AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2693-4779/264
Health Center Santa Maria de Benquerencia. Regional Health Service of Castilla-la Mancha (SESCAM), Toledo, Spain
*Corresponding Author: Jose Luis Turabian Health Center Santa Maria de Benquerencia Toledo, Spain.
Citation: Jose L. Turabian, (2025), Hybrid Immunity Effect Trend on Covid-19 Reinfection in A Fully Vaccinated Population According to The Number Needed to Treat Since 2020-2022 To 2023 Versus 2023 To 2024 In A General Medicine Office in Toledo (Spain), Clinical Research and Clinical Trials, 12(4); DOI:10.31579/2693-4779/264
Copyright: © 2025, Jose Luis Turabian. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 17 March 2025 | Accepted: 09 April 2025 | Published: 16 May 2025
Keywords: covid-19; sars-cov-2; hybrid immunity; risk and benefit data; population surveillance/methods; epidemiological characteristic; public health practice; general practice
Background
The evolution of the magnitude of the impact from 2020 to 2024 of prevention measures (vaccination and natural immunity) against covid-19 reinfection in daily practice on the population is not known.
Objective
To compare the number needed to treat (NNT) and the number needed to harm (NNH) for SARS-CoV-2 reinfections, associated with prevention measures (mainly acquired immunity through vaccination and natural immunity), since 2020-2022 period to 2023 vs. 2023 to 2024.
Methodology
Comparison of secondary data among covid-19 reinfection cases in 2020-2022 period to 2023 vs. 2023 to 2024 of previous studies. For the calculation of NNT and NNH of SARS-CoV-2 infections, cases in 2020-2022 period were considered control group with respect to cases in 2023, and cases in 2023 were considered control group with respect to cases in 2024.
Results
Lower NNT figures (greater magnitude of the hybrid immunity effect) and higher NNH figures (lower risk of harm with hybrid immunity) were found since the period 2020-2022 to 2023 versus 2024. 2023 to 2024. Since 2020-2022 period to 2023 the lowest NNT figures were for women (17) and People with some type of labor specialization (59). And the highest NNH figures were for men (1000) and Moderate-severe severity of reinfection (500). Since 2023 to 2024 the lowest NNT figures were Socio-Health Care Workers (5) and Complex families (111). And the highest NNH figures were for population >14 years (500) and People with some type of labor specialization (333).
Conclusion
In the context of this general practice setting in Toledo, Spain, there was a lower magnitude of the beneficial effect of hybrid immunity from 2023 to 2024 vs. from 2020-2022 to 2023. In any case, the greatest benefit in 2024 is for Socio-Health Care Workers and the least harm is for the population >14 years old.
Hybrid immunity, resulting from a combination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination, offers robust protection against coronavirus disease 2019 (covid-19) in the community. A large proportion of the world's population has acquired immunity through vaccination, infection, or a combination of both, i.e., hybrid immunity against SARS-CoV-2 by the end of 2022 [1]. But the temporal evolution of this natural and hybrid immunity is unknown [2].
Decreased immunity as a result of new variants must be taken into account. The efficacy of prior SARS-CoV-2 infection in preventing reinfection varies along the spectrum spanning alpha, beta, delta, and omicron (3). There is increasing scientific evidence showing that the protection generated by vaccination decreases over time, although it is restored with booster dose inoculation [4, 5].
Five years after the pandemic began, new SARS-CoV-2 infections continue to occur despite advances in vaccines. SARS-CoV-2 reinfections became common with the arrival of omicron [6-9]. Knowledge about immune protection induced by vaccines, previous infection or hybrid immunity is of great importance for intervention policies against covid-19 and for a better understanding of the immunological mechanisms that protect against infectious diseases (1).
Although various measures can be used to describe the benefits and harms of treatments or preventive interventions, not all of them clearly show the benefits or harms of these interventions in a clinically useful way. Relative risk and relative risk reduction (RRR) are commonly used to describe study results, but they have limited clinical utility as they do not take into account baseline risks and tend to exaggerate study results. Absolute risk measures, such as number needed to treat (NNT) and number needed to harm (NNH), allow risk to be expressed in a much more clinically relevant way. Absolute risk measures reflect baseline risk and more accurately indicate the magnitude of the treatment effect [10].
