PONE-D-21-08797

Risk and predictive factors for severe dengue infection: a systematic review and meta-analysis

PLOS ONE

Dear Dr. Liu,

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Mao-Shui Wang

Academic Editor

PLOS ONE

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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: Yes

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: N/A

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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

Reviewer #2: Yes

Reviewer #3: 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

Reviewer #2: Yes

Reviewer #3: Yes

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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 manuscript “Risk and predictive factors for severe dengue infection: a systematic review and meta-analysis” by Yuan et al., offers a comprehensive review and reanalysis of the data from the manuscripts published on Dengue Fever, over the last 20 years. The focus of the manuscript is detection of the factors that are correlated with SD with the idea of using those factors to be able to better predict which patients with DF will progress to develop severe form of disease. Early detection and treatment of the severe form of Dengue Fever would lead to significant reduction of mortality.

Authors searched PubMed database for specific articles using very focused search words which yielded almost 7000 manuscripts. Through a multi-step filtering process, final number of 87 manuscripts were selected for inclusion in this study.

A very significant contribution that these types of analyses, and indeed this one as well, provide is closer examination of findings from individual studies in the context of much larger pool of data. Authors have used relatively stringent parameters to exclude a number of different correlates, but also provided stronger association for a number of other ones. Overall, as it would be expected, no new factors showing correlation with the SD were found, but it is possible that a significance of some factors has been emphasized.

Overall, as such, the manuscript does have a significant contribution to the field. However, there are few changes that can be made. By far, the most obvious one seems to be factoring the timing for the correlates. In the discussion, authors correctly state that it is critically important to identify the predictive factors for SD early, but nowhere in the manuscript they discuss timing for the correlates they mention. I am not sure what data is available on this, but even the crudest grouping would be helpful (early, late). Is there anything that can be concluded about the timing of warning signs relative to the onset of symptoms?

Besides that, there are few parts of the manuscript, most notably introduction and discussion where manuscript would benefit from more clarity in the way it was written. I think that the readability would be greatly enhanced if authors would consider having a technical writer or an editor review the grammar and the style.

With all this in mind, I would recommend publishing this, especially if the above changes are made.

Reviewer #2: I would like to thank and congratulate all authors for conducting timely important systematic review and meta analysis on "Risk and predictive factors for severe dengue infection: I believe results of this study will be much important mainly in resources limiting developing counties where their health resources are stretched to its maximum due to present pandemic.

I have few minor suggestions.

1. In the discussion section authors can mention novel bio marks such as Atypical lymphocyte count has been identified as a predictor for sever dengue infection.

2. Furthermore immature platelet fraction (IPF) too can be a predictor for SD.

3. Furthermore Triple positivity for nonstructural antigen 1, immunoglobulin M and immunoglobulin G is predictive of severe thrombocytopaenia related to dengue infection.

Above mentioned points can be included in discussion section . These may help on completeness of the study and planning of future reviews.

Reviewer #3: If the statistical reviewer is fine with the overall statistical conclusions, the article would be suitable for publication

The article would benefit from further english language editing and simplifying some of the difficult to understand sentences

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Reviewer #1: No

Reviewer #2: Yes: Visula Abeysuriya

Reviewer #3: No

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Risk and predictive factors for severe dengue infection: a systematic review and meta-analysis

PONE-D-21-08797R1

Dear Dr. Liu,

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,

Mao-Shui Wang

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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 #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 #2: Yes

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

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 #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 #2: Yes

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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 #2: I would like to congratulate all authors for their commitment on compiling this very useful review. Authors have addressed all the reviewer comments comprehensively. This systematic review and meta analysis on Sever dengue and its early predictably will be benefited by all the counties which encounter dengue infection thought the world.

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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 #2: No