LAUSR

To the Editor, We have been recently scrutinizing a published article in the Journal of Medical virology entitled “Disease severity and efficacy of homologous vaccination among patients infected with SARS‐CoV‐2 Delta or Omicron VOCs, compared to unvaccinated using main biomarkers.” Although this paper claimed to have investigated the impact of SARS COV‐2 vaccines (Pfizer and AstraZeneca) on severities and inflammatory parameters (CRP and WBCs) in two different supposedly waves (third and fourth). The study design is inappropriate and contains several methodological, technical, grammatical and terminological errors that may skew the data resulting in the reduction of the importance of their findings claimed as shown in our Supporting Information. First of all, the article claimed that this is a “first molecular study” of covid‐19 variants in Iraq. However, it cannot be considered as a molecular study as there was no any proper molecular investigation of the studied variants except the molecular diagnosis of the virus. Also other molecular studies on SARS Cov‐2 variants were previously published in Iraq. Second, the title is inappropriate with the design of the study since the word “efficacy” is usually referred to clinical trials as described WHO. It is uncertain that the research is an epidemiological or a human trial study that would be investigating the efficacy of the vaccination on two control groups including placebo or randomized categories. Third, the research has based on “Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7)” to determine the severity of SARS COV‐2. However, this protocol includes four grades according to the severity, lab and radiological finding, the authors have not mentioned the “the critical cases (4th grade)” that is not clear if they missed or intentionally ignored the critical patients who would be surprisingly absent in both vaccinated or unvaccinated individuals used in their study. Moreover, there were no data about the severity of the disease in the result graphs, however, the title of the article begins with “Disease severity.” Fourth, the authors have mentioned 328 (166 males and 160 females) vaccinated covid‐19 confirmed patients; it is obvious that 166 + 160 is equal to 326 not 328. This calculation error has been repeatedly mentioned throughout the sections including abstract, methods and discussion. Fifth, in the discussion section, it was written: “It appears that SARS‐CoV‐2 induces an ‘imbalance host immune response’ in respect of the production of various cytokines like IL‐1, IL‐2, IL‐3, IL‐4, IL‐6, IL‐10, IL‐17, and interferon INF‐I, INF‐II, INF‐III, and TNF‐α. These cytokines can lift CRP levels which are pointers of inflammation and are more likely to influence viral elements (Bhargava).” In the introduction section by Bhargava (2021), it was written: “SARS‐CoV‐2 appears to induce an ‘imbalanced host response’ in terms of production of cytokines such as IL‐1, IL‐2, IL‐4, IL‐6, IL‐10, IL‐17, and TNF‐α, and interferon INF‐I, INF‐II, INF‐III. The cytokines can elevate C‐reactive protein levels that are indicators of inflammation and are likely to affect viral dynamics.” The article seems to take the above‐mentioned text from Bhargava 2021 without proper paraphrasing that they only brought few wrong synonymous words such as in respect of, lift, pointers; this may lead to partial plagiarism. Sixth, the authors have confused that “confounding factors” would include both comorbidities and treatment. Furthermore, they have not mentioned if they include or exclude the comorbidities or therapeutic factors in both vaccinated and unvaccinated individuals. Seventh, the article has no coherency and consistency among the sections. In introduction section the paragraphs are not consistent with other sections. For examples, using Omicron variants and molecular studies in the introduction section are missing in the methods. This inconsistency has been recently responded by Niranji and Al‐jaf 8 who also recommended to correct the article by avoiding the usage of “variants” instead of “waves” because they have not identified the variants. In discussion sections, we are skeptical why they added (Moderna vaccine) as this vaccine type is absent in other sections. Eighth, the discussion section was poorly written that contains many grammatical and terminological errors. For examples, this sentence “SARS‐CoV‐2 Omicron (B.1.1.529) observed the largest number of mutations......” is not clear. Other mistaking terminologies