Thus, in SARS-CoV-2 infection, it may be more intuitive to give the results of the intervention (community hybrid immunity: vaccination and natural immunity from having had the infection) over time, in the form of ARR, NNT and NNH. Consequently, measuring the ARR and NNT (people to be vaccinated and/or with past infection at the community level) may be more appropriate for prioritizing vaccination of vulnerable populations than relative measures, such as RRR [11, 12].
In this scenario, we present a comparative study, based on previously published data, to evaluate the NNT and the NNH of covid-19 reinfections since period 2020-2022 until 2023 [with alpha, delta and omicron SARS-CoV-2 variants; and in 2020 without vaccination, in 2021 with 1 or 2 dose vaccination and in 2022 with first booster] and since 2023 until 2024 [in 2023 omicron variant and with second booster -4th dose-, and in 2024 omicron variant with third booster -5th doses- of vaccine], from the same population attended in a general medicine consultation.
Design and emplacement
This study compares data from previous observational, longitudinal and prospective studies of covid-19 reinfections since Marzo 2020 to October, 2024, already published [13, 14]. These previous studies were conducted on the same population: patients saw in a general medicine office in Toledo, Spain, which has a list of 2,000 patients > 14 years of age (in Spain, general practitioner (GP) care for people > 14 years of age, except for exceptions). The GPs in Spain work within the National Health System, which is public in nature. GPs are the gateway for all patients to the system and each person is assigned a GP. The methodology of all studies has been previously published, but the main elements will be repeated here to facilitate understanding of the current study.
Outcome of interest
To compare the number needed to treat (NNT) and the number needed to harm (NNH) for SARS-CoV-2 reinfections, associated with acquired immunity by vaccination and/or infection) since March 2020-October 2022 period to October 2023 with October 2023 to October, 2024.
Definition, calculation and interpretation of NNT and NNH
NNT (defined as the number of individuals that must be treated with the experimental therapy to produce, or prevent, one additional event over those that would occur with the control treatment; it represents the number needed to treat to produce an effect in 1 of them) and NNH (number needed to treat to produce some harm in 1 of them; that is, a negative NNT indicates that the treatment has a harmful effect; the experimental treatment achieves less benefit than the control or standard; or that the adverse effects inherent to the treatment are greater in the experimental group. The NNH will have a negative absolute risk reduction) were calculated as the inverse of the Absolute Risk Reduction (ARR), or 1/ARR. The lower the NNT, the greater the magnitude of the effect of the intervention in question. The higher the NNH, the lower the risk of harm from the intervention [15]. NNT and NNH were calculated using the online Clinical Calculators at ClinCalc.com [16].
Definition of reinfection
SARS-CoV-2 reinfection was defined as a documented infection occurring at least 90 days after a previous infection [17-19].
Diagnosis of covid-19
The diagnosis was performed with reverse transcriptase polymerase chain reaction oropharyngeal swab tests or antigen testing [20] performed in health services or at home.
Covid-19vaccination
Patients could have received 1, 2 doses of vaccine, first booster for fall-winter 2021, fourth dose (second booster) for fall-winter 2022 [21] and fifth dose (third booster) for fall-winter 2023. In our study, only Pizfer / BioNTech, Spikevax (mRNA-1273- Moderna), Vaxzevria, Oxford / AstraZeneca and Janssen (Johnson & Johnson) vaccines were used for the first and second doses. For the first booster, only messenger RNA (mRNA) was used. And only Moderna and Pfizer-BioNTech's bivalent covid-19 vaccines were used for the second booster. Omicron XBB.1.5 adapted vaccines Pfizer / BioNTech y Spikevax (Moderna) were used for the third booster in autumn-winter 2023-2024 [22-25].
Collected variables
The following variables were collected:
-Age and sex
-Chronic diseases (defined as "any alteration or deviation from normal that has one or more of the following characteristics: is permanent, leaves residual impairment, is caused by a non-reversible pathological alteration, requires special training of the patient for rehabilitation, and / or can be expected to require a long period of control, observation or treatment” [26]
-Social-occupancy class (according to the Registrar General's classification of occupations and social status code) [27]
-If they were Health Care Workers
-Disease severity (classified according to: 1. mild cases: clinical symptoms are mild and no manifestation of pneumonia can be found on images; 2. moderate cases: with symptoms such as fever and respiratory tract symptoms and the manifestation of pneumonia can be seen on the imaging tests; and 3. severe cases: respiratory distress, respiratory rate ≥ 30 breaths / min., pulse oxygen saturation ≤ 93% with room air at rest, arterial partial pressure of oxygen / oxygen concentration ≤ 300 mmHg.) [28]; to simplify comparison, moderate and severe cases were counted together
-Problems in the family context based on the genogram. It was understood that "complex" genograms present families with psychosocial problems) [29, 30]
-Ethnic minority (defined as a “human group with cultural, linguistic, racial values and geographical origin, numerically inferior compared to the majority group”) [31]
Epidemiological analysis
Definition, calculation and interpretation of NNT and NNH was carried out as explained above. Figures with decimals were rounded to facilitate a more intuitive comparison. Similarly, to facilitate understanding of the data, the periods compared were rounded to full years: the period from October 1, 2022 to September 30, 2023 was labeled 2023; and from October 1, 2023 to September 30, 2024 was labeled 2024.
