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Vol. 113. Núm. 9.
Páginas T919-T921 (Octubre 2022)
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Vol. 113. Núm. 9.
Páginas T919-T921 (Octubre 2022)
Case and Research Letter
Open Access
[Translated article] Significant Contribution of Spanish Dermatology Toward Understanding COVID-19: A Bibliometric Study of PubMed-Indexed Articles
La significativa aportación de la dermatología española al conocimiento de la COVID-19: estudio bibliométrico en PubMed
C. Miñones-Ginartea, M. Pereiro-Ferreirósb, M. Ginarte-Valb,
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Corresponding author.
a Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Facultad de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
b Servicio de Dermatología, Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Complexo Hospitalario Universitario de Santiago, Facultad de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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C. Miñones-Ginarte, M. Pereiro-Ferreirós, M. Ginarte-Val
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To the Editor:,

Spain, a country among those most affected by the COVID-19 pandemic, was particularly impacted during the first year, when 2820000 cases and 64221 confirmed deaths were registered between February 2020 and the end of January 2021.1 This pandemic has generated a historic number of scientific publications. As the specialty of dermatology helped contribute knowledge over this short period of time, we wondered whether publications by Spanish dermatologists were proportional to the national impact of the disease.

To answer this question, we searched the literature for all publications in PubMed corresponding to the following search string: (SARS-CoV2[Title]) OR COVID-19[Title]) AND (Skin[Title] OR Cutaneous[Title] OR Dermato-[Title]). The time frame specified was February 1, 2020, to January 31, 2021. After excluding 76 articles that were not directly relevant to our objective, we analyzed 254 publications, recording country of origin and the authors’ workplace. When more than a single country was mentioned among the authors’ affiliations, the article was classified as multinational. Articles were also classified into 2 categories according to whether they made contributions directly related to clinical practice (such as case reports or case series) or did not make such contributions. Epidemiologic data were obtained from World Health Organization registries, and population statistics for 2019 came from the World Bank.

In absolute terms, the United States was the country that published the largest number of articles in dermatology (38). Second place was shared by Italy and multinational author groups, with 33 each. Spanish dermatology occupied third place, with 32 publications, or 12.60% of the total number published during the 12 months studied (Table 1).

Table 1.

Absolute and Relative Publication Output According to Country.

Country  No. of articles  Country  No. of articles 
USA  38  14.96  Indonesia  0.79 
Multinational  33  12.99  Netherlands  0.79 
Italy  33  12.99  Portugal  0.79 
Spain  32  12.60  Russia  0.79 
France  14  5.51  Singapore  0.79 
Iran  14  5.51  Austria  0.39 
China  11  4.33  Belgium  0.39 
Turkey  10  3.94  Bulgaria  0.39 
UK  3.54  Colombia  0.39 
Brazil  2.36  Ireland  0.39 
India  2.36  Morocco  0.39 
Thailand  1.97  Mexico  0.39 
Japan  1.57  Nigeria  0.39 
Germany  1.18  Norway  0.39 
South Korea  1.18  Pakistan  0.39 
Switzerland  1.18  Poland  0.39 
Canada  0.79  Romania  0.39 
UAE  0.79  South Africa  0.39 
Egypt  0.79  Tunisia  0.39 

Abbreviations: UAE, United Arab Emirates; UK, United Kingdom; USA, United States of America.

To estimate researcher effort according to country size, we adjusted output for population. In that analysis, Spain was the leader, with 0.68 pandemic-related dermatology publications per 100000 population, followed by Italy, with 0.055. Spain and Italy were the countries hardest hit by COVID-19 during the period our study focuses on (Table 2).

Table 2.

Population-Adjusted Publication Output by Country.

Country  Articles/100000 population  Country  Articles/100000 population 
Spain  0.06760666  South Korea  0.0058017 
Italy  0.05533061  Canada  0.00526243 
Singapore  0.03506311  Romania  0.00517362 
Switzerland  0.03485927  Germany  0.00360763 
France  0.02079613  Japan  0.00316982 
Ireland  0.02014326  Brazil  0.00285514 
Portugal  0.01944201  Morocco  0.00274185 
Norway  0.01863037  Poland  0.00263449 
UAE  0.01860638  Colombia  0.00198515 
Iran  0.01681298  Egypt  0.00198259 
Bulgaria  0.01438542  South Africa  0.00167723 
United Kingdom  0.01342772  Russia  0.00136287 
Turkey  0.01188015  China  0.00078569 
USA  0.01156911  Mexico  0.00078252 
Netherlands  0.01148924  Indonesia  0.00074018 
Austria  0.01123461  Nigeria  0.0004976 
Belgium  0.00867905  Pakistan  0.00047946 
Tunisia  0.0084868  India  0.0004391 
Thailand  0.00718123  Multinational  – 

Abbreviations: UAE, United Arab Emirates; UK, United Kingdom; USA, United States of America.

