AUCTORES
Globalize your Research
Research | DOI: https://doi.org/10.31579/2640-1053/093
*Corresponding Author: Ercan Karatas, Department of İnternal Medicine, Tuzla State Hospital, Istanbul 34959, Turkey.
Citation: E Karatas, L Aksoy, E Ozaslan. (2021) Association of Early Favipiravir Use with Reduced COVID-19 Fatality among Hospitalized Patients. Cancer Research and Cellular Therapeutics. 5(4); Doi: 10.31579/2640-1053/093
Copyright: © 2021 Ercan Karatas, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 04 August 2021 | Accepted: 13 August 2021 | Published: 23 August 2021
Keywords: COVID-19; favipiravir; time-to-treatment; hospitalization
Background: The antiviral agent favipiravir is an RNA-dependent RNA polymerase (RdRp) inhibitor.
Materials and Methods: We examined patients with a clinical, laboratory, and radiological diagnosis of severe coronavirus disease 2019 (COVID-19) pneumonia. We investigated the effect of administering enteral favipiravir at a 2 × 1,600 mg loading dose and 2 × 600 mg maintenance dose for 5 days in addition to the standard COVID-19 treatment.
Results: In total, 180 patients, who were hospitalized at the Istanbul Tuzla State Hospital and received favipiravir treatment between March 20, 2020 and May 30, 2020, were examined. Of these, 47 patients died. Thirty-three of the patients who died were aged over 65 years (70%), indicating that fatality was higher in elderly patients. Most of those who died had at least one comorbidity. Of the 101 patients who initiated favipiravir within ≤3 days of hospitalization, 17 died (17%). Of the 79 patients who initiated favipiravir after >3 days of hospitalization, 30 died (38%) (P = 0.002).
Conclusion: We found that initiation of favipiravir within the first 72 h after the onset of disease symptoms reduced fatality in patients with COVID-19.
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally and caused an unprecedented pandemic, with 150 million cases and over 3 million deaths in a year. SARS-CoV-2 is an enveloped, positive-sense, single-stranded RNA virus responsible for causing coronavirus disease 2019 (COVID-19) [1]. Although various strategies have been developed to treat COVID-19, there is still no standard treatment [2]. Antivirals that have been used to treat other viral infections are also being tried against COVID-19 [3]. Favipiravir is an oral broad-spectrum anti-viral agent that selectively and potently inhibits the RNA-dependent RNA polymerase (RdRp) of RNA viruses [4]. Favipiravir has shown potent in vitro activity against SARS-CoV-2 [5]. Consequently, favipiravir has been added to the options available for treating COVID-19 [6]. It was determined that favipiravir treatment reduced viral clearance and provided clinical and radiological improvement [7]. In Turkey, Ministry of Health suggested the usage of favipiravir as an antiviral according to clinical researches in Europe.In our study, we investigated whether the time when favipiravir is initiated influences the risk of fatality in hospitalized patients with severe COVID-19 pneumonia.
1. Patients
This study was carried out at Tuzla State Hospital, Istanbul, Turkey, with approval of the Marmara University Faculty of Medicine Ethics Committee after obtaining permission from the Scientific Research Unit of the Ministry of Health and the Istanbul Provincial Health Directorate (Marmara University Faculty of Medicine Research Ethics Committee; approval no.: E.70737436-050.01.04-2000202899; date: September 29, 2020). Patients with severe COVID-19 pneumonia, who were admitted to Tuzla State Hospital between March 20, 2020 and May 30, 2020 and treated with favipiravir at any stage of their treatment, were examined retrospectively. All patients with their or their family consent used favipiravir. The study conducted according to their health records with no personal information. Therefore, informed consent not asked to the patients whether their families. The study included patients aged over 18 years who were not pregnant, had severe pneumonia (respiratory rate >30/min) with or without comorbidities and/or severe respiratory distress (dyspnea or use of extra respiratory muscles) and/or fingertip oxygen saturation <90>
2. Statistical Analysis
The research data were collected retrospectively through the Tuzla State Hospital registration system. Descriptive statistics were used to analyze categorical variables, represented as numbers, and continuous variables, represented as mean ± SD or median and interquartile range. The results were compared using t-test with the software SPSS 22.0 Statistics (IBM, Armonk, NY, USA).
