Global Scientific Overview of Dermatology Related to COVID-19: A Bibliometric Analysis

Abstract

Background:

Coronavirus disease 2019 (COVID-19) has had a significant impact on dermatology, but to date no bibliometric analysis of this field has been identified. Therefore, the aim of this study was to perform a bibliometric indicator analysis of the worldwide scientific production of COVID-19 in dermatology.

Materials and Methods:

An advanced bibliographic search was performed in the Scopus database to identify articles on COVID-19 and dermatology from 2020 to 2021. The collected information was analysed with SciVal software. Bibliometric data were described through figures and summary tables.

Results:

A total of 1448 documents were collected and analysed. Torello Lotti was the author with the greatest scientific production; however, Esther Freeman had the greatest impact. Harvard University was the institution with the highest number of published articles. Most papers were published in the first quartiles. The United States and Italy were the leading countries in terms of production. Articles with international collaboration had the highest impact.

Conclusion:

Articles related to dermatology and COVID-19 are mostly published with American and Italian affiliations. In addition, there has been an increase in the distribution of articles published in the first quartile, which would reflect a growing interest in the community. Publications with international collaboration reported the highest impact, so future authors should take this into account.

Introduction

Since its origin in China in December 2019, coronavirus disease 2019 (COVID-19) has been the cause of more than 500 million confirmed cases of infection and more than 6 million deaths worldwide.[1] The symptomatology of this disease is characterised as primarily pneumological in nature. However, it has also been shown to trigger gastrointestinal,[2] neurological[3] and dermatological[4] manifestations. One of the first studies to focus on dermatological manifestations found that 45% of patients with mild-to-moderate severity COVID-19 showed some mucocutaneous findings.[5] Since then, the most common lesions have been reported to be erythema, urticaria and chickenpox-like rashes.[6]

However, bibliometric studies allow us to analyse large amounts of scientific data in certain areas of knowledge by means of quantitative analysis. This allows us to know the predominant trends in research, as well as providing us with a holistic view of the subject.[7] It also provides us with an approach to the articles, journals, authors, institutions and countries with the greatest influence on a specific topic.[8] This information orients new researchers and directs them towards the predominant trends in the topic of their interest.

Given the status of COVID-19 as an emerging infectious disease, the response of the scientific community has been rapid. This is reflected in the number of publications to date, including bibliometric analyses. Previous studies of this type have focused on various manifestations of this disease,[9] and a letter to the editor was even published emphasising the dermatologic implications;[10] however, an in-depth analysis of the topic has not yet been performed.

Our results could be useful for authors seeking to develop research in this field as they will be able to identify the journals focused on the topic, the institutions most involved and the collaborators with the greatest scientific production. Therefore, in this study, we conducted a bibliometric analysis with the aim of describing bibliometric indicators of publications related to COVID-19 in the field of dermatology.

Materials and Methods

Database

In our study, Scopus was chosen as the database because it provides a wide range of journals in addition to providing functions that allow us to perform bibliometric analyses.[11] This database also allows basic and advanced search strategies for the collection of articles.

Search strategy

In this study, an advanced search strategy developed independently by two authors was used. Discrepancies were resolved by consensus to obtain a single strategy. TITLE, ABS and KEY field restrictions referring to title, abstract and keyword, respectively, were used. In addition, the dermatology SUBJTERMS code was used to retrieve documents related to the field of dermatology. Free and controlled thesaurus terms (Medical Subject Headings (MeSH) and Emtree) were used in addition to the Boolean operators “OR” and “AND” (Supplementary Material 1).

Supplementary Material 1.

