Review Reports

Round 1

Reviewer 1 Report

A number of 12 patients treated with Belimumab, is a very low number, as far as I know, to establish any significant conclusions,  upon the evaluation of humoral and T-cell cellular-mediated immune response after three doses of SARS-CoV-2 mRNA vaccines. 

Not very clear how were the patients controls recruited.

No enough data are displayed about the needs of the third dose of mRNA COVID-19 vaccine to restore both humoral and cellular immune response in the Belimumab treated patients. 

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

The manuscript entitled: “Humoral and T-cell mediated response after the third dose of mRNA vaccines in patients with systemic lupus erythematosus on Belimumab” by Quartuccio et al. presented a comparative study between SLE patients under Belimumab and a control group assessing B and T-cell cellular-mediated immune response after three doses of SARS-CoV-2 mRNA vaccines. The work is very interesting, and it shows very important information about SLE patients’ vaccination, but I have some questions concerning the manuscript:

 #1: I suggest that the control group data are presented in the abstract section.

 #2: The authors should specify when the Friedman test followed by Dunn’s multiple comparisons test were used in the ‘Patients and methods’ section.

 #3: Two of the three patients that had presented undetermined or absent cellular response (T1 – 2D6M) were using another immunosuppressant (MTX and TCA3). Could these therapies influence these results?

 #4: Control group results must be clearly presented (To include in table may facilitate).

#5: What the conclusion about the SLE patients results (humoral and cellular responses) when compared to control group?

 #6: In Figure 1 the different patients and times should be represented by different colors or symbols to facilitate the visualization.

 #7 Which patients developed COVID-19 infection after the third dose of the vaccine? Since the study had a few patients, I think that it is better to identify each outcome regarding each patient.

 #8 Are there differences between anti-body levels from control group and SLE patients at T1 – 2D6M time?   

#9 The authors agree that “in immunocompromised patients the third vaccine dose is not a booster dose, but it is a necessary completion of a regular vaccination cycle”. However, is this also true for health control group?

Author Response

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Author Response File: Author Response.pdf