Neurological and Psychiatric Symptoms of COVID-19: A Narrative Review

Round 1

Reviewer 1 Report

It is a well-written manuscript on a timely topic. However, the structure of the manuscript is not clear. The manuscript was defined as a review; still, the important parts of the standard review methodology were omitted.  For example, databases for the search, keywords for the search, number of manuscripts that met inclusion and exclusion criteria and the process of the data synthesis, none of them were reported in the manuscript. The current version of the manuscript was prepared like an opinion letter. Based on my understanding of the Journal guidelines, this format less fits the scope.  

The definition of the manuscript structure is crucial for the understanding. The current structure of the manuscript makes it difficult to understand the selection of topics to be covered and the extent to which they are presented. For example, it is difficult to understand why headache and fatigue were addressed in-depth, including treatment options, while other symptoms were discussed much more briefly (e.g. cognition or psychiatric symptoms), even though they are the focus of the manuscript based on the title.

General comments:

I recommend rewording the title of the manuscript and reorganize according with the accepted  format  of review.

 

Abstract:

I recommend revising the structure of the abstract. The study type and design are not clear, the background and the findings are not separated. The study aim is presented too late to help in the manuscript understanding.

 

 

Introduction:

Lines 42-46: Please support your statements with relevant references. In addition, the wording should be changed to be less categorical to avoid overstating, especially since the long –COVID was not found in 100% of the cases.

Line 65: “Elderly individuals…” – please add reference(s).

Line 73: “Following the initial infection, the secondary inflammatory reaction associated with COVID-19 produces a significant cytokine and chemokine response”  - provide references and be less conclusive in your wording. Your next sentence states that this response is typical, but is the only possible one.

Author Response

Abstract:

I recommend revising the structure of the abstract. The study type and design are not clear, the background and the findings are not separated. The study aim is presented too late to help in the manuscript understanding.

 Answer: The study aim was placed in the revised version. The background and findings aren’t usually separated in a narrative review so this was left the same. However, we will make it more clear that it is a narrative review in the title.

 

Introduction:

Lines 42-46: Please support your statements with relevant references. In addition, the wording should be changed to be less categorical to avoid overstating, especially since the long –COVID was not found in 100% of the cases.

Answer: The reference is clearly cited. It’s merely introducing and defining what it is. It’s not overstating if the terms are used in the literature.

Line 65: “Elderly individuals…” – please add reference(s).

Answer: References have been added to this revision.

Line 73: “Following the initial infection, the secondary inflammatory reaction associated with COVID-19 produces a significant cytokine and chemokine response”  - provide references and be less conclusive in your wording. Your next sentence states that this response is typical, but is the only possible one.

Answer: This has been revised in the text.

Reviewer 2 Report

Title: Neurological and Psychiatry Symptoms of COVID 19

This article describes the clinical symptoms associated with COVID-19, such as new daily persistent headaches, fatigue, and cognitive impairment. The pathophysiological mechanism and treatment of these symptoms were simply introduced. But much of the content of this article has nothing to do with COVID-19. Most importantly, this paper is just a simple piece of related content and lack of internal logical connection, and lacks author's insights, hypotheses, or prospects.

 

I suggest rewriting the paper and resubmitting it to Psychiatry International.

Key points:

1. Content that is logically not associated with COVID-19 should be removed in rewritten article.
2. the author's views should be presented in rewritten article.
3. A cartoon of pathophysiological mechanism associated with neurological and psychiatry symptoms of COVID-19 should be drawn in rewritten article.

Author Response

This article describes the clinical symptoms associated with COVID-19, such as new daily persistent headaches, fatigue, and cognitive impairment. The pathophysiological mechanism and treatment of these symptoms were simply introduced. But much of the content of this article has nothing to do with COVID-19. Most importantly, this paper is just a simple piece of related content and lack of internal logical connection, and lacks author's insights, hypotheses, or prospects.

 

I suggest rewriting the paper and resubmitting it to Psychiatry International.

Key points:

1. Content that is logically not associated with COVID-19 should be removed in rewritten article.

Answer: some has been removed, but most is connected so it was left in.

1. the author's views should be presented in rewritten article.

Answer: As this is a review, strong views from the authors should be withheld. The views that are in the article are in the conclusion stating that this is an important cluster of symptoms that need to be understood, known, and screened for in COVID patients.

1. A cartoon of pathophysiological mechanism associated with neurological and psychiatry symptoms of COVID-19 should be drawn in rewritten article

Answer: This has been drawn and added to this revision

Round 2

Reviewer 1 Report

1. Abstract: Please replace the word "manuscript" - Line 38 with the "narrative review"

2. Please remove the following sentence from the conclusion:

"One may not think that a virus that caused respiratory symptoms could lead to a presentation of psychosis". (Line 427)

Good Luck

Author Response

1. Abstract: Please replace the word "manuscript" - Line 38 with the "narrative review"

            Answer: This has been replaced

2. Please remove the following sentence from the conclusion:

"One may not think that a virus that caused respiratory symptoms could lead to a presentation of psychosis". (Line 427)

        Answer: This has been removed

 

Reviewer 2 Report

Comments for author File: Comments.pdf

Author Response

Minor point 1: this has been edited

 

minor point 2: this has been edited