Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis

Jorge Luis Vélez-Páez; Pedro Legua; Pablo Vélez-Páez; Estefanía Irigoyen; Henry Andrade; Andrea Jara; Fernanda López; Jorge Pérez-Galarza; Lucy Baldeón

doi:10.1371/journal.pone.0262356

Peer Review History

Original SubmissionMarch 3, 2021
22 Jun 2021 Decision Letter - Andrea Ballotta, Editor PONE-D-21-06833 Mean Platelet Volume and Mean Platelet Volume to Platelet Count Ratio as Predictors of Severity and Mortality in Sepsis PLOS ONE Dear Dr. Baldeón, 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. Please submit your revised manuscript by Aug 06 2021 11:59PM. 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. 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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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: I Don't Know ****** 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 ****** 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 ****** 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 aim of the authors is to assess the value of MPV and MPV to platelet count ratio as predictors of severity and mortality in patients affected by sepsis. This has been previously done in various series of patients and clinical settings, and in sepsis in particular. Nevertheless, the manuscript may be of clinical interest if properly revised in order to highlight potential points of interest. In particular, I would to raise some major issues concerning the content of the manuscript: - the authors consider sepsis as all the same event, without giving detail whether it is of bacteric vs. viral origin, nor describe in detail the infective agents. A stratification of patients based on the nature of the infection and assessment of potential difference in influencing MPV and MPV to platelet count ratio may increase the value of the works. - the authors consider only the first 3 days for MPV monitoring (as the most published reports do). Extending the period of observation to the whole period of the hospitalization of the patients, assessing the dynamics and tracing the trajectory of MPV may also be very useful in understanding this condition and constitute the very point of novelty of the works. - grammar and syntaxis must be thoroughly revised: MPV is often reported as VMP, numbers are reported with 1 to 3 decimals, number are given with "." or "," . ****** 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: 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. 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Revision 1
4 Aug 2021 Author Response Review Comments to the Author Reviewer #1: The aim of the authors is to assess the value of MPV and MPV to platelet count ratio as predictors of severity and mortality in patients affected by sepsis. This has been previously done in various series of patients and clinical settings, and in sepsis in particular. Nevertheless, the manuscript may be of clinical interest if properly revised in order to highlight potential points of interest. Response: Dear reviewer thank you for your comment and for allowing us to review the manuscript. We agree with you, some studies evaluate the behavior of the mean platelet volume in several clinical scenarios and sepsis in particular. However, this study concerns interest, since it was carried out in Quito, a high-altitude city (2850 MASL), where the hypobaric hypoxia increases platelet reactivity. This could induce a prothrombotic phenotype determining an unusual behavior of the platelet indices. (Rocke AS, Paterson GG, Barber MT, Jackson AIR, Main S, Stannett C, et al. Thromboelastometry and platelet function during acclimatization to high altitudes. Thrombi Haemost. 2018; 118 (1): 63–71). In particular, I would to raise some major issues concerning the content of the manuscript: - the authors consider sepsis as all the same event, without giving detail whether it is of bacteric vs. viral origin, nor describe in detail the infective agents. A stratification of patients based on the nature of the infection and assessment of potential difference in influencing MPV and MPV to platelet count ratio may increase the value of the works. Response: The study was carried out only in patients with sepsis of bacterial etiology, with diverse infectious foci such as pulmonary, abdominal, urinary, and others; the site of infection was not associated with mortality in the bivariate statistical analysis, so we did not perform subgroup analysis. This was stated and clarified in the manuscript (lines 82, 120-127). Unfortunately, we did not have access to the data to describe in detail the infective agents; this is a limitation of our study. - the authors consider only the first 3 days for MPV monitoring (as the most published reports do). Extending the period of observation to the whole period of the hospitalization of the patients, assessing the dynamics, and tracing the trajectory of MPV may also be very useful in understanding this condition and constitute the very point of novelty of the works. Response: The kinetics of MPV in sepsis parallels the response to the antibiotic treatment administered; that is, it tends to decrease in patients in whom the systemic infection has been controlled and this is observed between 48 to 72 hours of management. For this reason, follow-up during the initial 72 hours is important (lines 249-252). Most studies on this subject, like ours, measure the MPV in the first hours after admission. However, we agree with you, few studies followed up to 15 days after the patients were discharged from intensive care and evaluated 90-day mortality. For example, Vardon Bounes F, Gratacap MP, Groyer S, et al. Kinetics of mean platelet volume predicts mortality in patients with septic shock. PLoS One. 2019; 14 (10): e0223553. Published 2019 Oct 17. doi: 10.1371 / journal.pone.0223553; that found that patients with MPV > 11.6 fL at day 10 of follow-up did not survive (HR: 3.79). This highlights the usefulness of this biomarker both in the critical unit and in hospitalization to determine the prediction of important outcomes such as mortality and prompts us to carry out longer follow-up in subsequent studies. We include this important observation in the manuscript (lines 299-302). - grammar and syntaxis must be thoroughly revised: MPV is often reported as VMP, numbers are reported with 1 to 3 decimals, the number is given with "." or ",". Response: We checked the grammar and syntaxis, the abbreviations are maintained as MPV, numbers reported with 2 decimals, and number are given with "," in all the manuscript. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0262356.r002
22 Dec 2021 Decision Letter - Andrea Ballotta, Editor Mean Platelet Volume and Mean Platelet Volume to Platelet Count Ratio as Predictors of severity and mortality in Sepsis PONE-D-21-06833R1 Dear Dr. Baldeón, 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, Andrea Ballotta Academic Editor PLOS ONE Additional Editor Comments (optional): The manuscript is ready for publication 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: I Don't Know ****** 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: No further comments from my side. My comments have been addressed thoroughly and extensively. I thank the authors for the consideration they gave to my observations. ****** 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 https://doi.org/10.1371/journal.pone.0262356.r003
Formally Accepted
28 Dec 2021 Acceptance Letter - Andrea Ballotta, Editor PONE-D-21-06833R1 Mean Platelet Volume and Mean Platelet Volume to Platelet Count Ratio as predictors of severity and mortality in Sepsis Dear Dr. Baldeón: 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. Andrea Ballotta Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0262356.r004

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