio measures are presented as median and range"; - statistical software used: "All statistical analyses were performed using R (version 3.3)". We thank you again for your consideration of our work and look forward to hearing from you in due course. Sincerely, Rosella Ciurleo PharmD, PhD IRCCS Centro Neurolesi “Bonino-Pulejo” S.S. 113, Via Palermo, C.da Casazza 98124 Messina, Italy Phone: + 39-090-60128109 Fax: + 39-090-60128850 e-mail: rossella.ciurleo@irccsme.it Attachments Attachment Submitted filename: Response to reviewers.doc https://doi.org/10.1371/journal.pone.0253958.r004
11 May 2021 Decision Letter - Muhammad Adrish, Editor PONE-D-20-26757R2 The impact of the SARS-COV2 infection on the Disorder of Consciousness Rehabilitation Unit PLOS ONE Dear Dr. Ciuerlo, 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. ============================== ACADEMIC EDITOR: Please review the edit suggested by the reviewer prior to acceptance. ============================== Please submit your revised manuscript by June 10th, 2021. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Muhammad Adrish, MD, MBA, FCCP, FCCM 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. [Note: HTML markup is below. Please do not edit.] 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 ******** 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 ****** 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 ****** 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: No 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 thank the authors for considering the review feedback. Kindly revise the grammatical context for there are subtle subject-verb agreement errors such as “ The male patient did not presented fever, had normal white blood cell counts and he did not showed typical lung CT findings for COVID-19 infection “ Reviewer #2: (No Response) ****** 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: Yes:** MM Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] 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. https://doi.org/10.1371/journal.pone.0253958.r005
Revision 3
23 May 2021 Author Response We regret there were problems with the English. The paper has been carefully revised to improve the grammar and readability. We have highlighted the changes in yellow. The words or sentences deleted are in red. https://doi.org/10.1371/journal.pone.0253958.r006
1 Jun 2021 Decision Letter - Muhammad Adrish, Editor PONE-D-20-26757R3 The impact of the SARS-COV2 infection on the Disorder of Consciousness Rehabilitation Unit PLOS ONE Dear Dr. Ciurleo, 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. ============================== ACADEMIC EDITOR: Please provide necessary changes as suggested below ============================== Please submit your revised manuscript by June 30th, 2021. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Muhammad Adrish, MD, MBA, FCCP, FCCM 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. Additional Editor Comments (if provided): I thank the authors for considering the review feedback. Kindly revise the grammatical context for there are subtle subject-verb agreement errors such as “ The male patient did not presented fever, had normal white blood cell counts and he did not showed typical lung CT findings for COVID-19 infection “ [Note: HTML markup is below. Please do not edit.] Reviewers' comments: I thank the authors for considering the review feedback. Kindly revise the grammatical context for there are subtle subject-verb agreement errors such as “ The male patient did not presented fever, had normal white blood cell counts and he did not showed typical lung CT findings for COVID-19 infection “ [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] 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. https://doi.org/10.1371/journal.pone.0253958.r007
Revision 4
5 Jun 2021 Author Response Reviewer: We thank the reviewer for the kind and appreciative words. We revised the paper, as suggested. - we revised grammatical context as required. https://doi.org/10.1371/journal.pone.0253958.r008
17 Jun 2021 Decision Letter - Muhammad Adrish, Editor The impact of the SARS-COV2 infection on the Disorder of Consciousness Rehabilitation Unit PONE-D-20-26757R4 Dear Dr. Ciurleo, 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. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. 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. Kind regards, Muhammad Adrish, MD, MBA, FCCP, FCCM Academic Editor PLOS ONE Additional Editor Comments (optional): All comments have been addressed. 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 ******** 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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: 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 ****** 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 ****** 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 thank the authors for their vigorous efforts both in manuscript preparation and abiding by the reviewers’ recommendations ****** 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: Yes:** MM https://doi.org/10.1371/journal.pone.0253958.r009
Formally Accepted
21 Jun 2021 Acceptance Letter - Muhammad Adrish, Editor PONE-D-20-26757R4 The impact of the SARS-COV2 infection on the Disorder of Consciousness Rehabilitation Unit Dear Dr. Ciurleo: 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. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Muhammad Adrish Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0253958.r010

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .