Round 1

Reviewer 1 Report

Journal of Applied Sciences (ISSN 2076-3417)

Section Applied Biosciences and Bioengineering

Special Issue Effect of COVID-19 on Public Health

Review „Asthma control during COVID-19 lockdown in patients with severe asthma under biological drug treatment“.  

Thank you for the chance to review the study mentioned above.

In their work, Pelaia and co-workers surveyed severe asthmatic patients, in therapy with one of three different biologics (Omalizumab, Mepolizumab, Benralizumab) in order to evaluate the effects of COVID 19 on the management of their clinical condition due to the difficulties to access to health facilities during the pandemic period.

In their prospective observational study, 28 severe asthmatic patients were asked to respond to a telephonic survey, which enclosed the evaluation of demographic and clinical data, as well as the number of lung function tests performed, exacerbations, biologic doses administered at hospital, at the general practitioner office or self-administered and the adherence to the therapy at baseline and during the pandemic.

They conclude, that severe asthma did not favour COVID-19 infection and the absence of any significant difference related to asthma control advocates the continuation of biologics administration, even under contingencies of difficult access to health facilities.

Although I doubt, that a population of 28 patients will favour external validity, here are my comments.

Introduction:

Line 57: “long-acting 2-adrenergic agonists (LABA)“ „Beta“ seems to be missing.

Materials and methods:

Line 89: “The institutional ethics committee approved the study protocol, and written informed consent was obtained from all patients for their participation.” Please provide the study number. Was the study also published in an international or national trial registration data base?

Results:

Line 120: “14 patients were normal weight” – do not start with numbers, reconfigure sentence or use “fourteen” instead.

Line 132: “Comparing the pre-pandemic with the pandemic period, the mean ACT value displayed a not significant increase from 21.5 ±2.8to 23.0±3.9(p = 0.1).”  There seem to be some problems with the syntax – please check.

Also in the following paragraph there seem to be problems with blanks – please check the pdf/ original manuscript.

Discussion 165 ff:

“Even if we have not data regarding this point the lockdown policy did not have any impact on the overall asthma control.” This sentence is mistakable – what are you trying to say?

In conclusion, I am not sure about the scientific contribution since the study population is really very small.

Author Response

Dear Editor,

We would like to thank very much the Reviewers for having carefully reviewed our manuscript, thus suggesting those changes which have significantly improved its overall quality. We have prepared a revised version of this paper, taking into account the comments of the reviewers. We also include a point-by-point response to the criticisms raised by the Referees. Therefore, we hope that our manuscript is now suitable for publication in Applied Sciences. Furthermore, because the third reviewer suggests to convert the paper format into a “Brief report”, we remit to your attention this eventual choice.

REVIEWER 1

Introduction:

Line 57: “long-acting 2-adrenergic agonists (LABA)“ „Beta“ seems to be missing.

The word “beta” was added in the revised text.

Materials and methods:

Line 89: “The institutional ethics committee approved the study protocol, and written informed consent was obtained from all patients for their participation.” Please provide the study number. Was the study also published in an international or national trial registration data base?

This information has been provided in the revised manuscript. Our trial was not published in an international or national trial registration database.

Results:

Line 120: “14 patients were normal weight” – do not start with numbers, reconfigure sentence or use “fourteen” instead.

This sentence has been reconfigured in the revised text.

Line 132: “Comparing the pre-pandemic with the pandemic period, the mean ACT value displayed a not significant increase from 21.5 ±2.8to 23.0±3.9(p = 0.1).”  There seem to be some problems with the syntax – please check.

This sentence has been rephrased in the revised text.

Also in the following paragraph there seem to be problems with blanks – please check the pdf/ original manuscript.

Problems with blanks have been fixed in the revised manuscript.

Discussion 165 ff:

“Even if we have not data regarding this point the lockdown policy did not have any impact on the overall asthma control.” This sentence is mistakable – what are you trying to say?

This sentence has been rephrased in the revised text, thus becoming much more understandable.

In conclusion, I am not sure about the scientific contribution since the study population is really very small.

This limitation has been mentioned in the discussion.

Reviewer 2 Report

This is an observational study on a small number of participants, on a matter of asthma control during the lockdown. The largest limitation of this study is this small number of participants, but also some data is missing. Furthermore, English language and scientific style must be improved. Here are some other suggestions for the authors:

1. use STROBE guidelines for your manuscript
2. abstract - add a setting, study period, and numbers in the results, also font seems different across the abstract
3. there are spaces missing before the brackets
4. start the introduction with asthma and then write about COVID. Further, add more references in the introduction
5. it is not usual to start a sentence with a number (line 120)
6. discussion must be expanded, including limitation section

Author Response

Dear Editor,

We would like to thank very much the Reviewers for having carefully reviewed our manuscript, thus suggesting those changes which have significantly improved its overall quality. We have prepared a revised version of this paper, taking into account the comments of the reviewers. We also include a point-by-point response to the criticisms raised by the Referees. Therefore, we hope that our manuscript is now suitable for publication in Applied Sciences. Furthermore, because the third reviewer suggests to convert the paper format into a “Brief report”, we remit to your attention this eventual choice.

REVIEWER 2

This is an observational study on a small number of participants, on a matter of asthma control during the lockdown. The largest limitation of this study is this small number of participants, but also some data is missing. Furthermore, English language and scientific style must be improved.

In the revised manuscript, English language and scientific style have been improved throughout the paper.

Here are some other suggestions for the authors:

1. use STROBE guidelines for your manuscript

STROBE guidelines have been implemented.

2. abstract - add a setting, study period, and numbers in the results, also font seems different across the abstract

These changes have been made in the revised manuscript.

3. there are spaces missing before the brackets

These spaces have been included in the revised text.

4. start the introduction with asthma and then write about COVID. Further, add more references in the introduction

These changes have been made in the revised text.

5. it is not usual to start a sentence with a number (line 120)

This sentence has been rephrased in the revised text.

6. discussion must be expanded, including limitation section

These changes have been made in the revised text.

Reviewer 3 Report

With interest, I read the brief report applsci-1468211.

The study group is small but, especially considering the prospecttive design of this investigation, it can give a hint.

Comments (no special order)

1. Is this manuscript classified as a brief report? I would suggest so. The data are very interesting but compact.

2. Lines 58-60. Please, refer also to PMID: 33926084.

3. Please, attach the telephonic survey form as a supplement.

4. Lines 119-120. Half of your study pariticipants were overweight/obese. Has this any efefct on the results? Please, mention in the reslults and address, at least shortly in the discussion (PMID: 30057383).

Other comment

1. Line 57. I guess "beta“ is missing.

Author Response

Dear Editor,

We would like to thank very much the Reviewers for having carefully reviewed our manuscript, thus suggesting those changes which have significantly improved its overall quality. We have prepared a revised version of this paper, taking into account the comments of the reviewers. We also include a point-by-point response to the criticisms raised by the Referees. Therefore, we hope that our manuscript is now suitable for publication in Applied Sciences. Furthermore, because the third reviewer suggests to convert the paper format into a “Brief report”, we remit to your attention this eventual choice.

With interest, I read the brief report applsci-1468211. The study group is small but, especially considering the prospective design of this investigation, it can give a hint.

Comments (no special order)

1. Is this manuscript classified as a brief report? I would suggest so. The data are very interesting but compact.

In regard to this suggestion, we remitted to the Editor the decision of changing the manuscript format.

2. Lines 58-60. Please, refer also to PMID: 33926084.

This reference has been included in the revised text.

3. Please, attach the telephonic survey form as a supplement.

The telephonic survey has been attached as a supplement.

4. Lines 119-120. Half of your study participants were overweight/obese. Has this any effect on the results? Please, mention in the results and address, at least shortly in the discussion (PMID: 30057383).

As suggested, this concept has been included within the revised sections referring to results and discussion, and the above reference has been added.

Other comment

1. Line 57. I guess "beta“ is missing.

The word “beta” was added in the revised text.

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Good luck

Reviewer 2 Report

The authors have improved their manuscript. Therefore, i believe IT is now ready for publicistkinja.