Comparison between the Viral Illness Caused by SARS-CoV-2, Influenza Virus, Respiratory Syncytial Virus and Other Respiratory Viruses in Pediatrics

Round 1

Reviewer 1 Report (Previous Reviewer 2)

Comments and Suggestions for Authors

Dear Authors of the manuscript entitled " 

Comparison between the viral illness caused by SARS-CoV-2, Influenza Virus, Respiratory Syncytial Virus and other respiratory viruses in pediatrics"

I would like to thank you for your updated version.

Good Luck

Reviewer 2 Report (Previous Reviewer 3)

Comments and Suggestions for Authors

The article improved a lot. The authors enriched the discussion and some points of the methodology. 

Add to the descriptions of the table that the numbers in brackets indicate the prevalence percentage.

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Comparisons between SARS-CoV-2, influenza virus, RSV, and other respiratory viruses in pediatrics can provide insights into their clinical characteristics, transmission patterns, severity, and outcomes. The findings of the study indicate that SARS-CoV-2 infections had a lower risk of admission, receiving respiratory support, needing antibiotic therapy, and developing complications compared to other viral RTIs. This suggests that COVID-19 in children is clinically similar to other viral RTIs but is associated with a less severe infection course. The study concludes that prevention strategies implemented for SARS-CoV-2 should still be considered during RSV and influenza epidemics. This highlights the importance of implementing preventive measures to mitigate the spread and severity of respiratory infections, including those caused by SARS-CoV-2.

 

1.      It's important to note that research on these viruses is ongoing, and new variants or strains may emerge, potentially impacting their characteristics and outcomes.

2.      Here are some key points to consider: Vaccines are available for influenza and RSV, which can help prevent infection or reduce the severity of the illness. Vaccination against COVID-19 is also being implemented worldwide. However, as of now, there is no specific antiviral treatment for COVID-19 in children, while antiviral medications are available for influenza and RSV. All these viruses primarily spread through respiratory droplets when an infected person coughs, sneezes, or talks. However, the ease of transmission and the speed at which they spread can vary. SARS-CoV-2 has shown to have a higher transmissibility compared to seasonal influenza and RSV, leading to larger outbreaks and faster community spread.

3.      To be complete, the authors should enrich the related references, such as in lines 52-55, “RSV is the leading cause of respiratory infections in infants (DOI: 10.15585/mmwr.mm7234a4). It is the second cause of death globally after malaria in children younger than one year and the first cause of death among respiratory infections. It is responsible for approximately 3 million hospitalizations and 120,000 deaths annually among children under the age of 5 years. (DOI: 10.1093/infdis/jiac137)”; in lines 61-62, “Influenza can lead to severe complications, such as pneumonia, myocarditis, and encephalitis (DOI: 10.3389/fped.2023.1249058)”; in lines 66-67, “At the end of 2019, a novel coronavirus emerged called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) (DOI: 10.1016/j.ejmech.2023.115503).”; in line 70, “Many strategies were employed to mitigate the transmission of the virus (DOI: 10.1021/acsnano.3c08323; DOI: 10.3390/nu15153443; DOI: 10.1002/jmv.29225; DOI: 10.2807/1560-7917.es.2023.28.46.2300595).”; in lines 300-304, “Various preventive strategies have proven effective in mitigating the spread of these respiratory infections and should be strongly considered during outbreaks, including vaccinations, hand hygiene, face masks, physical distancing, environmental cleaning, and disinfection (DOI: 10.3390/jcm12206465)”.

4.      There is currently very little direct data associated with the clinical effect of FDA-approved drugs against SARS-CoV-2 infection in children. More validation studies, with high-quality evidence (both in vitro and in animal models as well as on humans), are now needed. This should be mentioned and discussed in the conclusion.

Comments on the Quality of English Language

Minor editing of English language required

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

Thank you for manuscript entitled " Comparison between SARS-CoV-2, Influenza Virus, Respiratory Syncytial Virus and other respiratory viruses in pediatrics".

I have some comments that I wish that it may help to support your efforts in this work:

Minor comments.

1- in the manuscript title please identify from which prospective you are comparing, as an example " comparison between the viral illness caused by .......etc.. you mentioned in line 21 that you compare the illness.

2-  line 57-58, since you are studying the illness caused by pulmonary viral infections in italy, i do refer to add the statistics of Italy or global statistics , not the statistics of united states.

3- Line 95-96, please correct " with two or more detected viruses..." 

4- it is not mentioned which variant of SARS-CoV2 were involved in this study, since there are different variants with total different pathogensis and mortalities.

Major comment:

- When comparing the clinical outcomes of SARS-CoV2 infection compared to common and uncommon respiratory infection, I would expect to add some parameters to add some novelty to the well known disease complications, otherwise it would be a statistical study of patients hospitalization, I strongly recommend to add two or more parameters (like more clinical or lab data or measured immunological or molecular data).

This would bring more interest and novelty to your article.

Thank you and good luck.

Reviewer 3 Report

Comments and Suggestions for Authors

-What type of diagnosis was used to identify the infection of each virus? PCR? Was it the same diagnosis throughout your study, or did it change?

 

-What was the age range of the patients in your inclusion criteria?

-Various variables need to be declared in your study. For example, the cut-off points for the need for oxygen, what types of antibiotics were prescribed, and what complications there were.

-Were the same antibiotics prescribed for all types of viruses? Or were there differences between them?

-Was there temporality between virus infections in pediatric patients? Or did they all remain constant between November 2018 and April 2021?

 

Leaving patients with coinfections with viruses or bacteria would have been interesting. However, they were excluded from the study.