JMIRx Medxmed34JMIRx MedJMIRx Med2563-63165963910.2196/59639Peer Review of “Health Care System Overstretch and In-Hospital Mortality of Intubated Patients With COVID-19 in Greece From September 2020 to April 2022: Updated Retrospective Cohort Study”AnonymousMeinertEdward202410620245e596391704202417042024© Anonymous. Originally published in JMIRx Med (https://med.jmirx.org), 10.6.2024. 2024

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http://preprints.jmir.org/preprint/43341https://med.jmirx.org/2024/1/e59637https://med.jmirx.org/2024/1/e43341COVID-19pandemichealth care disparitiesintensive care unitICUright to healthquality of careintubationmortalityhealth disparityhealth inequalitysurveillance datain-patientmortalityCOVID-19 patienthospitalizationdisparityinequalitysurveillancehealth care systemGreeceregionDeltaOmicronvaccinationvaccinepublic healthpatient loaddeteriorationtime

This is the peer review report for “Health Care System Overstretch and In-Hospital Mortality of Intubated Patients With COVID-19 in Greece From September 2020 to April 2022: Updated Retrospective Cohort Study.”

Round 1 ReviewGeneral Comments

This paper [1] is interesting but needs improvement.

Specific CommentsMajor Comments

We aimed to update this analysis to include the large “Delta” and “Omicron” waves that affected Greece during 2021‐2022

So why did you analyze data also from 2020?

Vaccination did not affect the mortality of these already severely ill patients.

Did you check how many months before they had received the vaccine? How many of the participants were not vaccinated?

Vaccination did not show a statistically significant association with mortality, regardless of the number of doses received (Figure 2).

This needs rephrasing if all participants were vaccinated at least once.

Between 1 September 2020 and 3 April 2022...

I see that your previous study included data up to May 2021. Thus, there is a lot of overlap in the data of these two studies.

There are many errors in the use of English and typos which makes it difficult to understand. See examples below:

Mortality was significantly higher above 400 patients

This is not very clear (please rephrase).

...with an adjusted Hazard Ratio of 1.22, 95% CI: 1.09‐1.38)

Where does the parenthesis open?

...rising progressively up to 1.48 (95% CI: 1.31‐1.69) for 800+ patients.

This is not clear.

...we found no statistically association between mortality and...

Please correct typo.

Minor Comments

It would be good to include DOIs to all references.

None declared.

ReferencesLytrasT Health care system overstretch and in-hospital mortality of intubated patients with COVID-19 in Greece from September 2020 to April 2022: updated retrospective cohort studyJMIRx Med20245e4334110.2196/43341