Ethical issues
No personal data of the patients were used, but only group results, which were taken from the clinical history.
Lower NNT figures (greater magnitude of hybrid immunity effect) and higher NNH figures (lower risk of harm with hybrid immunity) were found since 2020-2022 to 2023 versus 2023 to 2024. From 2020-2022 to 2023, the lowest NNT figures were for women (NNT= 17), People with some type of labor specialization (NNT= 59), and total population >14 years (NNT= 77). And the highest NNH figures were for men (NNT= 1000) and Moderate-severe severity of reinfection (NNH= 500). From 2023 to 2024, the lowest NNT figures were for Socio-Health Care Workers (NNT= 5) and Complex families (NNT= 111). And the highest NNH figures were for population >14 years (NNH= 500), People with some type of labor specialization (NNH= 333) and carriers of chronic diseases (NNH= 200). The NNT and NNH of >= 65 years and Ethnic minority, from 2023 to 2024, were not calculable because they had the same incidence rate in both periods (TABLE 1, FIGURE 1).
| VARIABLES | INCIDENCE RATES OF COVID-19 RE-INFECTION 2020-2022 (control) | INCIDENCE RATES OF COVID-19 RE-INFECTION 2023
(Intervention for 2020-22, and control for 2024) | ABSOLUTE RISK REDUCTION 2020-2022 vs. 2023 (Control incidence minus intervention incidence) | NUMBER NEEDED TO TREAT (NNT) [1/ABSOLUTE RISK REDUCTION] 2020-2022 (control) vs. 2023 (intervention) (The lower the NNT, the greater the magnitude of the treatment effect in question; the higher the NNH, the lower the risk of harm from the intervention) | INCIDENCE RATES OF COVID-19 RE-INFECTION 2024 (intervention) | ABSOLUTE RISK REDUCTION 2023 vs. 2024 (Control incidence minus intervention incidence) | NUMBER NEEDED TO TREAT (NNT) [1/ABSOLUTE RISK REDUCTION] 2023 (control) vs. 2024 (intervention) (The lower the NNT, the greater the magnitude of the treatment effect in question; the higher the NNH, the lower the risk of harm from the intervention) |
| >=14 years | 1.9% | 0.6% | 1.9-0.6=1.3 | On average, 77 patients would have to receive the 2023 hybrid immunity level (instead of the 2020-2022 level) for an additional person >14 years of age to NOT have the covid-19 reinfection. | 0.8% | -0.2 | On average, 500 people >14 years of age would need to receive the 2024 level of hybrid immunity (instead of the 2023 level) for one additional person >14 years of age to HAVE covid-19 reinfection |
| >= 65 years | 0.9% | 1.1% | -0.2 | On average, 500 patients would have to receive the 2023 hybrid immunity level (instead of the 2020-2022 level) for one additional person to HAVE covid-19 reinfection | 1.1% | 0 | Not calculable |
| Women | 6.3% | 0.6% | 5.7 | On average, 17 patients would have to receive the 2023 hybrid immunity level (instead of the 2020-2022 level) for one additional woman to NOT have covid-19 reinfection | 2.1% | -1.5 | On average, 67 women would need to receive the 2024 level of hybrid immunity (instead of the 2023 level) for one additional woman to HAVE covid-19 reinfection |
| Men | 0.8% | 0.9% | -0.1 | On average, 1000 patients would have to receive the 2023 hybrid immunity level (instead of the 2020-2022 level) for one additional man to HAVE covid-19 reinfection | 0.5% | 0.4 | On average, 250 men would have to receive the 2024 level of hybrid immunity (instead of the 2023 level) for one additional man to NOT have covid-19 reinfection |
| Socio-Health Care Workers | 29% | 37% | -8 | On average, 13 socio-health care workers would have to receive the 2023 hybrid immunity level (instead of the 2020-2022 level) for one additional Socio-Health Care Workers to HAVE covid-19 reinfection | 17% | 20 | On average 5 socio-health workers would have to receive the 2024 hybrid immunity level (instead of the 2023 level) for one additional socio-health workers to NOT HAVE covid-19 reinfection |