We examined 180 patients who were hospitalized with severe pneumonia in the Istanbul Tuzla State Hospital and treated with favipiravir. The median age of the patients was 59 ± 17.4. Of these, 108 patients were aged ≤65 years. Fifteen of these patients died, indicating a fatality rate of 12% (15/108). In addition, 32 of 72 patients who were aged >65 years died; the fatality rate of these patients was 45% (32/72; P <0>
We observed that as the number of comorbidities increased, the fatality rate also increased. In our study, 113 of 180 patients (63% of all patients) had at least one comorbidity (Fig. 1). The main comorbidities were hypertension (79 patients), hyperlipidemia (57 patients), diabetes mellitus (52 patients), and coronary artery disease (33 patients). Of the 47 patients who died, 42 had at least one comorbid disease (89%). Cough (94 patients, 52%), dyspnea (86 patients, 47%), and fever (82 patients, 45%) were the topmost initial clinical findings (Fig.2).
HT, hypertension; CAD, coronary artery disease; PAH, peripheral artery disease; HL, hyperlipidemia; CHF, congestive heart failure; DM, diabetes mellitus; COPD, chronic obstructive pulmonary disease.
Among the hematological parameters, lymphopenia (lymphocyte count <1>7.5 × 109/L) (P = 0.001) and neutrophilia (neutrophil count >7.5 × 109/L) (P = 0.003) are associated with disease severity. In this study, disease severity and platelet count were not correlated (P >0.5). C-reactive protein (CRP) levels were increased in the patients; survivors had mean CRP values of about 85 mg/L, while non-survivors had mean values of 122 mg/L, which correlates with disease severity and prognosis (P = 0.004). Other predictors studied were the serum ferritin and lactate dehydrogenase (LDH) levels. High levels of ferritin (>200 µg/L) and LDH (>260 units/L) are associated with disease severity (P = 0.001). Survivors showed significantly higher plasma D-dimer levels than the non-survivors. Among the coagulation parameters studied, D-dimer level >1,000 ng/mL was a predictor of fatality (P = 0.0003). Clinicians should consider low lymphocyte, leukocyte, and hemoglobin counts as well as the CRP, LDH, ferritin, and D-dimer serum levels. These serum values can be used in risk stratification to predict severe and fatal COVID-19 in hospitalized patients (Table 1).
P-values were calculated using Pearson’s chi‐square test.
Abbreviation: IQR, ALT
Moreover, the need for advanced respiratory support increased in patients who initiated favipiravir after >72 h (Table 2). When we evaluated the time-to-treatment after hospitalization, we found that the fatality rate was lower in those who received favipiravir treatment within the first 72 h of hospitalization (P = 0.002; Fig. 3).
COVID-19 is a multisystemic inflammatory disease [8]. Currently, there is no universal standard for drug treatment, and various combination therapies are being administered [9]. Our standard treatment involves the administration of antivirals (favipiravir), broad spectrum antibiotics, low-molecular weight heparin, antithrombotic drugs, corticosteroids, and oxygen therapy [10]. For severe COVID-19 pneumonia, cytokine storm, macrophage activation syndrome, and acute respiratory distress syndrome, convalescent plasma, interleukin-6 inhibitors, and anakinra, an interleukin-1 receptor antagonist, are added to the treatment [11]. Combination therapy is currently customized for each patient.
Based on other viral infections, early antiviral therapy is considered more useful in the treatment of COVID-19. The benefit of early antiviral therapy in the treatment of influenza has been observed previously [12, 13]. SARS, Middle East respiratory syndrome (MERS), and COVID-19 are caused by viruses with similar genetic structures [14]. The benefit of early antiviral treatment has also been reported in SARS and MERS [15]. Several clinical trials on COVID-19 have demonstrated that early antiviral therapy is necessary and beneficial.
For instance, Magleby et al. conducted a retrospective cohort study in 678 hospitalized patients with COVID-19 in New York. They demonstrated that high viral load was independently associated with mortality, and that early antiviral therapy prevents increased viral load in the lower respiratory tract by inactivating the viruses in the upper respiratory tract [16]. Weiss et al. determined that the viral load in the upper respiratory tract peaks early in mild cases of COVID-19 (4 days) compared to that in moderate to severe cases (8 days). Similarly, viral load in the lower respiratory tract peaks early in mild cases (6 days) compared to that in moderate to severe cases (11 days). This indicates the importance of early diagnosis and the time to initiate treatment [17].
