Early Multi-Target Treatment of Mild-to-Moderate COVID-19, Particularly in Terms of Non-Steroidal Anti-Inflammatory Drugs and Indomethacin

Round 1

Reviewer 1 Report

It is not very clear how the drugs mentioned could help in COVID-19 treatment. There is not much corelation between COVID-19 pathophysiology and mechanims of action of indomethacin and other drugs mentioned in the manuscript. A great number of studies are quoted, in which indomethacin and other NSAIDs reduced symptoms of SARS-CoV-2, but little information is given about the exact impact of the drugs on viral infection development, based on their mechanism of action. Therefore, the manuscript should be reconsider, so that adequately explains the real benefits of the drugs in patients suffering from COVID-19.

 

Author Response

We thank very much the Reviewer for his/her valuable suggestions.

1. According to the first suggestion we have added in the text a paragraph to put in evidence the principal results obtained with NSAIDs in the treatment of patients with COVID-19.
2. Furthermore, we have also added a paragraph in the chapter on antiviral action of indomethacin to stress and explain the antiviral mechanisms of the drug.

Reviewer 2 Report

The authors have to specify that this is a descriptive review.

Please exemplify the guidelines that you speak about- Since then, little by little, all doctors started to follow the guidelines that stemmed from EBM to practice medicine. This has simplified and made the way medicine is applied more precise and safer, because everything or almost everything is managed in medicine through protocols and guidelines based on evidence of effectiveness.

Could the authors please explain how were the articles selected?

Please rephrase -This document also stresses that a virtuous system of disease control must be created, with referral of patients to hospitals only in case of aggravation, thus preventing overcrowding of the hospitals-

 

Author Response

We thank the Reviewer for his/her support and have modified the manuscript according to his/her suggestions.

   

1. We have specified in the text that our manuscript is a descriptive review.
2. We have modified the text eliminating the term guideline and explaining that EBM, starting from 1992, led to a change of the way of practicing medicine, but also underlining that, at the time of the onset of COVID-19 pandemic, we had no suggestion from EBM to treat this disease.
3. We have explained how the articles were selected.
4. Have rephrased the paragraph “This document also stresses…..”

Round 2

Reviewer 1 Report

The manuscript is now suitable for publication. Changes made by authors are in line with the reviewer's comments and make the article more understandable and scientifically thorough.