PONE-D-22-15286Severe COVID-19 with persistent respiratory failure- A retrospective cohort study in a tertiary centre in Malaysia.PLOS ONE

Dear Dr. Sia,

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We suggest to focus the discussion section on the novelty of the present investigation. Results should not be repeated in the Discussion, but evidence on this topic should be cited. The reason(s) why corticosteroids may or may have not been efficaceous shoudl be better explained. 

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Reviewer #1: Partly

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: The present paper reported the retrospective study of severe COVID-19 patients who were admitted to a single tertiary centre from 1 January 2021 till 30 June 2021. Further, the study mainly focused on the persistent respiratory failure (PRF).

Among the patients who came for follow up all were in higher age group (mean 61.5+12.6). Of these patients 56.1% had hypertension followed by diabetes mellitus (47.6%), obesity (30.5%), CVD (14.4%), CKD (5.9%). The authors didn’t try to find any relation of these co-morbidities with the PRF and prolonged treatment of oral corticosteroid.

In addition, the authors have accepted in the study that they were unable to conclude that the use of oral corticosteroid maintenance has its beneficial effect in preventing the inflammatory sequelae, or if supportive care alone with oxygen support is sufficient to help in the process of patient’s recovery.

In conclusion this paper is not giving any conclusive findings for the usage corticosteroid for long term to the patients with severe COVID-19.

Reviewer #2: Very nice descriptive case series describing duration of organizing pneumonia in COVID19 survivors in a Malaysian hospital showing prolonged time to recovery, prolonged use of corticosteroids, and some TB reactivation and secondary infection.

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Reviewer #1: No

Reviewer #2: No

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Severe COVID-19 with persistent respiratory failure- A retrospective cohort study in a tertiary centre in Malaysia.

PONE-D-22-15286R1

Dear Dr. Sia,

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

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