There has been rapidly growing scientific literature related to the coronavirus disease
2019 (COVID-19), in attempts to convey any potential hypotheses or confirmed facts
about the disease. Notably, there has been a plethora of viewpoints and other opinion
pieces to help guide ongoing research efforts. However, this trend carries a risk
of redundant publications.
Our objective was to evaluate the nature of the published scientific literature (original
investigations and opinion pieces) related to COVID-19 and to quantify their relative
proportions to determine whether the trend of publication of opinion pieces has changed
For this cross-sectional analysis, we searched the Medline database from February
1, 2020, to April 20, 2020, using the keywords “COVID-19” and “corona.” Articles were
categorized to “opinion” articles (i.e., narrative reviews, viewpoints, perspectives,
commentaries, news pieces, letters to the Editor, educational material, and consensus
statements/guidelines), and original investigations (i.e., randomized control trials
[RCTs], observational studies [retrospective, cross-sectional or prospective], meta-analyses,
translational or animal studies, and epidemiologic modeling studies). Consensus statements
and guidelines were considered as “opinion” articles since the recommendations from
these documents are mainly based on expert opinion. Case reports and case series of
≤ 10 patients as well as articles describing a clinical trial design or a prospective
study protocol were excluded. Editorials addressing articles published in the same
journal issue were excluded since those are integral part of the journal structure.
In addition, we excluded systematic reviews given the lack of consensus on whether
they should be considered as original investigations.
Non-English articles where the exact type could not be determined by reviewing the
title and abstract were also excluded. Importantly, to ensure that articles are classified
into the correct categories, we manually reviewed the content of each article rather
than depending on the provided journal classifications. Analysis of variance (ANOVA)
was used to assess the trend in the relative proportion of “opinion” articles over
the study period. Descriptive statistical analyses were performed using SPSS statistical
package (SPSS version 25.0, IBM Inc., Armonk, NY).
The search identified 5479 articles, among which 276 were non-COVID-related, 63 were
non-English articles that could not be classified, 8 were errata, and 3 articles were
retracted. In addition, 403 were case reports or case series of ≤ 10 patients, 89
were systematic reviews, 20 were trial design or study protocol, and 124 were editorials
related to an article within the same journal. The final analysis included 4493 articles.
Among 1030 (22.9%) original investigations, the majority were retrospective or cross-sectional
observational studies (57.9%). Most of the observational studies (93.4%) were related
to diagnosis of the disease. Translational or animal studies comprised 16.8% of original
investigations, epidemiological modeling analyses 14.8%, prospective observational
studies 5.7%, meta-analyses 4.6%, and RCTs 0.3%. The number of “opinion” articles
was 3463 (77.1%) (Table 1). The ratio of “opinion” articles to original investigations
was 3.4:1. There was no significant change in the trend of the relative proportion
of “opinion” articles to original investigations throughout the study period when
divided into quintiles from oldest versus latest, R
2 for quadratic trend model was 0.74 and corresponding p value for regression was
0.3 (Figure 1).
Types of Articles Included in the Analysis
Randomized controlled trial
Prospective, number (% of observational studies)
Retrospective/cross-sectional, number (% of observational studies)
Related to disease diagnosis, number (% of observational studies)
Evaluating a therapeutic intervention, number (% of observational studies)
Translational or animal study
Epidemiologic modeling analysis
Society guideline or consensus statement
Non-society multicenter guideline or consensus statement
Viewpoint, perspective, commentary or news piece
Letter to the Editor/Response to a letter to the Editor
Patient education material
The relative proportion of “opinion” articles (blue) to original investigations (orange)
throughout the study period. The total number of articles included in the analysis
was divided chronologically into quintiles from oldest (1) to newest (5).
In this cross-sectional analysis of published scientific articles related to COVID-19
in the Medline database over an 80-day period, we found that the number of “opinion”
articles was > 3 times the number of original investigations published in this time
frame. Interestingly, there was no significant change in the temporal trend of this
ratio, which illustrates that the number of “opinion” articles remains high. Since
our knowledge and understanding of this disease are premature, there is an understandable
need for valuable insights to guide research efforts. However, this analysis suggests
that the number of these “opinion” articles continues to be high, and there might
be some concerns for redundant publications. For example, there has been > 10 viewpoints
related to renin-angiotensin-aldosterone inhibitors and COVID-19 published in several
journals even before any original data about the topic became available.
This study is limited by search of one online database at a single time point. There
are many ongoing research efforts and this trend is expected to change with time.
Based on the findings from this analysis, medical journals might want to re-evaluate
the usefulness of COVID-19-related opinion pieces being considered for publication.