The communication of research on the novel coronavirus was made more efficient during the pandemic by the use of preprints—scientific papers yet to undergo peer review that are published immediately on open-access platforms. Over a 12-week period between June and August, a new initiative mobilized a network of researchers across Brazil to analyze 12 preprints on infectious diseases. The studies, all written in Portuguese, were published on SciELO Preprints, a Brazilian platform created two years ago by the SciELO library of open-access journals. The objective was to encourage more scientists to participate in this type of review, which is done on a voluntary basis, and to quickly provide authors and readers with an opinion on the quality of the results.
The papers and reviewers were chosen by American organization ASAPBio, founded in 2015 to promote the use of preprints in the life sciences. It was not only in Brazil that this collective effort took place. In the USA, a team is completing the analysis of approximately 30 biology and biochemistry papers written in English. “We want to ensure that all communities, regardless of field, language, and location, participate in scientific communication using preprints,” said Iratxe Puebla, associate director of ASAPBio.
“The experience was productive,” says technology and digital media specialist Alex Mendonça, coordinator of SciELO Preprints. “There were manuscripts that fit into several stages of this means of scientific communication. They were released as preprints and quickly reviewed by experts, but also submitted to journals in the SciELO collection, which are performing a more detailed review. At the same time, their research data are stored in our SciELO Data repository.” Dozens of researchers applied to take part after the activity was publicized by the organizers. “If there is one point that could be improved in future initiatives, it would be to increase the number of reviewers,” says Mendonça. “The group participated unequally. Some contributed to almost every article, while others were less available.”
A new paper was chosen every week and distributed to the reviewers, each of whom wrote their considerations, which were then consolidated into a text attached to the manuscript. In April, Raphael Guimarães of the Oswaldo Cruz Foundation published one of the papers analyzed by the initiative on SciELO Preprints and submitted it to a scientific journal at the same time. The study, carried out together with Mariana Passos and Viviane Dutra, analyzed excess mortality in the first year of the pandemic—the number of deaths above expected based on the average of the previous five years. These excess deaths may have been caused by COVID-19 or by failures in the treatment of other illnesses during the health emergency.
According to the study, Brazil’s excess mortality in 2020 was 19%. Deaths from infectious diseases, which includes COVID-19, were 80% higher than expected, but there were also other causes unrelated to the novel coronavirus. Deaths related to mental illness were 29% higher than average and deaths of pregnant women 27% higher. The excess mortality rate for endocrine and cardiovascular diseases was 16%.
Just two months after submitting the paper, Guimarães received feedback from reviewers of the preprint and editors at the journal Revista Brasileira de Epidemiologia (Brazilian journal of epidemiology), which accepted the article for publication. In this instance, the two processes were complementary to one another. The group of six preprint reviewers focused on formal aspects, suggesting the incorporation of certain data and explanations. “There were few details in the original because we chose to publish a quick communication, presenting a general summary of the results in a short text,” explains Guimarães. The reviewers from the journal, on the other hand, proposed more in-depth analyses and pointed out that there was enough content to write a much longer article. “We took the suggestions of both groups on board and rewrote the article. It grew from 900 words to over 3,000,” says Guimarães.
In some cases, the authors found the preprint assessments too generic. Fabianne Dias de Sousa of the Nursing Department at the Federal University of Pará and colleagues presented a survey of 49 COVID-19 patients who were admitted to a hospital in Belém and continued to receive professional care at home after being discharged. The study served to validate a questionnaire developed to measure homecare efficiency and showed that it was of a satisfactory level in the surveyed sample. “We used many of the contributions to write a second version of the paper, which is being submitted to a journal,” explains Sousa. She accepted some suggestions, but believes some made no sense, such as a recommendation not to mention readmissions in the abstract. “It seemed like the reviewers did not have in-depth knowledge of transitional care, a topic that the article addresses,” she says.
One advantage appreciated by most authors is the chance to receive a quick response and promote dialogue with other qualified scientists about their results. “Producing a scientific article can be a lonely job. The usual way is to submit a manuscript to a journal and wait months for the reviewers to respond. A review at the preprint stage helps combat this isolation,” says Raquel Maria Soares Freitas, an economist currently studying a master’s degree in public policy management at the University of São Paulo (USP). She is coauthor of a study, written in partnership with the legal scholar Marta Battaglia Custódio—both work at Brazil’s Ministry of Citizenship—which analyzed mortality rates among people aged 65 to 85 who received social welfare payments (BPC) between 2015 and 2021. Equal to the monthly minimum salary, BPC is granted to the elderly and other people unable to support themselves. The study compared data from the first two years of the pandemic with previous years. The results show that the mortality rate in this group rose by 18.76% in 2020 and 21.64% in 2021 over the 2005–2019 period.
The reviewers of the paper recommended elaborating on several points. One suggestion the authors agreed with was to create not only mortality tables separated by the sex and age of welfare recipients, but also consolidated annual figures. “When we saw this data, new questions emerged that we had to address in the article,” says Battaglia. One such revelation was a mortality peak in 2016 that was evident in the aggregated tables. “We hypothesized that the increase was related to the H1N1 flu epidemic and that a change in the BPC management system in 2016 may have led to previous deaths being recorded,” she says. In August, the two researchers uploaded a new version of the manuscript, which includes most of the suggested changes, and will now submit it to a scientific journal.
For the reviewers, the experience was also useful. Mariana de Almeida Rosa Rezende, a PhD student at the Federal University of Juiz de Fora, was one of the selected volunteers. She found out about the initiative online and saw it as an opportunity to learn about emerging topics. “In papers on subjects that I know in depth, I made recommendations relating to the bibliographies and methodology descriptions. In others, I focused on more formal problems. One point that bothered me was the absence of important data in the abstract.” What she appreciated most was the collective nature of the process. “Reviewers have different profiles. Some highlight spelling and grammatical errors, while others point out structural problems or suggest references. I learned a lot from my colleagues and will use these lessons in my own work,” she explains.
Alex Mendonça, from SciELO Preprints, says the experience helped inspire changes to the repository’s website. “It is currently not easy enough to find comments made by reviewers. You need to open the PDF of the manuscript and search in a specific field. We plan to make these contributions more visible by bringing all comments together on one webpage.”
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