The Impact of the Second Wave of COVID-19 on Outcomes in Hip Fracture Patients: An Observational Study

Round 1

Reviewer 1 Report

Peer Review - applsci-1481069

The manuscript entitled "The impact of the second wave of COVID-19 on outcomes in hip fracture patients: an observational study" from Mattia Morri et al. is an extremely relevant and well-designed study to measure the healthcare outcomes for patients undergoing surgery for femur fractures during the second wave of the COVID-19 pandemic.

The manuscript is well-written and fits perfectly within the scope of the special issue COVID-19: Rehabilitation Needs, Therapeutic Development, and Impact on the Health System. Therefore, I strongly recommend the publication of this study in the journal Applied Sciences (ISSN 2076-3417).

 

 

Author Response

We are glad that you find interesting our manuscript. We believe that it is really important to understand what happened in the hospital context when the first lockdown period was get over.

Reviewer 2 Report

Dear authors, I propose my suggestions for the acceptance of your manuscript
Introduction: it is explained that the authors' analysis of the incidence of pressure ulcers in the first wave was 21%, the manuscript does not detail data from the first wave and it would be interesting to see the evolution in three moments: pre-pandemic , first wave and second wave. If it is from another published work, it should appear referenced. Furthermore, this comparison is interesting since, as noted in the introduction, caregivers were even less present during the first wave.
It is recommended to review the formulation of the objectives. They appear divided into two that are the same reality. Specify correctly.

Author Response

Thank’s for the reviewer comment.

In the introduction section, we have better explained the period of the first wave: from March to June. The pressure ulcers incidence of the first wave come out from a clinical audit that we have conducted and not yet published.

As suggested, we have simplified the objective of the study.

Reviewer 3 Report

The article is a retrospective observational study regarding the healthcare outcomes after surgery for femur fractures during the second wave of the COVID-19 pandemic.

Any study on human health in these complicated pandemic periods is welcome.

I consider that in terms of the depth of the scientific approach, things could be improved.

In this sense, a clearer relationship must be determined between the studied subject and the particularities of the COVID-19 pandemic. Also to be useful, studies must have a greater degree of generality, by extending research to other hospitals or for other orthopedic interventions or other surgeries. 

Author Response

Thanks for the reviewer comment.

The data about of the impact of pandemic and the hospital organization in that period are few. It not easy to provide a clear picture of change and a clear relationship between particularities of the COVID-19 pandemic and health outcomes. In the study, according to our data and our experience we have suggested some hypothesis.

To clarify this relationship, new studies could be necessary maybe prospective, but the change of the pandemic situation is so fast that is not easy to plan this kind of study.

We have pointed our attention to the subjects with hip fracture, because, in the orthopaedic context, these subjects are the frailest and with a major risk of low health outcomes. We are working to provide data also about other orthopaedic surgery us the joint replacement, to better understand the impact of pandemic. We added this suggestion in the discussion of the study.