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COVID-19 Case Series: Publishing Trends in High-Incidence Countries

Written by GIDEON co-founder, Dr. Steve Berger

Medical publishing has been significantly influenced by this year’s events. An unfortunate side effect of the COVID-19 pandemic has been an explosion of professional publications dealing with every possible aspect of the disease. Innumerable studies dissect the clinical features, epidemiology, imaging characteristics, and risk factors of a series of patients treated in hospitals or clinics.

The GIDEON database collates all case series dealing with COVID-19 that have been cited in PubMed. These numbers do not include drug trials and disease prevalence surveys. 1,316 relevant series have been cited by PubMed as of August 13, published from 55 (28.2%) countries and dependencies which report the disease. Seven hundred and eleven series were published from China, encompassing 185,280 individual patients. The total number of COVID-19 cases reported by China to that date was 84,756. In other words, 2.19 Chinese patients appear in case series – for every 1 patient that is actually reported!

China alone accounts for 54.0% of all published case series, despite the fact that only 0.041% of the World’s cases were reported by that country. In part, these numbers might reflect the fact that “publishable data” were already accumulating in China before significant numbers were reported elsewhere, or delays that might be inherent in the publishing cycle itself. Other factors could include the relative numbers of clinical staff and institutions involved in research and publishing from any given country. Nevertheless, the unusually high number of case studies reported by China is difficult to explain. Assuming that “double-publication” can be discounted, large groups of patients are clearly “recycled” through multiple studies. From an epidemiological standpoint, this practice could actually contribute to the quality of data, since multiple studies of a given patient cohort can serve as excellent control groups for one another.

In the following bar graph, I’ve contrasted the ratio of published case series / reported cases among high-incidence countries. A pie graph contrasting the relative proportion of total case series from individual countries is also presented.

Publishing trends: number of published case series per 100,000 reported COVID-19 cases

* Cumulative data to August 13, 2020

Publishing trends: percentage of case series published by high incidence countries pie chart

Blog reproduced in ProMED

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One Response to “COVID-19 Case Series: Publishing Trends in High-Incidence Countries”

  1. Walther von Stolzing Says:

    The idea of this compilation may be well intended but testing capacity and reporting vary wildly, with some countries massively under-reporting. Consequently these graphs are rather meaningless. However, I do agree with criticizing the deluge of publications, few of which contain useful information let alone clinical relevance.