The Outcomes of COVID-19 Patients with Spontaneous Intracerebral Hemorrhage Comorbidity and the Efficacy of Enoxaparin in Decreasing the Mortality Rate in Them: Single Egyptian Center Report
, Alzhraa M. Fahmy 4, Doaa Mahmoud Khalil 5, Ahmed O. El-Gendy 6, Tamer M. Mahmoud 7 and Mohamed E. A. Abdelrahim 8Round 1
Reviewer 1 Report
Dear Authors,
Congratulations on your paper, but some changes are required.
- Extensive editing of the English language and style is required.
- Line 88 „than18". Line 92 „COVID-19by"
- Your study contains some interesting data, but there are some points that are not clear and should be improved.
- In the first section, you describe the study population. A table of patient characteristics would help to get a better overview of the patient population.
- Please provide some images of the cases' CT scans. Also, you should detail one or two cases.
- The tables can be optimized as a design.
- A comparison between your cases and resembling cases from the literature is needed (you should make a table to be easy to read).
Author Response
- Extensive editing of the English language and style is required.
Author: I have corrected the grammatical errors in the manuscript by (grammarly) program, Thank you very much.
- Line 88 „than18". Line 92 „COVID-19by"
Author: Done, thank you
- Your study contains some interesting data, but there are some points that are not clear and should be improved.
Author: improved as much as possible, thank you
- In the first section, you describe the study population. A table of patient characteristics would help to get a better overview of the patient population.
Author: The study population was shown in table 1 which titled the characteristics of the studied patients, thank you
- Please provide some images of the cases' CT scans. Also, you should detail one or two cases.
- The tables can be optimized as a design.
Author: improved as much as possible, thank you
- A comparison between your cases and resembling cases from the literature is needed (you should make a table to be easy to read).
Author: we compared our cases findings with other studies in discussion, thank you
Reviewer 2 Report
This center report shows different outcomes, based on CT findings and clinical courses, in a population with spontaneous intracerebral hemorrhage infected with COVID19, based on antithrombotic therapy administration. Authors suggest a possible role of enoxaparin in decreasing the mortality in this population, although it is a potential cause for worsening ICH.
I think that all the significative relations identified in the study are affected by the inadequate number of the sample of the two groups. Moreover, a second issue is the lack of patient stratification based on early brain lesions severity. Please provide this information.
Introduction: CO-RAD scale should be explained in introduction and Tab 1
Line 76: How was randomization carried out?
Line 136: The maximum GCS score is 15; mean (11.5) plus SD (3.9) is 15.4
Line 153-155: The two groups are not homogeneous, 8 untreated vs 45 untreated.
Tab 3 does not provide additional information; it could be deleted
Author Response
I think that all the significative relations identified in the study are affected by the inadequate number of the sample of the two groups. Moreover, a second issue is the lack of patient stratification based on early brain lesions severity. Please provide this information.
Author: During the period from May 2021 to December 2021, only 102 patients were admitted to the neurosurgical unit with spontaneous ICH, as a result of that, the sample size is not small at the time of study.
Regarding the early brain lesions severities for the participants were shown in table 2 (for ex. Hematoma course on admission)
Introduction: CO-RAD scale should be explained in introduction and Tab 1
Author: added, thank you
Line 76: How was randomization carried out?
Author: corrected, thank you
Line 136: The maximum GCS score is 15; mean (11.5) plus SD (3.9) is 15.4
Author: corrected, thank you
Line 153-155: The two groups are not homogeneous, 8 untreated vs 45 untreated.
Author: it is a cohort study aimed to evaluate the results of patients management who were admitted to the neurosurgical unit with spontaneous ICH, as a result of that, we reported in this study how they were managed in Beni-Suef university hospital and extracted our results regardless group homogeneity.
Tab 3 does not provide additional information; it could be deleted
Author: removed, thank you
Round 2
Reviewer 1 Report
Reviewer 2 Report
Thank you for the clarifications
