PONE-D-21-34752Low versus high dose anticoagulation in patients with Coronavirus 2019 pneumonia at the time of admission to critical care units: A multicenter retrospective cohort study in the Beaumont Healthcare SystemPLOS ONE

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Reviewer #1: Yes

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: Yes

Reviewer #2: Yes

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Reviewer #1: The authors conducted a study of treatment with high dose anticoagulation at the time of ICU/SDU admission which was

associated with decreased adjusted mortality among critically ill adult patients with COVID-19 infection. The major concern of this retrospective study is how to decide the dosage of anticoagulation. Since the D-dimer and fibrinogen levels were similar between the two groups, how the doctors used higher or lower dosage of anticoagulation?

Reviewer #2: At the outset,a big thank you for allowing me to review this article.It is a very interesting study and like all other studies on COVID,there are a lot of grey areas.I have some questions for the authors.

1)How many of these patients were on vasopressors,CRRT,how many required NIV support and how many were on high flow 02 ,although a mention was made about the intubated patients.Was there any correlation between these and mortality.

2)Was there any association between x ray pattern,CT severity score and D dimer levels.

3)Was a bed side 2 D echo done and if so how many of them had PAH or RV dysfunction.

4)Was there sepsis induced coagulopathy. Were procalcitonon levels done in this study ?

Possible association between development of antiphospholipid antibodies ,notably lupus anticoagulant (LAC) has been seen in many studies which may contribute to coagulopathy,was there any such observation in this study?

5) How many of these patients received steroids,remdesevir?There has been a weak association between the treatment modalities used in COVID especially more so with corticosteroids resulting in a thrombogenic state.

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Reviewer #1: Yes: HSIEH MING-HSIUNG

Reviewer #2: No

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Low versus high dose anticoagulation in patients with Coronavirus 2019 pneumonia at the time of admission to critical care units: A multicenter retrospective cohort study in the Beaumont Healthcare System

PONE-D-21-34752R1

Dear Dr. Al-Banaa,

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,

Tai-Heng Chen, M.D.

Academic Editor

PLOS ONE

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

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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

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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

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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: no more comments

The authors have good response to my previous comments and also have good answers to other reviewers' comments.

Reviewer #2: Bypass,all comments have been addressed and there are no conflicts of interests,the article is recommended for publication

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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: Ming-Hsiung Hsieh

Reviewer #2: No