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Case Report | DOI: https://doi.org/10.31579/2690-4861/964
1Department of Medical, Human Movement and Well-being Sciences, University "Parthenope", Naples, Italy. Electronic.
2ICS Maugeri Hermitage, 80145 Naples, Italy.
3Neuroscience, Reproductive and Odontostomatological Sciences (NSRO) Department, Federico II University, Naples, Italy.
4Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy.
5Clinical Neurophysiology Unit, Cardarelli Hospital, Naples, Italy.
6Cognitive Impairment and Neurorehabilitation Unit, Policlinico Federico II University Hospital, Naples, Italy; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
*Corresponding Author: Assunta Trinchillo, Department of Medical, Human Movement and Well-being Sciences, University
Citation: Assunta Trinchillo, Patrizia Ruosi, Gianpaolo Maggi, Cinzia Valeria Russo, Marcello Esposito, et al, (2025), Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Current Stage of Knowledge and Research – Facts and Assumptions, International Journal of Clinical Case Reports and Reviews, 31(1); DOI:10.31579/2690-4861/964
Copyright: © 2025, Assunta Trinchillo. 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: 03 September 2025 | Accepted: 19 September 2025 | Published: 28 October 2025
Keywords: alpha coma; covid-19; electroencephalography (eeg); huntington’s disease; post-hypoxic encephalopathy
Neurological complications of COVID-19 include encephalopathy and, less commonly, seizures. Electroencephalogram (EEG) findings are heterogeneous, with the alpha coma pattern rarely reported and typically observed during active infection. We describe a 49-year-old man with Huntington’s Disease who developed an alpha coma EEG pattern two weeks after recovering from COVID-19-related encephalopathy. Initial EEGs showed diffuse slowing, while a later EEG revealed bifrontal alpha activity with partial reactivity. Brain MRI demonstrated cortical-subcortical hypoperfusion without contrast enhancement, and cerebrospinal fluid and immunological tests were unremarkable. The patient gradually improved, and the alpha pattern resolved. A literature review of 13 studies reporting EEG findings in COVID-19 patients revealed that generalized slowing is the most common abnormality, with alpha coma rarely observed and only during active infection. Our case uniquely documents the alpha coma pattern post-recovery, suggesting that chronic hypoxic injury may underlie this phenomenon. These findings highlight the potential for prolonged neurological sequelae after COVID-19 resolution.
The Coronavirus Disease 2019 (COVID-19) pandemic has been associated with a wide range of neurologic manifestations, attributed to: (i) indirect cytokine-mediated responses, (ii) direct central nervous system (CNS) invasion, and (iii) neural injury via angiotensin-converting enzyme 2 (ACE2) receptors [1]. Neurological symptoms have been reported in up to 36.4% of hospitalized COVID-19 patients, with encephalopathy occurring in approximately 31.8% and new-onset seizures in about 0.8% of cases [2].
Electroencephalogram (EEG) findings in COVID-19-associated encephalopathy are diverse, most commonly showing diffuse slowing or frontal intermittent rhythmic delta activity (FIRDA) [3]. The alpha coma pattern is exceedingly rare, and all documented cases have occurred during the acute phase of infection [4,5]. To our knowledge, this is the first report of an alpha coma EEG pattern emerging after clinical recovery from COVID-19, in a patient with underlying Huntington’s Disease (HD). We also provide a focused literature review of EEG findings in COVID-19 patients, with the aim of exploring whether post-infectious EEG abnormalities reflect direct viral neurotropism or indirect systemic mechanisms such as hypoxia or inflammation.
We conducted a structured literature review using the Medline (PubMed) database to identify studies published between January 2020 and December 2022. The search strategy included the following keywords and Boolean operators: (“COVID-19” OR “SARS-CoV-2”) AND (“EEG” OR “electroencephalography” OR “encephalopathy” OR “seizures”). Only English-language articles involving human subjects were included.
Studies were eligible if they reported EEG findings in patients with confirmed COVID-19 infection. We focused specifically on articles describing encephalopathy, altered mental status, seizures, or distinct EEG patterns (e.g., diffuse slowing, FIRDA, or alpha coma). Case reports, case series, and observational studies were included; editorials, reviews, and experimental studies were excluded.
Titles and abstracts were screened for relevance, followed by full-text review of selected articles. A total of 14 articles met the inclusion criteria and were analyzed qualitatively. Data extracted included patient demographics, clinical features, EEG findings, and timing of EEG in relation to COVID-19 onset.