| Moderate-severe severity of reinfection | 0 | 0.2% | -0.2 | On average, 500 patients with moderate severe severity would have to receive the 2023 hybrid immunity level (instead of the 2020-2022 level) for one additional patient with moderate severe severity to HAVE covid-19 reinfection | 0 | 0.2 | On average, 500 patients with moderate severe severity would have to receive the 2024 level of hybrid immunity (instead of the 2023 level) for one additional patient with moderate severe severity to not HAVE covid-19 reinfection |
| Chronic disease carriers | 1.7% | 0.3% | 1.4 | On average, 71 patients with chronic diseases would have to receive the 2023 hybrid immunity level (instead of the 2020-2022 level) for one additional patient with chronic diseases to NOT have covid-19 reinfection | 0.8% | -0.5 | On average, 200 patients with chronic diseases would have to receive the 2024 hybrid immunity level (instead of the 2023 level) for one additional patient with chronic diseases to HAVE covid-19 reinfection |
| People with some type of labor specialization | 1.8% | 0.1% | 1.7 | On average, 59 people with some type of labor specialization would have to receive the 2023 hybrid immunity level (instead of the 2020-2022 level) for one additional patient to NOT have covid-19 reinfection | 0.4% | -0.3 | On average, 333 people with some type of labor specialization would have to receive the 2024 level of hybrid immunity (instead of the 2023 level) for one additional patient to HAVE covid-19 reinfection |
| Complex families | 0.5% | 1.2% | -0.7 | On average, 143 people with complex families would have to receive the 2023 hybrid immunity level (instead of the 2020-2022 level) for one additional people with complex families to HAVE covid-19 reinfection | 0.3% | 0.9 | On average, 111 people with complex families would have to receive the 2024 hybrid immunity level (instead of the 2023 level) for one additional people with complex families to NOT have covid-19 reinfection |
| Ethnic minority | 6.2% | 1.2% | 5 | On average, 20 ethnic minority people would have to receive the 2023 hybrid immunity level (instead of the 2020-2022 level) for one additional ethnic minority people to NOT have covid-19 reinfection | 1.2% | 0 | Not calculable |
Table 1: Nnt or nnh by hybrid immunity for covid-19 reinfections since 2020-2022 period to 2023 and since 2023 to 2024
Figure 1: Nnt or nnh by hybrid immunity for covid-19 reinfections since 2020-2022 period to 2023 and since 2023 to 2024
1. Main findings
Our main findings were:
1. Lower NNT figures (greater magnitude of hybrid immunity effect) and higher NNH figures (lower risk of harm with hybrid immunity) were found since 2020-2022 to 2023 versus 2023 to 2024.
2. Since 2020-2022 to 2023, the lowest NNT figures were for women, people with some type of labor specialization, and total population >14 years. And the highest NNH figures were for men and moderate-severe severity of reinfection.
3. Since 2023 to 2024, the lowest NNT figures were for Socio-Health Care Workers and Complex families. And the highest NNH figures were for population >14 years, people with some type of labor specialization, and carriers of chronic diseases.
To interpret the results, it is necessary to take into account SARS-CoV-2 lineages that were successively prevalent [32] and the vaccines received. In the period 2020-2022 SARS-CoV-2 variants were successively alpha, delta and omicron, and the population had received only 1, 2 or 3 doses of vaccine (14). In Spain, in April 2022, the population vaccinated with the complete regimen (2 or 3 doses) was more than 85% [33]. In November 2022, more than 60% of people over 80 years of age, and 37% of people over 60 years of age, already had the second booster dose of the covid-19 vaccine [34, 35]. In 2023, the omicron SARS-CoV-2 variant predominated and the population received the 4th booster dose of the vaccine. By June 2023, the number of people with the 1st booster dose was 56% of the population [36]. In 2024, the omicron SARS-CoV-2 variant predominated and the population received the 5th booster dose of the vaccine. 60% of the population over 80 years of age had received the vaccine adapted against the covid-19 subvariants of the 2023/2024 campaign [37].