Goyal et al. reported that if a patient receives antiviral therapy in the early phase of infection, there are high chances that the duration of shedding and intensity of the effector immune response may decrease; however, there may be a limited impact on viral area under the curve, possibly owing to higher levels of early SARS-CoV-2 replication [18]. Early antiviral therapy can effectively reduce virus clearance time and prevent the rapid progression of COVID-19. Therefore, COVID-19 patients should receive combination treatment with antiviral agents at an early stage. By reducing the rate, quantity, or duration of viral replication, the degree of direct viral injury to the respiratory epithelium, vasculature, and organs may be minimized. Additionally, secondary processes that depend on viral stimulation, including the activation of inflammatory cells, cytokines, and coagulation, could potentially be minimized if the viral replication is attenuated [19].
According to Saber-Ayad et al., antiviral drugs administered shortly after the onset of symptoms can shorten the course of clinical illness and reduce its infectivity by lowering viral shedding [20]. In another study conducted in Wuhan, Yu et al. divided 129 hospitalized patients with mild to moderate COVID-19, who were treated with antiviral drugs, into the early antiviral treatment and late antiviral treatment groups. The group receiving early antiviral treatment recovered in 7 days less than the group receiving late antiviral treatment [21].
Wu J et al. found that older adults and patients with underlying diseases are more likely to experience severe COVID-19 progression. It is recommended to start antiviral treatment in time to slow the progression of the disease and improve the prognosis [22]. Early antiviral therapy, along with the combination therapy, increases viral clearance and reduces viral load, resulting in fatal complications including cytokine storm, macrophage activation syndrome, and acute respiratory distress syndrome [23]. According to a previous multivariate analysis, one comorbidity and the time from illness to antiviral treatment are statistically significantly associated with the severity of disease [24]. Similarly, since it is not known precisely which patients will have a more severe course of viral infection, antiviral treatment should be initiated without delay, especially in the elderly patients, patients with multiple chronic diseases, and patients who meet the clinical and laboratory criteria for severe COVID-19 at the time of onset [25]. Murohashi et al. demonstrated the importance of the early-stage use of a combination of favipiravir and methylprednisolone in severe cases, to achieve a favorable clinical outcome [26] Doi et al. described the successful treatment of patients with COVID-19 using favipiravir to rapidly and substantially clear SARS-CoV-2 from nasal secretions irrespective of whether it was started relatively early or later within the first week of infection [27].
Similar to the above-mentioned studies, we found that early antiviral therapy is beneficial and reduces fatality in patients with COVID-19.
The primary defense mechanism against viral infections is the response formed by the humoral immune system. However, in some infectious diseases, such as COVID-19, the immune system may not be able to neutralize the virus. In these cases, it is necessary to use treatments that will reduce the rate of replication of the virus. Early initiation of antiviral drugs will reduce the rate of viral replication and decrease the time required for the humoral defense mechanism to neutralize the virus.
In conclusion, we found that initiation of the antiviral agent favipiravir, an RdRp inhibitor, within the first 72 h of the onset of disease symptoms significantly reduced fatality. Nevertheless, the research has limitations, such as the fact that the study was conducted with the participation of a small group of patients.
No funding required for this study.
There is no conflicts of interest regarding researchers that none of the researchers have ever had any funding from private company, share-holder companies and drug companies.
Ercan Karatas https://orcid.org/0000-0002-3133-4199
Lacin Aksoy https://orcid.org/0000-0002-4105-0595
Ersin Ozaslan
Conceptualization: Ercan Karataş
Data curation: Ercan Karataş
Formal analysis: Laçin Aksoy
Funding acquisition: -
Investigation: Laçin Aksoy
Methodology: Ersin Özaslan
Project administration: Ercan Karataş
Resources: Ercan Karataş
Software: Laçin Aksoy
Supervision: Ersin Özaslan
Validation: Laçin Aksoy
Visualization: Ercsn Karataş
Writing - original draft: Ercan Karataş
Writing - review & editing: Laçin Aksoy
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
