Authors of a case report on COVID-19 in a prisoner say they ‘are unsatisfied with the quality of [their] work’

The authors of a 2020 case study of COVID-19 have retracted the work because they were “unsatisfied with the quality” of the work. Nor, judging from the retraction notice, should they — or the journal that published the report — be. 

The article was titled “Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Mimicking as Pulmonary Tuberculosis in an Inmate” and was written by a group led by Hina Akbar, of the University of Tennessee Health Science Center, in Memphis. According to the abstract:

Here, we describe a case of SARS-CoV-2 infection in a low prevalence area which was initially diagnosed and managed as pulmonary tuberculosis (TB) in a high-risk inmate population. These ambiguous presentations can lead to mismanagement of such patients resulting in potentially fatal outcomes and public health crises in confined facilities. This also highlights the significance of a high index of clinical suspicion for SARS-CoV-2 especially in high risk and vulnerable populations.

That might be true, but evidently the article did a poor job of making the argument. The nostra culpa retraction notice states

Our case report, “Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Mimicking as Pulmonary Tuberculosis in an Inmate” contains some inadvertent errors and lacks some pertinent patient information that could have been added to the manuscript. Information about COVID-19 was rapidly evolving at the time the article was published so we are unable to confirm if the patient’s presenting symptom of hemoptysis was from COVID-19. We believe the report may not accurately represent the patient’s clinical course, diagnosis and treatment and there is a chance that the reader can get confused and possibly misinterpret our case. We think that a more thorough review of literature and a more detailed discussion with other care team members/consultants would have greatly improved the quality of our article.

We are unsatisfied with the quality of our work and we think that the report in its current form is not up to the mark or as scientifically sound as we intended our work to be. As COVID-19 is a topic of great interest with a large reader population, we want readers to receive our work in the highest possible standard. We hope to publish a revised article which is higher quality, error-free and without any ambiguity. For these reasons, we would like to request a retraction of the article in order to replace it with an article that meets the best standards of our own work, the journal and the scientific community as a whole.

The retraction is the 155th of COVID-19 papers, by our count.

And we have questions. 

For starters, if the paper was that bad, why did the authors try to foist it off on readers of Cureus, or any journal, for that matter? 

Akbar did not respond to a request for comment. We also asked John Adler Jr., the editor-in-chief of the journal, about the origin story of the retraction. He told us: 

Cureus executed the retraction entirely on behalf of the author’s (seemingly spontaneous) request. Discussion was had with the authors about simply issuing an erratum but ultimately, they felt it would be cleaner to retract and republish a more thorough analysis at a later date. Generally if an author for any reason loses confidence in what they publish, and requests retraction, I believe a retraction is compulsory.

And we also asked Adler if he felt the errors — given their apparent magnitude — should have been picked up during the peer review process. 

He said: 

Yes, in the ideal world the reviewers would have identified the weaknesses in this article before publication. However, that level of critique tends to be the exception in all journals, even the biggest names.

He has a point there.

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