Comparable Detection of SARS-CoV-2 in Sputum and Oropharyngeal Swab Samples of Suspected COVID-19 Patients

Round 1

Reviewer 1 Report

General Comments

·       How was uniformity in collection of samples ensured during the data collection period given the fact that multiple people would have been involved in data collection as it continued for approximately 5 months?

·       Was there any formal training done of the concerned healthcare staff on collection, handling and transfer of the samples prior to data collection

·       This study seems to have some confounding factors which authors have not mentioned. Please mention what were those confounding factors and what strategies were adopted to cater them

·       Introduction is too short, maybe statistics on effectiveness and efficiency of existing sampling techniques as well as diagnostic methods be added in it.

·       How far the two facilities situated and how many subjects were included from each of these facilities

 

Specific comments

·       Line 39 is confusing; better write as, “65.9% of total recruited did not have any co-morbidity…..”

·       Line 43 is confusing; better writ as, “sputum samples yielded more covid positive 120/317(37.9%) as compared to OPS 83/317(26.2%)….”

·       Line 49; “mitigating uncomfortable process” is not a correct statement, better write as, “…thereby easing the uncomfortable process and mitigating risk of aerosol….”

·       Lines 54-56 are more of a common knowledge now so better be replaced with some other scientific information

·       Line 62; “Africa spared” not a good term, should replace it

·       Lines 64-67; Not clear what actually authors want to convey, looks confusing and an incomplete sentence. Please revise

·       Lines 75-76; Mention a few of these uncertainties perhaps in parenthesis

·       Figure 2; It would have been better if it was also mentioned that how many patients were positive by both methods combined as well as through either of the method adopted

·       Line 190; “Most findings have reported to affect elderly…..” is not a better phrase, rather write something like, “literature shows…..”

Comments for author File: Comments.pdf

Author Response

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Author Response File: Author Response.docx

Reviewer 2 Report

The article aimed to reveal the relationship between oropharyngeal sampling and sputum sampling for the diagnosis of COVID-19 using RT PCR method.

General concept

It is considered appropriate to design a cross-sectional study to analyze differences in sampling methods in the same patient.

Specific comments

Page 3, line 120: Many patients cannot fully understand the ‘expectoration of sputum’ so the sputum samples might be taken improperly. I would like to ask if there were procedures or protocols to be monitored or be teached by the physician when taking sputum samples. Maybe the inappropriate samples only contained saliva, not sputum.

Page 5, Table 1: The proportion of unknown comorbidity history was large (28.1%). This would affect the result of statistical analysis. Please mention the reason. Also, it is important to consider the time from symptom onset when interpreting the result of viral loads. This might be included in the analysis if possible.

Page 10, line 310: Journal name was omitted in 19^th reference.

Author Response

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Author Response File: Author Response.docx

Reviewer 3 Report

Dear Authors

1) Add your affiliations properly. 

2) Abstract is too long. reduce it according to journal guideline. 

3) The WHO named it a pandemic in March 2020 owing to its global spread, cite this statement can be cited with this paper "DOI:10.3390/ijerph17072225".

4) Results need some English improvements.

5) Conclusion is weak need improvement. 

 

Author Response

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Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Authors have professionally addressed all the relevant concerns.
The manuscript is in better shape now.