Search strategy

(TITLE-ABS-KEY (2019*cov OR ncov OR (((cov) W/2 (19 OR 2019 OR 2)) AND NOT (“Coefficient* of variation” OR “Torsion” OR cov*o*)) OR (covid W/2 (19 OR 2019 OR 2)) OR covid19 OR (*covid AND NOT tocovid) OR ((coronavirus OR “Corona virus” OR cov) W/2 (disease OR infection) W/2 (2019 OR 19 OR 2)) OR ((sars OR “Severe acute respiratory syndrome” OR sras) W/2 (cov OR coronavirus OR “Corona virus” OR covid) W/2 (“2” OR 2019 OR 19)) OR “SARS-CoV2” OR sarscov2 OR “SRAS-CoV2” OR “Severe acute respiratory syndrome COV2” OR ((((novel OR wuhan OR china OR pandemi* OR outbreak OR “new human” OR crisis OR “new cases” OR “normalcy”) W/2 (coronaviru* OR “corona viru*” OR covid)) OR (“new corona*” AND NOT (coronar*)))) OR “Corona pandemic” OR (wuhan W/2 pneumonia) OR “Corona crisis” OR “Corona outbreak” OR “20I 501Y.V1” OR “20J501Y.V3” OR “CAL.20C” OR “20H501Y.V2” OR “mRNA 1273 vaccine” OR “Covishield” OR “AZD1222” OR “Ad26.COV2.S” OR “JNJ 78436735” OR “Ad26COVS” OR “BNT162 vaccine” OR “BNT162-01” OR “BNT162b1” OR “BNT162a1” OR “BNT162b2” OR “BNT162c2”)) AND SUBJTERMS (2708) AND (EXCLUDE (DOCTYPE, “le”) OR EXCLUDE (DOCTYPE, “ed”) OR EXCLUDE (DOCTYPE, “no”) OR EXCLUDE (DOCTYPE, “er”) OR EXCLUDE (DOCTYPE, “cp”) OR EXCLUDE (DOCTYPE, “sh”)) AND (LIMIT-TO (PUBYEAR, 2021) OR LIMIT-TO (PUBYEAR, 2020) OR LIMIT-TO (PUBYEAR, 2019))

Selection of information

Articles on this topic published between 2020 and 2021 were included. Articles published in Scopus in any language were considered. However, letters, editorials, notes, conference papers, errata and short surveys were excluded.

Data analysis

The information collected was exported to Microsoft Excel 2019. The bibliometric indicators were obtained with the SciVal tool (https://www.scival.com/). SciVal is a software, property of Elsevier, that allows processing large amounts of data and generating powerful bibliometric analyses. With it, we analysed the following variables: number of articles published by institution, country, author or journal related to COVID-19 in dermatology. Type of collaboration: obtained from the affiliations of the authors of each document, it was classified as follows: international collaboration: document with affiliation from different countries among the authors; national collaboration: article where all the authors’ affiliations belong to a single country; and institutional collaboration: article where all authors belong to the same institution. Single authorship (without collaboration): article without collaboration referred to in the affiliation. Number of citations: total number of citations received by a document from January 2020 to December 2021. Citations per document: it is calculated as the division of the number of citations by the number of manuscripts. It is the impact that a document has on other publications related to the subject. Also, we used CiteScore, which measures the ratio of citations per published article. Finally, we applied the field-weighted citation impact, which was calculated by the ratio between the total number of citations and the total number of expected citations as a function of the mean of the subject field.

Results

A total of 1448 papers related to dermatology and COVID-19 were collected and analysed. Torello Lotti was the most productive author (17 papers), while Ether Freeman had the highest impact (50 citations per paper) in her 11 published articles. Robert Schwartz and Ümit Türsen were the second and third most productive authors, respectively. Most authors were Italian (4) and American (3) [Table 1].

Table 1.

Top 10 authors publishing on COVID-19 and dermatology

Rank	Author	Documents (n%)	Total citation	Citations per document	h-Index	FWCI	Country
1	Lotti, Torello Maria	17 (1.2)	281	16.5	43	3.5
2	Schwartz, Robert Allen	16 (1.1)	108	6.8	59	2.4
3	Türsen, Ümit	13 (0.9)	142	10.9	22	2.6
4	Rongioletti, Franco	13 (0.9)	249	19.2	34	6.2
5	Tedeschi, Gioacchino	13 (0.9)	238	18.3	60	5.7
6	French, Lars Einar S.	13 (0.9)	587	45.2	67	25.6
7	Goldust, Mohamad	12 (0.8)	67	5.6	19	1.8
8	Mazzotta, Francesco	11 (0.8)	131	11.9	10	5.6
9	Freeman, Esther Ellen	11 (0.8)	550	50	20	29.9
10	Feldman, Steven R.	10 (0.7)	115	11.5	81	7.4

FWCI=Field-weighted citation impact

The 10 institutions with the highest number of published papers are shown in Table 2. Harvard University (United States) was the institution with the highest scientific output (59 papers), while the University of Pennsylvania had the highest impact (27.9 citations per paper). The University of Milan (Italy) was the second institution with the second highest scientific output, with 42 published papers. Five of the 10 institutions are North American.

