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Does the introduction explain the objective of the research presented in the preprint?

Partly

1) The introduction section does give general information on the problem and how it affects people globally. However, it does not give enough information on how it has affected people over the years, what the risks associated with it are, and the first paragraph does not have sufficient citations. We would like that the authors consider adding more literature to the section give a more robust explanation on the problem and extent. 2) With reference to the first paragraph, the mentioned "incident rates" are not quantified. It would be good to add statistics to that to really show the burden of the problem. 3) The last paragraph presents that there is "alarming data" around the epidemiology of IE but does not include that data. The statement is needs more supporting information to support the rationale behind wanting to do this retrospective analysis. We suggest that the authors add that information.

Are the methods well-suited for this research?

Somewhat appropriate

1) Study design/setting: We recommend that authors add more information with regardless to the choice of the setting i.e. Sao Paulo Hospital, than that it is a reference in care, teaching and research in Brazil. 2) Participants: The "possible IE" needs more defining and how does it possibly affect their findings. 3) Data collection: When and how was the data collected? This section needs to include that not only the characteristics or variables. 4) Variable definition: There is no concerns on this one as it explains the variables well. 5) Statistical analysis: This study is a retrospective cohort study and there was no mention of qualitative data, however this section mentions an analysis of qualitative variables. More information may be needed to qualify that. There should be a clear explanation on the comparative statistical analysis utilized concerning chi-square test or Fisher's exact test, Student's test and Mann-Whitney test. Furthermore, the phrase "student's test or Mann-Whitney test" is not clear an this is a report how the data was analyzed and adding "or" seems more like a proposal and not a report. 6) Ethical aspects: We recommend an addition of ethical considerations looked at for this study and how the data was managed. A section for data management/handling would suffice if authors see it fit.

Are the conclusions supported by the data?

Somewhat supported

1) Authors should consider to add more information with regards to the morbidity and risk factors contributing to the mortality rates.

Are the data presentations, including visualizations, well-suited to represent the data?

Somewhat appropriate and clear

1) The authors stated in the methods section that they utilized the multivariate and t-test or Mann-Whitney test but there is no reflection of results from these analyses in the results section.

How clearly do the authors discuss, explain, and interpret their findings and potential next steps for the research?

Neither clearly nor unclearly

1) The statistics are unclear to the readers. While the statistics are being modified, the discussion section should also reflect what the results states. 2) With these recommendations, if addressed, the authors should consider adjusting the conclusion section to be in tune with the adjusted sections before it.

Is the preprint likely to advance academic knowledge?

I don’t know

Would it benefit from language editing?

Yes

There is need for authors to improve the grammatical flow in the preprint and also clarify on the few ambiguous statements as stated in the comment on the methods section, specifically on statistical analysis.

Would you recommend this preprint to others?

No, it’s of low quality or is majorly flawed

For now it is of low quality but can be improved provided the comments raised are taken into consideration make it more clear.

Is it ready for attention from an editor, publisher or broader audience?

No, it needs a major revision

Competing interests

The authors declare that they have no competing interests.