The Effect of COVID-19 on Hemoglobinopathy Patients’ Daily Lives While Quarantined: Four Greek Hospitals’ Experiences

Round 1

Reviewer 1 Report

Review of article entitled: The effect of COVID 19 on hemoglobinopathies patients' daily 2 lives while quarantined: four Greek hospitals' experiences

The authors studied the impact of pandemic in thalassemic patients regarding psychological aspects as well as diet. This is a multicenter study that enrolled more than 100 patients.

Methods and results are however only briefly described, more details would be of interest.

Comparison between healthy individuals and thalassemic population regarding psychological burden during pandemic is important to be mentioned,

or even information about psychological issues – depression, anxiety etc- in thalassemic patients before pandemic (due to chronic disease, comorbidities, lifelong transfusions and chelation therapy) would provide an idea of changes in this patient group during pandemic.

Introduction:

1. References are missing
2. Please provide more details about published COVID related psychological consequences (stress, sorrow, depression, suicide, aggressiveness etc)

Methods

1. References are missing regarding FCV-19S and ACAB
2. Please provide more details about the questionnaire used, what kind of questions are exactly included?

Results

1. Line 62: clarify „other”
2. Line 64 and 66: what exactly “mood changes” and “emotions” are meant
3. Please add mean patients’ age and range of age
4. Please provide the number of affected patients, not only percentage
5. Line 71: Please explain more “communication and exercise”
6. Line 81: what kind of physical activity did the patients have? To be better understood provide information about changes before and during pandemic. Some people started having physical activity during lockdown due to lack of alternatives, other ceased previous activities, what happened with your patients exactly?
7. Table 1 is missing
8. Statistics are missing

Discussion

1. Line 103: “treat” is not right
2. Line 109: Please give reasons for blood deficiencies
3. Line 110-113: reference is missing
4. Line 116: data is not included in results session
5. Line 131-132: What about depression in your patients?
6. Line 157-158: Reasons for “not showing up” better in results session

Conclusion

1. Line 178-179: Comments about COVID clinics should be mentioned in other sessions
2. Line 180-181: New information in conclusion session, should be mentioned also in results

Reference

1. Reference 2 and 9: data missing
2. More recent references could be cited

Author Response

We appreciate your comments and/or corrections.
Due to the complexity of these patients, there are no similar research on individuals with hemoglobinopathies; consequently, no comparison can be established.

Reviewer 2 Report

Good work

It could be useful if the authors consider the chance of a control group to verify how the questionnaries work on others population groups (out patients and normal population) It could be a plus for the paper

Author Response

We appreciate your comments and/or corrections.
Due to the complexity of these patients, there are no similar research on individuals with hemoglobinopathies; consequently, no comparison can be established.

Reviewer 3 Report

In this manuscript the effects of COVID-19 on hemoglobinopathies patients' daily lives while quarantined were presented. Especially emotions experienced by patients were presented.

What is the distribution of children and adults among study group?

As known, the causes of anxiety may stem from different concerns in childhood and adulthood.

Is there a difference between the emotions experienced by women and men patients?

women think in an emotional way while men think in a rational way.

What was the positivity for COVID PCR among participants? was there covid positive cases? did covid positive cases, if any, experience additional complcations? and if so, was there a difference between positive and negative cases regarding emotions?

It would be appropriate to see the details (questions) on the questionnaire form. 

Author Response

Many thanks for your comments / corrections.
There have been additions to the text, which are marked with highlighter.
Regarding your questions about the positivity of COVID PCR among the participants, it was not possible to record the pcr because the confidentiality of the patients would be violated.

Round 2

Reviewer 3 Report

Thanks for the changes.

Almost all studies are based on the laboratory results of patients and sharing those regular laboratory results like PCR positivity (not genetic results) do not violate the rights of the participants. Thank you for your sentiment. 

Author Response

Again, thank you for your feedback.
The revisions were made in accordance with the recommendations.