However, associations between publication output and incidence and mortality must be interpreted more cautiously given that the accuracy of epidemiological data is highly disputed.2 Based on known data, Spain ranked seventh in the world in number of publications, with 1.135 articles per 100000 cases (Table 3). Asian countries ranked as high as they did in this analysis because of the low number of cases and deaths they reported. One observation is that 3 countries with a high absolute number of publications — Spain, Italy, and the United States — all have cumulative incidence rates above 4000. From these data we can infer that even though it is not possible to detect a direct correlation between cumulative incidence and scientific output, the countries that most contributed articles on dermatology and COVID-19 are also those that were more severely impacted by the disease.

Table 3.

Publication Output by Country Adjusted for Number of Covid-19 Cases and Deaths.

Country  Articles/100000cases  Articles/100000deaths  Country  Articles/100000cases  Articles/100000deaths 
Thailand  26.596  6493.51  Canada  0.259  10.1 
China  12.077  241.02  Austria  0.244  13.1 
South Korea  3.836  211.27  UK  0.236  8.53 
Norway  1.597  177.62  Morocco  0.212  12.11 
Italy  1.299  37.38  Netherlands  0.205  14.34 
Egypt  1.209  21.59  Indonesia  0.188  6.73 
Spain  1.135  49.83  Pakistan  0.184  8.6 
Japan  1.034  70.75  USA  0.148  8.77 
Iran  0.992  24.18  Belgium  0.14  4.71 
Nigeria  0.766  63.37  Romania  0.138  5.48 
UAE  0.605  238.66  Germany  0.135  5.27 
Switzerland  0.574  33.4  South Africa  0.069  2.28 
Ireland  0.512  30.38  Brazil  0.066  2.69 
Tunisia  0.482  14.97  Poland  0.066  2.69 
Bulgaria  0.457  11.08  India  0.056  3.89 
France  0.448  18.55  Mexico  0.054  0.64 
Turkey  0.405  38.66  Russia  0.052  2.73 
Portugal  0.281  16.42  Colombia  0.048  1.88 

Abbreviations: UAE, United Arab Emirates; UK, United Kingdom; USA, United States of America.

More reliable comparisons can be made between European Union countries given that they have similar health systems and socioeconomic conditions and have also used similar approaches to diagnosing COVID-19. Here the indicators do provide a useful tool for showing which countries made more contributions to the literature according to pandemic severity during the first year. Our data show that Spain and Italy, with more than 1 article published per 100000 cases of COVID-19 diagnosed, were at the head of European output in dermatology.

Another interesting comparison is whether articles were published by authors affiliated with a single hospital or multiple centers. Spanish authors more often collaborated with colleagues from other centers (for 78.1% of Spanish dermatology's publications), whereas authors from other countries collaborated among centers for 67.3% of theirs.

We reviewed the literature until May 2021 but found no bibliometric studies focusing on dermatology in relation to COVID-19. We did find, however, studies of general publication output over different time periods. Haghani et al.3 and Liu et al.4 found that US and Chinese authors produced the largest number of articles, whereas Spain ranked 15th in both studies. Diéguez-Campa et al.5 reported similar findings, with China and the US leading in publications; Spain ranked 18th in that study. In another study, Spain ranked seventh or ninth, however, depending on which database was being analyzed.6

Yet another interesting observation based on our data is that 81% of the Spanish publications on dermatology and COVID-19 were case reports and case series (versus 58% of the articles from the rest of the countries in our study). By contrast, 70% of all publications between November 2019 and March 2020 were case reports and case series.7

In conclusion, we wish to emphasize the outstanding role Spanish dermatology played in contributing direct clinical knowledge during the COVID-19 pandemic. Spain ranked third in the world in total number of articles focused on the skin in this disease, but it ranked first when output was adjusted for population.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

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Estimation of global case fatality rate of coronavirus disease 2019 (COVID-19) using meta-analyses: comparison between calendar date and days since the outbreak of the first confirmed case.
Int J Infect Dis, 100 (2020), pp. 302-308
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The scientific literature on Coronaviruses, COVID-19 and its associated safety-related research dimensions: a scientometric analysis and scoping review.
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