SARS-CoV-2 Variant-Specific Gastrointestinal Symptoms of COVID-19: 2023 Update

Round 1

Reviewer 1 Report

Even is well elaborated and it follows the pattern of a study, the paper has a lack of novelty and originality. This subject is already debated in numerous studies. It holds importance in the field of research, but not practical applicability.

There is nothing controversial. 

Even if the paper is comprehensive written, the reader can be lost in details. 

The thesis does not mention what data is currently known about the subject being addressed.

There are some grammatical errors throughout the text.

Author Response

Comments and Suggestions for Authors

Even is well elaborated and it follows the pattern of a study, the paper has a lack of novelty and originality. This subject is already debated in numerous studies. It holds importance in the field of research, but not practical applicability.

There is nothing controversial. 

Even if the paper is comprehensive written, the reader can be lost in details. 

The thesis does not mention what data is currently known about the subject being addressed.

• Dear reviewer, thank you for your time to review our paper. We acknowledge that paper has some issue in conformity with your comments.
• We can also see that some of the comments are seriously critical. However, we did our best to present the state-of-the-art data on the topic.
• We can agree that there are a plenty of papers focused on the gastrointestinal involvement of COVID-19. However, no paper so far has been published, that covers the influence of different SARS-CoV-2 variants on the rate of gastrointestinal symptoms, as well as the possible explanation for this.
• We can also agree at some degree about the practical importance. However, as we stated above, we did our best to gather all the available information on the topic, thus, to be helpful theoretically, and also practically to our colleagues.
• Regarding the hypothesis and the objective of our review, we added to improve the paper, as you recommend. We would be thankful if the referee reviews our revised paper again and find the improvements satisfactory.

Comments on the Quality of English Language

There are some grammatical errors throughout the text.

• Thank you. We revised the text accordingly and also the paper was proofread by a Canadian colleague of us who is bilingual in English.

Reviewer 2 Report

I would like to first congratulate the authors for writing the review "SARS-CoV-2 variant-specific gastrointestinal symptoms of 2 COVID-19: 2023 update", which is according to me well organized and covers all the major aspects.

The review still further requires minor revisions as there are some grammatical errors and some unnecessary repetitions here and there. That gives a sensation to the reader that authors are trying just to increase the word count. Furthermore, regarding the citations I would like to suggest the authors, to include studies conducted worldwide. For example, while discussing the eye-related symptoms and involvement in COVID-19,  you can cite the study on conjunctivitis as a lone COVID-19 feature DOI: 10.1159/000521808 , and where you have described fecal calprotectin you may cite ( DOI: 10.26355/eurrev_202212_30689) an interesting study in non-covid population comparing to the covid-19 populations studies. 

Apart from this, the concept DILI should be explained in more detail with examples. 

correct the errors like line 360 " but much research needs to be done" more not much, or further....

line 495-496 need to be reformulated. 

Correct the grammatical errors

Author Response

Comments and Suggestions for Authors

I would like to first congratulate the authors for writing the review "SARS-CoV-2 variant-specific gastrointestinal symptoms of 2 COVID-19: 2023 update", which is according to me well organized and covers all the major aspects.

• Dear reviewer, thank you very much for your time to review our paper and for the overall evaluation of it as good.

The review still further requires minor revisions as there are some grammatical errors and some unnecessary repetitions here and there. That gives a sensation to the reader that authors are trying just to increase the word count.

• Thank you for the critical note. We want to assure you that our main goal was not to increased the word count but to explain our thoughts. We agree that this makes text heavy and difficult to read and follow.
•  We revised the text accordingly trying our best to make it compact and more comprehensive, and to reduce the repetitions and unnecessary passages. The paper was proofread by a Canadian colleague of us who is bilingual in English.

Furthermore, regarding the citations I would like to suggest the authors, to include studies conducted worldwide. For example, while discussing the eye-related symptoms and involvement in COVID-19,  you can cite the study on conjunctivitis as a lone COVID-19 feature DOI: 10.1159/000521808 , and where you have described fecal calprotectin you may cite ( DOI: 10.26355/eurrev_202212_30689) an interesting study in non-covid population comparing to the covid-19 populations studies.

• Thank you for the useful suggestions. We added the recommended papers and also extend the topic with more available published information.

correct the errors like line 360 " but much research needs to be done" more not much, or further....

• Thank you for noticing this mistake, we corrected it.

line 495-496 need to be reformulated.

• We agree that the sentence needed rearrangement and we revised it.

Reviewer 3 Report

Authors need to explain the mechanism associated with GI and the covid. How can it be improved or whether vaccines play any role to control those GI issues?
How does it affect the renal angiotensinogen system (RAS)?

