Long Covid stigma: Estimating burden and validating scale in a UK-based sample

Marija Pantelic; Nida Ziauddeen; Mark Boyes; Margaret E. O’Hara; Claire Hastie; Nisreen A. Alwan

doi:10.1371/journal.pone.0277317

Peer Review History

Original SubmissionJuly 6, 2022
15 Aug 2022 Decision Letter - Dong Keon Yon, Editor PONE-D-22-19124Long Covid stigma: estimating burden and validating scale in a UK-based samplePLOS ONE Dear Dr. Ziauddeen, 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 Sep 29 2022 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 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. 2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. 3. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section. Additional Editor Comments: I read it with great interest. Please address excellent comments from the reviewers. [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: Partly Reviewer #2: Yes Reviewer #3: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: I Don't Know Reviewer #2: Yes Reviewer #3: 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 Reviewer #3: No ****** 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 Reviewer #2: Yes Reviewer #3: 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 study is very relevant . My only concern in with the use of sometimes/often etc as a scale. As a scale I think you move from 'sometimes' to 'often' to 'more often', then 'always'. I therefore think the authors should use 'sometime/often' and 'more often/always' as opposed to 'sometimes/more often' and 'often/always. For the rest methods and results, I do not have adequate statistical expertise to evaluate. Reviewer #2: Manuscript has been written in an intelligible fashion and in depth statistical analysis has been performed.It presented with a good flow and very understandable manner. It is very useful study in the present context. I congratulate all authors for their heard work. Reviewer #3: Overall, an interesting read and very well written. Would like to see a bit more discussion on this limitation: university educated white women from England are over-represented. Do you have any information on the prevalence of Long Covid in the UK and who is most impacted? Men or women? Socioeconomic status? Age? Etc. I don't have a point of comparison for understanding the results. Also would the next steps be to get a more generalizable sample across SES? It may be that your results will be different with a more diverse sample. An interesting future article would be to look at how stigma differs by gender, SES, age, etc. ****** 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 Reviewer #2: No Reviewer #3: 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/. 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Revision 1
27 Sep 2022 Author Response 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. Thank you, we have formatted the manuscript in line with PLOS ONE’s style requirements. 2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. Written consent was recorded digitally on the survey platforms (details in lines 93-95). The survey was restricted to adults aged 18 years and over (line 84). 3. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section. This study received no specific funding as stated in the funding information and financial disclosure sections. The funding information in the manuscript has been updated so the sections match. Additional Editor Comments: I read it with great interest. Please address excellent comments from the reviewers. Thank you. 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 study is very relevant . My only concern in with the use of sometimes/often etc as a scale. As a scale I think you move from 'sometimes' to 'often' to 'more often', then 'always'. I therefore think the authors should use 'sometime/often' and 'more often/always' as opposed to 'sometimes/more often' and 'often/always. The possible responses to the scale were never, rarely, sometimes, often, and always. We created two condensed categories: 1) those who responded sometimes/often/always to reflect the proportion of those experiencing stigma at least sometimes (referred to as ‘sometimes or more often’ in the tables) and 2) a more conservative estimate of those who responded often/always to reflect the proportion of those experiencing some stigma more frequently (‘referred to often and always’ in the tables). For the avoidance of confusion, we have now updated any reference to the former to ‘at least sometimes’ throughout the manuscript and have kept the description of the latter to ‘often or always’ For the rest methods and results, I do not have adequate statistical expertise to evaluate. Reviewer #2: Manuscript has been written in an intelligible fashion and in depth statistical analysis has been performed. It presented with a good flow and very understandable manner. It is very useful study in the present context. I congratulate all authors for their heard work. Thank you. Reviewer #3: Overall, an interesting read and very well written. Would like to see a bit more discussion on this limitation: university educated white women from England are over-represented. Do you have any information on the prevalence of Long Covid in the UK and who is most impacted? Men or women? Socioeconomic status? Age? Etc. I don't have a point of comparison for understanding the results. Also would the next steps be to get a more generalizable sample across SES? It may be that your results will be different with a more diverse sample. An interesting future article would be to look at how stigma differs by gender, SES, age, etc. Thank you, we have added more information in the discussion section on prevalence rates in lines (218-222). In the UK, prevalence of Long Covid in higher in women and in adults aged 35-69 years and in more deprived communities. We agree with the reviewer’s suggestions about future research directions on this topic and have added this to the discussion (lines 262-264). We thank the reviewer for suggesting these thoughtful discussion points. Attachments Attachment Submitted filename: Response-DataAvailability.docx https://doi.org/10.1371/journal.pone.0277317.r002
25 Oct 2022 Decision Letter - Dong Keon Yon, Editor Long Covid stigma: estimating burden and validating scale in a UK-based sample PONE-D-22-19124R1 Dear Dr. Ziauddeen, 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, Dong Keon Yon, MD, FACAAI Academic Editor PLOS ONE Additional Editor Comments (optional): This is an excellent paper. 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 Reviewer #3: 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 #2: Yes Reviewer #3: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: Yes Reviewer #3: 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 Reviewer #3: No ****** 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 Reviewer #3: 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 #2: I thank all author for their wounder full work. Authors have address all the review comments and re arrange the manuscript. It is a very interesting study. Reviewer #3: (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 #2: No Reviewer #3: No ******** https://doi.org/10.1371/journal.pone.0277317.r003

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