Implementing Early Phase Treatments for COVID-19 in Outpatient Settings: Challenges at a Tertiary Care Center in Italy and Future Outlooks
, Filippo Lagi 1,2, Anna Barbiero 1, Marco Fognani 1, Nicoletta Di Lauria 2, Costanza Malcontenti 2, Costanza Fiorelli 2, Michele Spinicci 1,2, Vega Ceccherini 3, Paola D’Onofrio 3, Manuela Angileri 4, Francesca Malentacchi 5, Michele Cecchi 4, Gian Maria Rossolini 1,5, Matteo Tomaiuolo 3, Lorenzo Zammarchi 1,2 and Alessandro Bartoloni 1,2,*Round 1
Reviewer 1 Report
I cannot confirm/speak of the accuracy of the treatments/medications used in this manuscript (eg. molnupiravir, etc); I am not qualified for that. However, I can speak of the design used and how it is presented to the reader. Here a few notes for improvement:
page 1: now dominant in Europe instead say since when (date);
Page 2: Materials and methods: between the ID and ED departments - instead spell them out. You did in the Discussion section; do on page 2 first.
Page 2: 2.2. Cost estimation: provided by the Hospital - I recommend to include the name of the Hospital for accuracy or to be as specific as possible
Pages 2-3: I am not qualified to verify the accuracy of the treatment/medications included in these sections and/or the manuscript.
Page 4: Resources like ours - I recommend to be specific. Not everyone knows how health care works in Italy or at this hospital specifically
NOTE: I recommend the authors to review the manuscript to have it more 'user friendly' for those readers who are not used to the language used in this manuscript.
Author Response
Reviewer 1:
I cannot confirm/speak of the accuracy of the treatments/medications used in this manuscript (eg. molnupiravir, etc); I am not qualified for that. However, I can speak of the design used and how it is presented to the reader. Here a few notes for improvement:
page 1: now dominant in Europe instead say since when (date);
Page 2: Materials and methods: between the ID and ED departments - instead spell them out. You did in the Discussion section; do on page 2 first.
Page 2: 2.2. Cost estimation: provided by the Hospital - I recommend to include the name of the Hospital for accuracy or to be as specific as possible
Pages 2-3: I am not qualified to verify the accuracy of the treatment/medications included in these sections and/or the manuscript.
Page 4: Resources like ours - I recommend to be specific. Not everyone knows how health care works in Italy or at this hospital specifically
NOTE: I recommend the authors to review the manuscript to have it more 'user friendly' for those readers who are not used to the language used in this manuscript.
Authors reply: We thank the reviewer for hsi/her comments. We have taken the suggestions into account. Regarding the last point, the manuscript has been reviewed and abbreviations have been eliminated when possible.
Reviewer 2 Report
line 26: were hydroxychloroquine and lopinavir/ritonavir employed also for hospital treatment? In case add "used them ALSO for at-home treatment" in line 26 phrase
line 50 and line 53: delete redundant space (after RMD in line 50 and after [2,12]. in line 53). Control all the manuscript for redundant space (line 57, 59, 79....)
line 64: add location of the center (also in the abstract in line 18)
line 71: specify ID and ED acronym (and delete from line 118)
line 73-75: sentence not clear
line 78-79: uniform verb tense (present, past...)
2.2 Cost estimation parapraph: more information on cost data sources are needed
line 94-95: move the sentence on risk classes in the Methods and add references
line 96-98: move the sentence in the Methods or Results and add only the table title
Table 1: where is the explanation of * of Overheads
line 100-101: sentence not clear
Author Response
Reviewer 2:
We thank the reviewer for his/her comments. Please find our replies below.
line 26: were hydroxychloroquine and lopinavir/ritonavir employed also for hospital treatment? In case add "used them ALSO for at-home treatment" in line 26 phrase
AR: Done
line 50 and line 53: delete redundant space (after RMD in line 50 and after [2,12]. in line 53). Control all the manuscript for redundant space (line 57, 59, 79....)
AR: Done
line 64: add location of the center (also in the abstract in line 18)
AR: Done
line 71: specify ID and ED acronym (and delete from line 118)
Done
line 73-75: sentence not clear
AR: changed, hoping claroity has improved
line 78-79: uniform verb tense (present, past...)
AR: corrected
2.2 Cost estimation parapraph: more information on cost data sources are needed
We would kindly ask the reviewer to clarify what supplemental information is needed. As previously stated, costs were estimated based on previous reports from published articles. Official pricing of drugs used to treat covid patients in Italy is currently not available. We felt that using label prices would tend to overestimate the prices themselves (e.g. for remdesivir, the label price is 750€ but published estimates place it at roughly half the price). A further reference has been added for completeness.
line 94-95: move the sentence on risk classes in the Methods and add references
line 96-98: move the sentence in the Methods or Results and add only the table title
AR: It’s not clear whether the author refers to the caption of figure 1. A reference has been added there to justify the content of the table
Table 1: where is the explanation of * of Overheads
Inserted
line 100-101: sentence not clear
Changed