There is so much typing and other errors have been found in the manuscript. Author needs to check thoroughly before resubmission .

1) Authors need to explain the effect on gut microbiome and the effect on the digestive system since they are explaining gastrointestinal symptoms.
2) Authors should include the detailed gastrointestinal symptoms of Covid-19 patients
I3) Including the mechanisms of gastrointestinal tract involvement in Covid 19 would be highly recommended. 

Extensive editing of English language required

Author Response

Comments and Suggestions for Authors

Authors need to explain the mechanism associated with GI and the covid. How can it be improved or whether vaccines play any role to control those GI issues?

• We agree with the referee that this is essential part of the paper and we included a detailed mechanisms of GI involvement during SARS-CoV-2 infection in section 2 (from lines 136). However, no direct link of COVID-19 vaccines efficacy is linked to GI improvement. We added this statement as the reviewer`s suggestion (line 221)

How does it affect the renal angiotensinogen system (RAS)?

• Thank you for the valuable suggestion. We haven`t thought about this problem before, and added a paragraph on the topic.

There is so much typing and other errors have been found in the manuscript. Author needs to check thoroughly before resubmission .

• Thank you for the critical note. We revised the text accordingly trying our best to make it compact and more comprehensive, and to reduce the repetitions and unnecessary passages. The paper was proofread by a Canadian colleague of us who is bilingual in English.

• Authors need to explain the effect on gut microbiome and the effect on the digestive system since they are explaining gastrointestinal symptoms.

• Thank you for the valuable suggestion, this is covered in the section 2.

• Authors should include the detailed gastrointestinal symptoms of Covid-19 patients

• Thank you very much. We supplemented the information available, including for the stool changes and GI symptoms.

I3) Including the mechanisms of gastrointestinal tract involvement in Covid 19 would be highly recommended.

• We appreciate the great suggestion. Please find the information added in section 2.

Comments on the Quality of English Language

Extensive editing of English language required

• Thank you for the critical note. We revised the text accordingly trying our best to make it compact and more comprehensive, and to reduce the repetitions and unnecessary passages. The paper was proofread by a Canadian colleague of us who is bilingual in English.

Round 2

Reviewer 3 Report

Authors needs to specify the changes with lines number. I couldnt find any of the revised comments. 

N/A

Author Response

Dear Reviewer,

We made all the corrections denoted by page/line numbers for your convenience. Please, pay attention that some of the needed information was stated at the submission, and now supplemented with the new recommendations.

Authors need to explain the mechanism associated with GI and the covid. How can it be improved or whether vaccines play any role to control those GI issues?

• We agree with the referee that this is essential part of the paper. Detailed mechanisms of GI involvement during SARS-CoV-2 infection in section 2 were included in the first submission (from lines 126 – section 2 – COVID-19, mucosal involvement and GI symptoms), and further added more information (from lines 142-148, 218-222). However, we took your suggestion in serious, and make the statement on it - no direct link of COVID-19 vaccines efficacy is linked to GI improvement. We added this statement as the reviewer`s suggestion (line 218-222)

How does it affect the renal angiotensinogen system (RAS)?

• Thank you for the valuable suggestion. We haven`t thought about this problem before, and added a paragraph on the topic (lines 142-148)

There is so much typing and other errors have been found in the manuscript. Author needs to check thoroughly before resubmission .

• Thank you for the critical note. We revised the text accordingly trying our best to make it compact and more comprehensive, and to reduce the repetitions and unnecessary passages. The paper was proofread by a Canadian colleague of us who is bilingual in English.

Authors need to explain the effect on gut microbiome and the effect on the digestive system since they are explaining gastrointestinal symptoms.

• Thank you for the valuable suggestion, this is covered from the first submission in the section 2 (lines 149-170)

Authors should include the detailed gastrointestinal symptoms of Covid-19 patients

• Thank you very much. We supplemented the information available, including for the stool changes and GI symptoms (lines 92-115; 263-269) + Figure 1, lines 542-552)

I3) Including the mechanisms of gastrointestinal tract involvement in Covid 19 would be highly recommended.

• We appreciate the great suggestion. Please find the information added in section 2, as we answered the previous comments above (from lines 142-148, 218-222).

Comments on the Quality of English Language

Extensive editing of English language required

• Thank you for the critical note. We revised the text accordingly trying our best to make it compact and more comprehensive, and to reduce the repetitions and unnecessary passages. The paper was proofread by a Canadian colleague of us who is bilingual in English.

Round 3

Reviewer 3 Report

It would have been better if the mechanisms are explained schematically as well to make the review interestion. I do not see any schematics which is always the strength of the reviews.