Case Presentation
We describe the case of a 49-year-old man with a 15-year history of Huntington's Disease (HD), manifesting mood depression, cognitive impairment, and gait instability, treated with haloperidol 1 mg/day. In November 2020, he presented with his first generalized tonic-clonic seizure. At admission, he tested positive for SARS-CoV-2. Chest CT revealed typical COVID-related ground-glass opacities. Brain CT showed HD-related subcortical atrophy, and EEG demonstrated generalized delta slowing consistent with cortico-subcortical dysfunction. Levetiracetam 500 mg BID was initiated, [6] but the patient's condition deteriorated rapidly, requiring high-concentration oxygen via Venturi mask. Delirium developed and was managed with IM aripiprazole and IV diazepam, replacing haloperidol. After one month, despite COVID-19 recovery (confirmed by swab negativity), he remained in a comatose state (GCS 8: O3, V1, M4), prompting transfer to our neurology unit. Follow-up CT revealed new cortical and subcortical hypoperfusion. EEG again showed frontal-predominant delta slowing with overlying 14–16 Hz monomorphic activity (likely related to sedation). Despite partial sedation withdrawal, coma persisted. The patient then developed a bacterial superinfection. Two weeks post-negative swab, a second EEG revealed a bifrontal alpha coma pattern (10–11 Hz, low-voltage, transient), with limited reactivity to eye opening (Figure 1a-b).
Figure 1 A-B: EEGs show low-voltage, frontally predominant alpha activity at 10–11 Hz, without an anterior–posterior gradient. Red rectangles and black arrows highlight bifrontal alpha bursts. Black stars mark eye opening, where the alpha rhythm transiently disappears, indicating partial reactivity consistent with post-hypoxic alpha coma.
Brain MRI confirmed chronic cortico-subcortical hypoperfusion, with pre-existing caudate atrophy but no contrast enhancement. We considered two potential mechanisms: a post-infectious autoimmune encephalitis or prolonged hypoxic injury. CSF analysis (normal proteins, glucose, cell count, negative antibodies, and PCR panel) did not support autoimmune etiology. Nevertheless, empiric treatment with IV immunoglobulins and broad-spectrum antibiotics was initiated; levetiracetam was increased to 750 mg BID. MRI findings were more suggestive of chronic hypoxia than inflammation. Absence of contrast enhancement and presence of new hypoperfusion changes further supported this. Over time, the patient's clinical condition improved. EEG showed disappearance of the alpha coma pattern, replaced by reactive theta and delta activity. Subsequent EEGs revealed reappearance of sleep patterns including spindles and K-complexes. He was discharged one month later with improved consciousness (GCS 12: O4, V2, M6). At present, he has a Unified Huntington Disease Rating Scale score of 56, with moderate dementia, mood instability, and the inability to walk unaided. Levetiracetam is ongoing with reported benefit.
We identified 13 relevant studies, the majority of which described EEGs performed during active infection. Only one study reported EEG follow-up after infection. [4] In most cases, EEG was requested to assess for encephalopathy. Generalized slowing was the most common finding, followed by focal slowing, triphasic waves, burst suppression, and epileptiform discharges. [5] However, no consistent EEG pattern emerged as predictive of outcome. New-onset seizures were uncommon and mainly generalized; focal seizures were rare and typically linked to underlying cerebrovascular lesions. EEG improvement after infection was generally reported, but post-infection patterns remain understudied. (Table 1) [9-20].
| Author/year | Patients | Timeline | Findings |
| Saez-Landete/2022[4] | 11
| 15 acute; 14 follow-ups | Acute: 6.6% symmetric posterior alpha, no reactivity Follow-up: 42.8% symmetric posterior alpha; 35% no reactivity |
| Pellinen/2020[9] | 111 | During infection | 61% encephalopathy 9% seizure exacerbation 21% paroxysmal activity (unclear cause) 57% generalized slowing, 30% epileptiform |
| Hwang/2022[10] | 192
| During infection | 88.5% generalized slowing 15.6% focal slowing 3.6% burst suppression 3.1% attenuation 3.1% normal EEG |
| Gogia/2021[11] | 19
| During infection | Survivors (13): 36% generalized slowing; 16% normal EEG Non-survivors (6): 66% generalized slowing; 17% seizures |
| Corazza/2020[12] | 28 | During infection | 35.7% generalized slowing 10.7% slow posterior activity |
| Galanopoulou/2020[13] | 22 | During infection
| 40.9% epileptiform discharges 88.9% frontal sharp waves 63.6% seizure-like events |
| Besnard/2020[14] | 42 | During infection | 28.6% normal EEG 21.4% slight slowing rhythm 19% unspecific anomalies 9.5% focal/diffuse epileptic pattern 21.4% encephalopathic patter |
| Pastor/2020[15] | 20 | During infection | Posterior dominant rhythm in theta band Sharp waves in 4/20 patients. |
| Tantillo/2022[16] | 93 | During infection
| 97% generalized slowing 31% generalized attenuation 17% generalized periodic discharges 15% generalized sharp waves 43% epileptiform abnormalities |
| Canham/2020[17] | 10 | During infection | Generalized slowing consistent with encephalopathy Asymmetry and triphasic waves associated with cerebrovascular changes |
| Chen/2020[18] | 5 | During infection
| Diffuse slowing and generalized rhythmic delta activity 2/5 epileptiform discharges reaching 2–3 Hz |
| Niguet/2021[19] | 33 | During infection | 85% slow activity 42% unreactive activity 21% low-voltage activity 61% rhythmic or periodic delta waves |
| Petrescu/2020[20] | 36 | During infection | 42.5?G alterations 32.5% generalized multifocal or rhythmic periodic discharges |
| Koutroumanidis/20203 | 13 | Non-recovery after sedation suspension | 5 cases of alpha coma pattern |
Table 1: Review of literature
This case is the first to document a post-infectious alpha coma EEG pattern emerging after clinical and virological recovery from COVID-19 in a patient with underlying Huntington’s Disease (HD). While previous studies have reported alpha coma patterns predominantly during the acute phase of infection, often implicating viral neurotropism or immune-mediated encephalopathy as key mechanisms, [3] our findings challenge this framework by revealing a delayed manifestation likely driven by secondary hypoxic injury.