In any case, the results must be evaluated with caution. In Spain, since April 28, 2022 there was a new "Surveillance and Control Strategy Against Covid-19" that includes the non-performance of diagnostic tests, except on over 60 years of age [38]. This means that positive cases have been counted with tests carried out in health services and with tests carried out at home and later reported to the GP. Thus, there is probably an underreporting.
2. Comparison with other studies
Understanding the protection that prior infection provides or vaccination against repeat infection, disease, and severe disease, in the transition from an epidemic to an endemic state, where a pathogen is stably maintained in a population. is key to projecting the future epidemiology of coronavirus disease 2019 (covid-19), and guiding decisions on vaccination policies (12).
One of the key questions in predicting the course of covid-19 is how well and how long immune responses protect the host from reinfection [39]. Reinfection occurs in an individual is not only determined by the magnitude and duration of specific immunity, but also by the various circumstances of their risk of exposure to the virus [40].
Omicron variants have demonstrated their potential to escape vaccine-induced humoral immunity, leading to many post-vaccination infections and the development of hybrid immunity (1). Reinfections before the omicron variant were very rare, but as new subvariants appeared, immune escape is greater; Not only from vaccines, but also from natural immunity [41-43]. Neither natural immunity nor first-generation vaccine-induced immunity have been able to effectively prevent transmission. Booster doses (third or fourth) of the vaccine played an important role in preventing symptomatic infection, although the booster effect only lasts several months [44, 45].
A systematic review of the magnitude and duration of protective efficacy of prior SARS-CoV-2 infection and hybrid immunity against infection and severe disease caused by the omicron variant showed that all estimates of protection against reinfection declined within months [46]. Clinical trials for covid-19 vaccines by 2021 reported impressive efficacy in preventing symptomatic disease: 95% RRR for the Pfizer-BioNTech vaccine and 94% for the Moderna vaccine. If ARR were calculated in the same population of these clinical trials, this reduction provided by the vaccines would be much less striking [47, 48]. The RRR has the disadvantages that it does not differentiate very large from very small risks or benefits and does not vary according to sample size (15). The calculation of the NNT allows to evaluate not only the magnitude of the effects but also the cost-benefit of the intervention (15).
In some cases where the risk is greater in the exposed group, some authors prefer to speak of relative risk increase (instead of RRR) and absolute risk increase (instead of ARR) [49]. A negative NNT indicates that the treatment has a harmful effect (the experimental treatment achieves less benefit than the control or standard), or that the adverse effects inherent to the treatment are greater in the experimental group. The lower the NNT, the greater the magnitude of the treatment effect in question. The higher the NNH, the lower the risk of harm with the new treatment (15).
In summary, in a general practice setting in Toledo, Spain, we found a greater magnitude of hybrid immunity effect and lower risk of harm with hybrid immunity, since 2020-2022 to 2023 versus 2023 to 2024. Greatest benefit since 2023 to 2024 is in Socio-Health Care Workers and the least harm in the population >14 years. This data suggests that covid-19 vaccination should be maintained, at least in Socio-Health Care Workers. In any case figures since 2023 and 2024 may have a bias due to underreporting.
1. Absolute risk measures reflect baseline risk and more accurately indicate the magnitude of the treatment effect. However, because they vary according to the population's baseline risk, their generalizability is limited and the published NNT of a treatment in one population cannot be directly applied to another population with a different baseline risk.
2. The sample was small, so some data may cause misinterpretation.
3. Asymptomatic cases were missing because they did not attend GP consultation, as no surveillance or systematic screening was done.
4. There may be an underreporting of infections to GP of patients with a positive test at home.
5. The great accessibility of patients to the GP, and the fact of continuity of care that characterizes family medicine, have important epidemiological connotations, presenting a unique opportunity to study benefit-risk values of interventions.
In the context of this general practice setting in Toledo, Spain, there is a lower magnitude of beneficial effect and lower harm of hybrid immunity since 2023 to 2024 versus 2020-2022 to 2023. In any case, the greatest benefit in 2024 is in Socio-Health Care Workers and Complex families, and the least harm in the population >14 years old. Two future strategies are suggested; 1) prioritize vaccination in Socio-Health Care Workers, or 2) vaccinate the entire population >14 years old.
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.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
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
