Association between Multimorbidity and COVID-19 Mortality in Qatar: A Cross-Sectional Study
, Basant Elsayed 1,†, Mohamed Elmarasi 1,†, Mona Kotob 1,†, Reham Taha 1,†, Fardous Abbasher 1,†, Ahmed Amarah 1,†, Mariam El Hamawi 1,†, Soha S. Albayat 2, Jazeel Abdulmajeed 2, Mohamed A. H. Sallam 2, Maha H. M. Al-Shamali 2, Hamad E. Al-Romaihi 2, Devendra Bansal 2, Omran A. H. Musa 2, Elmoubasher Farag 2, Mohammed H. J. Al-Thani 2, Tawanda Chivese 3,* and Mohamed M. Emara 1,*Round 1
Reviewer 1 Report
REVIEW REPORT
Association between multimorbidity and COVID-19 mortality in Qatar: a cross-sectional study
NO: microbiolres-1912662
Journal: Microbiology Research
Date: 11.09.2022
Conflict of interest statement for peer reviewer:
I declare that I do not have any competing interests
Language and formatting-related comments:
- Please check the length of the abstract (200 words max.)
- The authors could potentially include some more keywords (not necessary, but it will make it easier for the algorithm to potentially find their article)
- From a linguistic point of view - vulnerable to mortality? The sentence sounds off. Perhaps rephrase.
- Below the age of 18 years (the word old should be deleted)
- There should be a full stop behind the table numbering
- COVID-2019 ? COVID-19 – “coronavirus disease outbreak” is not the correct abbreviation for this. https://www.cdc.gov/library/covid19/acronyms.html
- Literature – please check citation style.
Minor English revision.
Data presentation:
- The citations are lackluster and should be improved (e.g., Evidence from several countries suggests that individuals with pre-existing comorbidities are at a greater risk of death from COVID-19. Some of these pre-existing comorbidities are malignancies, …) – there is a number of papers that could potentially be cited:
o https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258154
o https://www.bmj.com/content/377/bmj.o1431
o https://pubmed.ncbi.nlm.nih.gov/34418980/
o Etc.
- Notably, studies on multimorbidity and mortality from COVID-19 are few and, … - This statement is not true – a PubMed search with the keywords “comorbidities” and “COVID-19” results in 9,119 hits (not all applicable and relevant, nevertheless, certainly not few …)
- How were cancer patients categorized? Any tools used in predicting their outcome (e.g., CORONET Predictive Score)
- Was the Charlson Comorbidity Index calculated?
o https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314426/
- Materials section should describe exactly how many patients there were and how they were categorized according to the presented parameters, also, how did the patient numbers change during the months?
- The authors should include the Helsinki ethical statement: The study was conducted according to the guidelines of the Declaration of Helsinki …
- Unspecified gender? – what is this supposed to mean?
- This is especially relevant for our population, which has in an increased risk for genetic-related disease due to a high consanguinity prevalence. – if this is the case, then please elaborate on the most common entities from this group.
- Generally – a table with the corresponding disease entities and their percentages (I saw the supplementary table) would be appreciated.
- Individuals with various muscular dystrophies, including myotonic dystrophy, and those who have ventilatory muscle weakness or cardiomyopathy have been found to have a higher risk of severe COVID-19, in one study. – were there any such patients in the cohort?
The authors set out to do the following:
Determine the association between multimorbidity and COVID-19 mortality in Qatar.
Their goal was met. However, there is already a large body of data on this topic (not specifically this region though).
My suggestions to improve the novelty of the article:
- Addition of a time-lapse of patients with corresponding No. of wave
- Potential inclusion of the Charlson Comorbidity Index
- Subdivision of the cancer patients cohort and their comparison
I believe the article should undergo major revision.
With best regards.
Author Response
Please see the attachment.
Author Response File: 
Author Response.docx
Reviewer 2 Report
The article is well done but need English language and style are fine/minor spell check required
Author Response
Please see the attachment.
Author Response File: Author Response.docx
Reviewer 3 Report
AbouGalala et al. summarizes correlation of multimorbidity linked with mortality from COVID-19 in the MENA region. I appreciate authors for high sample size included in this study which is challenging to achieve because of several reasons. Another drawback of this study is lack of SARS-CoV-2 strain, since the data obtained in mid of 2020 so one can assume not much variability in the SARS-CoV-2 strain, however with known strain is always better to interpret the results. I have few doubts and suggestions.
1. In table 1, age 60-69 has highest death over other older ages. This is because of high infection rate in 60-69 age group or there is other reasons as well?
2. In table 2, CVD is additionally adjusted for Diabetes and Dyslipidemia, meaning patients from three different diseases are included under CVD or what?
3. To me it looks like Diabetes is the major contributor of death because of COVID-19 over other diseases. This is important to know because of precaution perspective.
4. What authors conclude from this study and what precaution measures are advised should be briefly summarized in the discussion section.
Author Response
Please see the attachment.
Author Response File: Author Response.docx
Round 2
Reviewer 1 Report
The authors have adequately corrected their manuscript (with limitations). Citation 13 seems odd. The authors should check its correctness.
With best regards.