The timing of the alpha coma pattern—appearing two weeks after negative SARS-CoV-2 testing—strongly suggests that ongoing viral invasion or acute neuroinflammation are unlikely causes. Notably, prior reports have associated alpha coma with bilateral MRI abnormalities involving the basal ganglia and brainstem, areas integral to the reticular activating system, which is critical for maintaining consciousness. [3] In contrast, our patient’s neuroimaging demonstrated diffuse cortico-subcortical hypoperfusion without basal ganglia inflammation or contrast enhancement, consistent with chronic hypoxic injury rather than immune-mediated damage. The absence of inflammatory markers in the CSF further supports this interpretation.
Alpha coma, characterized by unreactive, frontally predominant alpha-frequency rhythms (8–13 Hz), has historically been linked to poor prognosis, particularly following cardiac arrest. [7–8] However, emerging evidence indicates that alpha coma after respiratory hypoxia or prolonged hypoxemia can have a more favorable prognosis, especially if some EEG reactivity is preserved. Our patient’s EEG evolution—transitioning from an alpha coma pattern to the re-emergence of normal sleep architecture elements such as spindles and K-complexes—correlates with his gradual clinical improvement and partial recovery of consciousness. This EEG trajectory aligns with the notion that post-hypoxic alpha coma may be reversible under certain conditions.
Critically, this case underscores the complexity of interpreting EEG patterns in COVID-19 survivors, particularly those with pre-existing neurodegenerative disorders like HD, who may be more vulnerable to hypoxic insults. It highlights the importance of differentiating between active infectious encephalopathy and secondary injury mechanisms when assessing late neurological deterioration. Such differentiation has direct clinical implications for management strategies, including the decision to pursue immunotherapy versus supportive care targeting hypoxic brain injury.
While we cannot categorically exclude a subclinical immune-mediated process, the convergence of clinical timeline, neuroimaging, and CSF findings collectively favors chronic hypoxia as the primary driver. This case thus broadens the spectrum of COVID-19-related neurological sequelae, revealing that alpha coma patterns can arise as delayed manifestations rather than exclusively during acute infection.
Future studies should prioritize longitudinal EEG monitoring and multimodal neuroimaging in post-COVID-19 patients to better characterize the timing, mechanisms, and prognostic significance of delayed encephalopathic patterns. Additionally, investigation into the interplay between neurodegenerative diseases and COVID-19-related hypoxic injury is warranted to optimize patient outcomes.
This case expands current understanding of COVID-19-related EEG abnormalities by documenting the emergence of an alpha coma pattern after infection resolution, diverging from prior reports that emphasize acute-phase autoimmune mechanisms. Our findings suggest that prolonged hypoxia during severe respiratory illness can induce delayed alpha coma EEG changes, especially in vulnerable patients with underlying neurodegenerative conditions. We advocate for continued EEG surveillance in post-COVID-19 patients with persistent altered consciousness, as early recognition of post-hypoxic complications may inform prognosis and guide tailored therapeutic interventions. Recognizing this delayed pattern is essential to avoid misdiagnosis and unnecessary immunomodulatory treatments, ultimately improving patient management in the evolving landscape of COVID-19 neurological care.
Ethical approval was not required for this case report, as determined by the Ethics Committee of the University of Naples Federico II. The report is based on a retrospective review of anonymized clinical data and did not involve any experimental intervention. Written informed consent for publication, including use of clinical information and video material, was obtained from the patient and his legal guardian (wife).
The authors confirm that they have read and adhered to the journal’s guidelines on ethical publication and affirm that this work complies with those standards.
No specific funding was received for the preparation of this manuscript.
The authors declare no conflicts of interest relevant to this work.
The authors have no additional financial disclosures to report.
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My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
Dear Grace Pierce, Editorial Coordinator of the journal IJCCR, I had a very positive experience with Auctores - Journal throughout the publication process. The Editorial Team was highly responsive, professional, and supportive at every stage. I would like to extend my sincere thanks to the Editor: Grace Pierce, for her guidance and assistance. The peer-review process was smooth and constructive, helping improve the quality of my work. I would gladly recommend Auctores Journal to fellow researchers and authors. Dr. SABITA SINHA, Medical Oncologist, MD (Electro Homeopathy).