Table 2.

Top 10 productive institutions on COVID-19 and dermatology

Rank	Institution (country)	Country	Documents (n%)	Total citation	Authors	Citations per document	FWCI
1	Harvard University	United States	59 (4.0)	930	130	15.8	8.4
2	University of Milan	Italy	42 (2.9)	953	56	22.7	7.1
3	University of Pennsylvania	United States	32 (2.2)	892	57	27.9	14.3
4	Tehran University of Medical Sciences	Iran	31 (2.1)	335	76	10.8	3.6
5	University of California at San Francisco	United States	27 (1.9)	682	41	25.3	13.2
6	University of Health Sciences	Turkey	27 (1.9)	214	54	7.9	2.8
7	Shahid Beheshti University of Medical Sciences	Iran	26 (1.8)	171	57	6.6	2.2
8	Icahn School of Medicine at Mount Sinai	United States	26 (1.8)	367	50	14.1	5.7
9	University of Toronto	Canada	25 (1.7)	304	31	12.2	3.4
10	Cornell University	United States	23 (1.6)	267	24	11.6	4.9

FWCI=Field-weighted citation impact

With respect to the journals, Dermatologic Therapy, Neurological Sciences and Journal of the American Academy of Dermatology are the ones with the highest number of publications on our topic, with 172, 152 and 138 documents, respectively. However, the journal with the highest impact was Mycoses, with 27.9 citations per paper [Table 3].

Table 3.

Bibliometric indicators of production and impact on journals on COVID-19 and dermatology

Rank	Journals	Country	Quartile	Scimago Journal Rank	Documents (n%)	Citations	Citations per document	Cite Score 2020
1	Dermatologic Therapy	United Kingdom	Q2	0.6	172 (11.9)	1975	11.5	1.7
2	Neurological Sciences	Italy	Q2	0.8	152 (10.5)	2009	13.2	4.0
3	Journal of the American Academy of Dermatology	United States	Q1	2.0	138 (9.5)	2784	20.2	7.4
4	Clinics in Dermatology	United States	Q1	0.8	68 (4.7)	293	4.3	5.4
5	JAAD Case Reports	United States	Q3	0.5	61 (4.2)	572	9.4	1.5
6	Journal of Cosmetic Dermatology	United Kingdom	Q2	0.6	50 (3.5)	172	3.4	2.3
7	Actas Dermo-Sifiliograficas	Spain	Q3	0.3	37 (2.6)	124	3.4	1.1
8	Mycoses	United Kingdom	Q1	1.1	30 (2.1)	836	27.9	6.1
9	Journal of Dermatological Treatment	United Kingdom	Q2	0.8	30 (2.1)	248	8.3	3.9
10	Pediatric Dermatology	United Kingdom	Q2	0.5	30 (2.1)	450	15.0	2.1

In addition, according to CiteScore, Figure 1 shows the number of manuscripts according to the quartile of the journal. It describes an increase in the number of papers in 2021 compared with 2020. There is a higher percentage of papers published in first-quartile journals during 2021.

Figure 1.

Manuscripts published according to CiteScore quartile on COVID-19 and dermatology

Figure 2 shows the type of collaboration and its bibliometric indicators. Most of the retrieved papers had only national collaboration (661 papers; 44.7%), followed by only institutional collaboration (489 papers; 33.0%) and international collaboration (250 papers; 16.9%). However, in terms of impact, international collaboration (12.5 citations per paper) exceeds both national collaboration (10.7 citations per paper) and institutional collaboration (6.8 citations per paper). The remaining papers belong to the “single-authored” or “no collaboration” category (80 manuscripts: 5.4%).

