Review for 10.1186/s12876-020-01518-2 (2020)

Reviewer’s report
Title: 
Acute portal vein thrombosis secondary to COVID-19: a case report
Version: 
0 
Date: 
10 Aug 2020
Reviewer's report:
Interesting clinical case. However some criticisms may be raised and should be
addressed. Please, follow the list below for more details:
1.Please, specify if they started intravenous heparin or low-molecular-weight
heparin (LMWH). All the anticoagulant doses should be presented adjusted for
the body weight. Therefore authors should also add 
the body weight of the
patient.
2.How was the Hb drop during the acute 
bleeding? Did the patient need packed
red blood cell transfusion? How was the mean arterial pressure drop? How were
lactates? In other words did the patient develop a hemodynamic shocK? 
If this is
the case, this information would enhance the importance of seeking for this
thrombotic complication during Sars-Cov-2 infection.
3.How was managed the gastro-intestinal bleeding? Did the patient receive
terlipressin or other vasocative drug? This would be in line with the
interpretation of teh episode as consequence of portal hypertension due to the
portal vein thrombosis. 
4.Could authors add the mean corpuscolar volume and ferritin to the blood
analysis presented in the table? This would be useful for differential diagnosis of
anemia. How do authors explain the Hb drop before the episode of the acute
bleeding? Did authors think about any ectopic gastro-intestinal varice as
bleeding source in this case? 
5.What about anticoagulation after discharge of the patient? Do authors have any
follow up data? It would be important checking if the prompt start of
anticoagulation was efficacious to avoid the evolution to cavernoma of the portal
vein 
6.The interpretation of platelet-count drop as thrombotic thrombocytopenic
purpura is quite hazardous. Did authors test the patient for adamts-13 activity in
line with this hypothesis? Did they exclude disseminated intravascular
coagulation as consequence of the acute respiratory failure? Was there an
overlap with any bacterial infection which could be associated with platelet drop
during acute infection? Did authors ruled out/considered heparin induced
thrombocytopenia? 
7.Authors should provide the references of the clinical case mentioned in the
discussion as the first reported on portal vein thrombosis during covid. Along
this line they should also update the reference list. There is at least one other
report already published on the same topic (V. 
La Mura et al AJG 2020).
Minor comments.
Some typos: PH instead of pH; vital sign instead of vital signs. Was creatinine
level 17 mg% and BUN 1mg% on the 21st of April or is it symply 
a typos?
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