Global Research on COVID-19 Disease: A Scientific Assessment of Publications during 2020-21

Copyright © 2021 Phcog.Net. This is an openaccess article distributed under the terms of the Creative Commons Attribution 4.0 International license. Cite this article : Gupta BM, Dhawan SM, Ahmed KKM, Mamdapur GM. Global Research on COVID-19 Disease: A Scientific Assessment of Publications during 2020-21. Int J Med Public Health. 2021;11(2):76-84. ABSTRACT The study aims to evaluate global research output (103054 records) on coronavirus disease (COVID-19) based on quantitative and qualitative indicators. It presents a bibliometric profile of most influential countries, organizations, authors and journals and their collaborative linkages, besides identifying broad subject areas of research, most significant keywords and highly-cited papers related to COVID-19. During 2020-21, more than 150 countries participated in COVID-19 research, of which top 10 countries accounted for a 82.93% global share. The USA, China and U.K. produced the most articles (25.86%, 10.77% and 10.7% respectively). The top three organizations, namely Harvard Medical School, USA, Huazhong University of S&T, China and Tongji Medical College, China contributed 1755, 1344 and 1267 papers, respectively. The most cited organizations in COVID-19 research are: Peking Union Medical College, China (97.41 CPP), University of Hong Kong (82.17 CPP) and Renmin Hospital of Wuhan University, China (59.88 CPP). The top three most productive authors are: V. Wanitlit, E. Mahase and G. Lacobucci (with 152, 135 and 108 papers). The top three most cited authors in terms of citations per paper (CPP) are: Y. Hu (319.82), L. Liu (303.91) and J.F.W. Chan (169.55). The most productive organizations originate from most productive countries and they contribute the most collaborative papers. The top three journals, namely International Journal of Environmental Research, BMJ and PLOS One contributed 961, 854 and 781 papers, respectively. The top three journals in terms of citations per paper (CPP) are New England Journal of Medicine (122.78), The Lancet (106.3) and JAMA (75.17). The most ubiquitous topic was COVID-19 clinical studies, with maximum focus on virological aspects (9.58%), respiratory aspects (6.97%), molecular aspects (3.11%), genetic aspects (3.09%) and immunological aspects (1.3%). The results of this study should be of interest to working scientists, clinicians and policy-makers in improving their understanding of COVID-19 disease and in its management.


INTRODUCTION
The Coronavirus Virus Disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). WHO first learned of this new virus on 31 December 2019, following a report of a cluster of cases of 'viral pneumonia' in Wuhan, China. The disease has since spread world-wide, leading to an ongoing pandemic. The COVID-19 aggressively spread throughout China in the following several weeks and became a worldwide pandemic affecting almost every country in the world within the subsequent few months. Further, according to WHO, the dissemination of this virus has been observed with 111,102, 016 confirmed cases and 2462,911 confirmed deaths in 223 countries, areas or territories as on 22 February 2021. 1 Coronaviruses (CoVs) are a large family of viruses, several of which cause respiratory diseases in humans, from the common cold to more rare and serious diseases, such as the Severe Acute Respiratory Syndrome (SARS) and the Middle East respiratory syndrome (MERS), both of which have high mortality rates and were detected for the first time in 2003 and 2012, respectively. CoVs are divided into four genera: alpha-, beta-, gamma-and delta-CoV. All CoVs currently known cause disease in humans belonging to the alpha-or the beta-CoV. 2 Symptoms of COVID-19 are variable, but often include fever, cough, fatigue, breathing difficulties, and loss of smell and taste. Symptoms begin one to fourteen days after exposure to the virus. Of those people who develop noticeable symptoms, most (81%) develop mild to moderate symptoms (up to mild pneumonia), while 14% develop severe symptoms (dyspnea, hypoxia, or more than 50% lung involvement on imaging), and 5% suffer critical symptoms (respiratory failure, shock, or multi-organ dysfunction) [6]. At least a third of the people who are infected with the virus remain asymptomatic and do not develop noticeable symptoms at any point in time, but they still can spread the disease. [3][4][5] SARS-CoV-2 is thought to have an animal (zoonotic) origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus Betacoronavirus, in subgenus Sarbecovirus (lineage B) together with two bat-derived strains. The structural proteins of SARS-CoV-2 include membrane glycoprotein (M), envelope protein (E), nucleocapsid protein (N), and the spike protein (S). 6 Although COVID-19 mainly affects respiratory and immune systems, other systems likely to be hit are cardiovascular, urinary, gastrointestinal tract, reproductive systems and integumentary systems (skin, hair, nails, and exocrine glands). It is believed that virus can damage almost every part of the body including kidneys, the brain, small intestine and rectum.
In respiratory system, COVID-19 can affect the upper respiratory tract (sinuses, nose, and throat) and the lower respiratory tract (windpipe and lungs). The lungs are the organs most affected by COVID-19 because the virus accesses host cells via the enzyme angiotensin-converting enzyme 2 (ACE2), which is most abundant in type II alveolar cells of the lungs. 7 The effects and impact of COVID-19 has put unprecedented pressures on healthcare systems worldwide. Although the numbers of confirmed cases and deaths continue to rise, the scientific research community has promptly responded and a number of COVID-19-related clinical trials are currently underway. Research and scientific inquisitions are of paramount importance in the wake of pandemics such as COVID-19. The absence of clinically proven curative treatments or vaccines (now available) coupled with paucity in our understanding of the disease and long term clinical squeal fuels the need for further research to help us better combat the current pandemic.
As COVID-19 spreads rapidly, the research community has been active in publishing novel articles on this dreadful disease. Therefore, it is important to understand the global scientific output of COVID-19 right from the early stage of the outbreak till today. Thus, to track the current hotspots and highlight future directions, we performed a bibliometric analysis to obtain an approximate scenario of COVID-19 research to date. Such efforts will improve clinicians' understanding of the large and growing body of evidence on the topic.
Bibliometrics studies map various disciplines to identify their research trends, discover knowledge structures and monitor research performance at global, national, institutional and individual level. These studies also analyses global research on different metrics of quantity (output) and quality (performance) and by using relational indicators describe relationships between research networks, teams, institutions, and countries. In recent years, bibliometrics have been used to provide strong insights into several subject fields linked to COVID-19 research. [8][9][10][11][12][13][14][15][16][17] But most of these bibliometric studies on COVID-19 research are based on a limited data sets covering (2 to 6 months) publications period. Till date, not a single study has been undertaken that attempts to evaluate the status of COVID-19 research in a comprehensive way by covering publication data since the outbreak of COVID-19 disease till today. It is to fill this gap that a comprehensive study on this topic has been planned. This study will therefore attempt to examine and assess the global publications on COVID-19 research since the early stage of the COVID-19 outbreak till date (covering around 13 month publications data) using bibliometric methods. The study will attempt to identify the key countries, organizations and authors in global research, discover global collaborative trends in COVID-19 research, bring out leading source journals on this theme, identify highly cited publications and their bibliometric characteristics, and explore prominent research areas (broad and narrow subject areas) in COVID-19 research. The results from the study will provide policy-makers and scholars a valuable resource that they could apply to identify national research priorities and draw up future plans in COVID-19 research.