Figure 2.

Production and impact according to type of collaboration on COVID-19 and dermatology

Figure 3 describes the countries with the highest productivity on COVID-19 in dermatology. The United States (427 papers; 4050 citations) and Italy (252 papers; 3164 citations) were the leading countries in terms of production and number of citations.

Figure 3.

Top 10 productive countries on COVID-19 and dermatology

Discussion

The COVID-19 pandemic has had a significant impact on all medical specialties, causing an increase in scientific publications, and the area of dermatology is no exception. Therefore, the aim of this bibliometric analysis was to evaluate the scientific production of COVID-19 and dermatology up to 2021. Our study found 1448 published papers.

Bibliometric analysis studies have gained greater popularity in recent years, allowing the investigation of large volumes of publications and even of relatively new but high-impact areas.[7] In addition, this type of study allows researchers and academics to identify and describe gaps and trends in research on a given topic.[12]

Torello Lotti was the author with the highest output. His most cited article during the pandemic was a narrative review of cutaneous signs in COVID-19 patients, reporting differences in clinical manifestations between those who developed mild and severe disease.[13] The author with the greatest impact was Esther Freeman. One of her most cited articles was published during our study period. This study aimed to characterise cutaneous adverse reactions after COVID-19 messenger RNA (mRNA) vaccines, generally reporting minor and self-limited reactions, so vaccination should not be discouraged.[14]

With respect to the most productive institutions, Harvard University ranked first in a number of publications. This is consistent with another bibliometric analysis of global dermatology publications, which showed that this institution was the most productive.[15] In addition, Harvard University was one of the most productive with respect to other topics related to COVID-19, such as pharmacological treatment and vaccine development.[16,17] It is noteworthy that half of the 10 most productive institutions are American.

The journal Dermatologic Therapy published the largest number of papers related to dermatology and COVID-19; however, the journal Mycoses had the greatest impact with the highest number of citations per paper. The latter journal led to the scientific production of mucormycosis worldwide.[18] This is consistent with the most cited articles of this journal during the pandemic that reported the outbreak of mucormycotic, as well as recommendations for its management.[19,20] Regarding the quartile of the journals, most publications were in the first three quartiles; furthermore, the number of articles during 2021 has been almost double that of 2020. The 2021 distribution suggests an increase in the first quartile compared with that of 2020. All this could indicate that publications related to dermatology and COVID-19 have received greater interest from the scientific community.

Regarding collaboration between authors, although national collaboration had the highest percentage, international collaboration had the highest impact. This is consistent with a bibliometric analysis related to COVID-19 in Southeast Asia that reported a statistically significant association between international collaboration and bibliometric indicators.[21] Therefore, we suggest that future publications consider international collaboration to have a greater impact.

The United States was the country with the highest number of publications and citations. This result is consistent with other bibliometric studies of COVID-19 and other topics, such as depressive disorders and vaccines, where the United States has led the production.[22,23] This is consistent with the fact that half of the most productive institutions are from that country. All this could indicate that this country has made a significant contribution during the pandemic. In addition, it is worth noting that Italy is in second place in production. This is consistent with other bibliometric analyses on COVID-19, where Italy is always among the most productive and cited.[24,25] This could be since Italy was one of the first countries in the West to be affected by the pandemic.

This study has some limitations.[26] First, we only identified the publications and bibliometric data provided by the Scopus database, which may not reflect the totality of publications referring to our topic of study; however, it should be considered that this database, in comparison with others, covers a wide spectrum of journals worldwide.[11] Second, documents published up to 2021 were considered, so constant updates are recommended. Finally, some types of documents, such as editorials, notes and letters, were excluded, so that the number analysed is lower than the actual number; however, these documents do not usually have a significant contribution and remain with low impact.

Conclusions

Articles related to dermatology and COVID-19 are mostly published with American and Italian affiliations. In addition, there has been an increase in the distribution of articles published in the first quartile, which would reflect a growing interest in the community. Publications with international collaboration reported the highest impact, so future authors should take this into account.

Ethical statement

Ethics committee approval was not required, as this manuscript is a bibliometric study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.