Review for 10.1186/s12876-020-01458-x (2020)

Reviewer’ s report
Title: A severe coronavirus disease 2019 patient with high-risk predisposing factors died from
massive gastrointestinal bleeding: a case report
Version: 0Date: 08 Aug 2020
Reviewer's report:
The authors present a case of massive GI bleed on day21 of hospitalisation from severe Covid-19.
The authors propose that direct viral invasion of the GI tract may predispose towards GI
hemorrhage. However this patient clearly was high risk for GI bleed to begin with, given criticalillness and comorbidities. It is also surprising that despite GI bleed starting on day 17, noendoscopic evaluation was performed for 4 days until patient's demise. This may be due toresource limitations but is not entirely clear why endoscopic evaluation was not performed early.Based on the information provided in the case, we can not make any conclusions regardingpossible etiology of the hemorrhage and an autopsy would have been helpful. Common thingsbeing common, peptic ulcer disease or diverticular hemorrhage will remain the two most commonetiologies. Regretfully I will not be able to recommend this manuscript for publication.
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Is the study design appropriate to answer the research question (including the use of appropriate
controls), and are the conclusions supported by the evidence presented?
NoAre the methods sufficiently described to allow the study to be repeated?YesIs the use of statistics and treatment of uncertainties appropriate?YesIs the presentation of the work clear?
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