MATERIALS AND METHODS
The study sourced publications and citations data related to COVID-19 from Scopus database on 15 February 2021. The fact that the Scopus database is the largest abstract and citation database of peer-reviewed scientific literature; it was decided to use it as the bibliometric resource for sourcing data for the present study. A comprehensive search was performed using a set of keywords (shown below) tagged to "Title" or "Keyword" tags in the Scopus database, and limiting the search results to publication years 2020-2021. The search yielded a total of 1, 03, 054 hits. All the data records relevant to COVID-19 were downloaded from the Scopus database. Excel as a tool was used to statistically analyse the total publications output on a series of bibliographic variables. TITLE ("COVID 19" OR "2019 novel coronavirus" OR "coronavirus 2019" OR "coronavirus disease 2019" OR "2019-novel CoV" OR "2019 related to COVID-19 AND SHOWN BELOWcov" OR covid 2019 OR covid19 OR "corona virus 2019" OR ncov-2019 OR ncov2019 OR "nCoV 2019" OR 2019-ncov OR covid-19 OR "Severe acute respiratory syndrome coronavirus 2" OR "SARS-CoV-2") OR KEY ("COVID 19" OR "2019 novel coronavirus" OR "coronavirus 2019" OR "coronavirus disease 2019" OR "2019-novel CoV" OR "2019 ncov" OR covid 2019 OR covid19 OR "corona virus 2019" OR ncov-2019 OR ncov2019 OR "nCoV 2019" OR 2019-ncov OR covid-19 OR "Severe acute respiratory syndrome coronavirus 2" OR "SARS-CoV-2") AND (LIMIT-TO (PUBYEAR, 2021) OR LIMIT-TO (PUBYEAR, 2020)).

Overall
As seen from Scopus database, a total of 103,054 publications (2020=87290; 2021=15764) related to COVID-19 had appeared from the early stage of the COVID-19 outbreak till 15 February 2021. Of the global (103,054) publications in the subject, a 32.11% share (33087) resulted from research projects sponsored by 1000+ national and international funding agencies. The top 20 funding agencies that supported research projects in this area are listed in Table 1. In terms of distribution of global output by document type, it was seen that the bulk of the research output (55.18%) on COVID-19 had appeared as articles, followed by letters and reviews (15.70% and 11.31%), notes and editorials (7.63% and 6.82%), short surveys and erratum (1.51% and 1.06%) and others accounted for a less than 1% share each: book chapters and data papers (0.59% each), books (0.01%), etc. Most of the research output (a 94.13% share) appeared in English language, followed by Spanish (2.35%), Chinese, French and German (1.22%, 1.11% and 1.04%), Portuguese, Russian, Italian (0.54%, 0.43% and 0.35%), and rest in 31 other languages.

Subject-Wise Distribution
As per the subject classification of Scopus database, the total COVID-19 publication output is distributed across 21 broad subjects. Of these, Medicine accounted for the largest share (71.44%), followed by Biochemistry, Genetics and Molecular Biology (10.61), Social Sciences (9.70%), Immunology and Microbiology (6.71%), Nursing (4.41%), Pharmacology, Toxicology and Pharmaceutics (4.38%), Environment Science (4.02%) and other subjects contributing from 0.56% to 3.22% in global publication share respectively. The subject-wise distribution of COVID-19 reflects the multidisciplinary nature of research as well as its impact in different subjects (Table 3, Figure 2).

COVID-19 Output by Significant Keywords
As seen from the Scopus database, 185 significant keywords seem to identify and define global literature on COVID-19. The co-occurrence of these keywords in more than one document provide a secondary approach to identify broad research trends in the investigation and treatment of the COVID-19, and to assess its impact on different subject fields and on various human organs. These keywords have been classified under broad subject headings along with the frequency of keyword occurrence ( Table 5).

Productivity of Most Productive Organizations
The top 50 organizations involved in COVID-19 research together contributed 32, 653 papers (31.69% share) and 674442 citations, with     Table 7.