Background

This bibliometric analysis examines the top 50 most-cited articles on COVID-19 complications, offering insights into the multifaceted impact of the virus. Since its emergence in Wuhan in December 2019, COVID-19 has evolved into a global health crisis, with over 770 million confirmed cases and 6.9 million deaths as of September 2023. Initially recognized as a respiratory illness causing pneumonia and ARDS, its diverse complications extend to cardiovascular, gastrointestinal, renal, hematological, neurological, endocrinological, ophthalmological, hepatobiliary, and dermatological systems.

Methods

Identifying the top 50 articles from a pool of 5940 in Scopus, the analysis spans November 2019 to July 2021, employing terms related to COVID-19 and complications. Rigorous review criteria excluded non-relevant studies, basic science research, and animal models. The authors independently reviewed articles, considering factors like title, citations, publication year, journal, impact factor, authors, study details, and patient demographics.

Results

The focus is primarily on 2020 publications (96%), with all articles being open-access. Leading journals include The Lancet, NEJM, and JAMA, with prominent contributions from Internal Medicine (46.9%) and Pulmonary Medicine (14.5%). China played a major role (34.9%), followed by France and Belgium. Clinical features were the primary study topic (68%), often utilizing retrospective designs (24%). Among 22,477 patients analyzed, 54.8% were male, with the most common age group being 26–65 years (63.2%). Complications affected 13.9% of patients, with a recovery rate of 57.8%.

Conclusion

Analyzing these top-cited articles offers clinicians and researchers a comprehensive, timely understanding of influential COVID-19 literature. This approach uncovers attributes contributing to high citations and provides authors with valuable insights for crafting impactful research. As a strategic tool, this analysis facilitates staying updated and making meaningful contributions to the dynamic field of COVID-19 research.

A bibliometric analysis of the most cited articles about COVID-19 complications was conducted in July 2021 using all journals indexed in Elsevier’s Scopus and Thomas Reuter’s Web of Science from November 1, 2019 to July 1, 2021. All journals were selected for inclusion regardless of country of origin, language, medical speciality, or electronic availability of articles or abstracts. The terms were combined as follows:

(“COVID-19” OR “COVID19” OR “SARS-COV-2” OR “SARSCOV2” OR “SARS 2” OR “Novel coronavirus” OR “2019-nCov” OR “Coronavirus”)

AND

(“Complication” OR “Long Term Complication” OR “Post-Intensive Care Syndrome” OR “Venous Thromboembolism” OR “Acute Kidney Injury” OR “Acute Liver Injury” OR “Post COVID-19 Syndrome” OR “Acute Cardiac Injury” OR “Cardiac Arrest” OR “Stroke” OR “Embolism” OR “Septic Shock” OR “Disseminated Intravascular Coagulation” OR “Secondary Infection” OR “Blood Clots”  OR “Cytokine Release Syndrome” OR “Paediatric Inflammatory Multisystem Syndrome” OR “Vaccine Induced Thrombosis with Thrombocytopenia Syndrome” OR “Aspergillosis” OR “Mucormycosis” OR “Autoimmune Thrombocytopenia Anaemia” OR “Immune Thrombocytopenia” OR “Subacute Thyroiditis” OR “Acute Respiratory Failure” OR “Acute Respiratory Distress Syndrome” OR “Pneumonia” OR “Subcutaneous Emphysema” OR “Pneumothorax” OR “Pneumomediastinum” OR “Encephalopathy” OR “Pancreatitis” OR “Chronic Fatigue” OR “Rhabdomyolysis” OR “Neurologic Complication” OR “Cardiovascular Complications”  OR “Psychiatric Complication” OR “Respiratory Complication” OR “Cardiac Complication” OR “Vascular Complication” OR “Renal Complication” OR “Gastrointestinal Complication” OR “Haematological Complication” OR “Hepatobiliary Complication” OR “Musculoskeletal Complication” OR “Genitourinary Complication” OR “Otorhinolaryngology Complication” OR “Dermatological Complication” OR “Paediatric Complication” OR “Geriatric Complication” OR “Pregnancy Complication”) in the Title, Abstract or Keyword.

A total of 5940 articles were accessed, of which the top 50 most cited articles about COVID-19 and Complications of COVID-19 were selected through Scopus. Each article was reviewed for its appropriateness for inclusion. The articles were independently reviewed by three researchers (JRP, MAM and TS) (Table 1). Differences in opinion with regard to article inclusion were resolved by consensus.

The inclusion criteria specified articles that were focused on COVID-19 and Complications of COVID-19. Articles were excluded if they did not relate to COVID-19 and or complications of COVID-19, Basic Science Research and studies using animal models or phantoms. Review articles, Viewpoints, Guidelines, Perspectives and Meta-analysis were also excluded from the top 50 most-cited articles (Table 1).

The top 50 most-cited articles were compiled in a single database and the relevant data was extracted. The database included: Article Title, Scopus Citations, Year of Publication, Journal, Journal Impact Factor, Authors, Number of Authors, Department Affiliation, Number of Institutions, Country of Origin, Study Topic, Study Design, Sample Size, Open Access, Non-Original Articles, Patient/Participants Age, Gender, Symptoms, Signs, Co-morbidities, Complications, Imaging Modalities Used and outcome.