A New Viral Coinfection: SARS-CoV-2 Pneumonia and Cytomegalovirus Pneumonitis in a Renal Transplant Recipient
Round 1
Reviewer 1 Report
The title is not appropriate. If the case was truly unique then it would be of little interest. The conclusion correctly notes that the combination should be anticipated in high risk cases. The title should reflect this.
Author Response
Thank you for your feedback. I will change the title to "A New Viral Coinfection: SARS-CoV-2 Pneumonia and Cytomegalovirus Pneumonitis in a Renal Transplant Recipient."
Reviewer 2 Report
A great paper, no suggested changes.
Author Response
Thank you for your feedback!
Reviewer 3 Report
Authors presented interesting case of the CMV and SARS-CoV-2 coinfection complicated with CMV resistance. It seems that rather prolonged CMV replication was associated with risk factor for COVID-19. Suboptimal dose of valgacyclovir is associated with development of resistance. The risk was aggravated by recipient's seronegative CMV status.
Authors did not provide information regarding immunosuppression modification. I agree that CNI may have positive effect on cytokine storm but not MMF especially in the setting of severe lucopenia. MMF sholuld be withdrawn and cyclosporine dose should be reduced. There is lack of this information.
Author Response
Thank you for your feedback! I have added the changes in his immunosuppression into the paper.