Assistance Publique des Hôpitaux de Paris (AP-HP), Département de dermatologie, Hôpital Henri Mondor, Créteil, France.
Laboratoire Génie Industriel, CentraleSupélec, Université Paris-Saclay, Gif-sur-Yvette, France.
JMIR Public Health Surveill. 2021 Feb 25;7(2):e25651. doi: 10.2196/25651.
During COVID-19, studies have reported the appearance of internet searches for disease symptoms before their validation by the World Health Organization. This suggested that monitoring of these searches with tools including Google Trends may help monitor the pandemic itself. In Europe and North America, dermatologists reported an unexpected outbreak of cutaneous acral lesions (eg, chilblain-like lesions) in April 2020. However, external factors such as public communications may also hinder the use of Google Trends as an infodemiology tool.
The study aimed to assess the impact of media announcements and lockdown enforcement on internet searches related to cutaneous acral lesions during the COVID-19 outbreak in 2020.
Two searches on Google Trends, including daily relative search volumes for (1) "toe" or "chilblains" and (2) "coronavirus," were performed from January 1 to May 16, 2020, with the United States, the United Kingdom, France, Italy, Spain, and Germany as the countries of choice. The ratio of interest over time in "chilblains" and "coronavirus" was plotted. To assess the impact of lockdown enforcement and media coverage on these internet searches, we performed an interrupted time-series analysis for each country.
The ratio of interest over time in "chilblains" to "coronavirus" showed a constant upward trend. In France, Italy, and the United Kingdom, lockdown enforcement was associated with a significant slope change for "chilblain" searches with a variation coefficient of 1.06 (SE 0.42) (P=0.01), 1.04 (SE 0.28) (P<.01), and 1.21 (SE 0.44) (P=0.01), respectively. After media announcements, these ratios significantly increased in France, Spain, Italy, and the United States with variation coefficients of 18.95 (SE 5.77) (P=.001), 31.31 (SE 6.31) (P<.001), 14.57 (SE 6.33) (P=.02), and 11.24 (SE 4.93) (P=.02), respectively, followed by a significant downward trend in France (-1.82 [SE 0.45]), Spain (-1.10 [SE 0.38]), and Italy (-0.93 [SE 0.33]) (P<.001, P=0.004, and P<.001, respectively). The adjusted R values were 0.311, 0.351, 0.325, and 0.305 for France, Spain, Italy, and the United States, respectively, suggesting an average correlation between time and the search volume; however, this correlation was weak for Germany and the United Kingdom.
To date, the association between chilblain-like lesions and COVID-19 remains controversial; however, our results indicate that Google queries of "chilblain" were highly influenced by media coverage and government policies, indicating that caution should be exercised when using Google Trends as a monitoring tool for emerging diseases.
在 COVID-19 期间，有研究报告称，在世界卫生组织（WHO）确认疾病症状之前，人们已经在互联网上搜索过这些症状。这表明，使用包括 Google Trends 在内的工具监测这些搜索，可能有助于监测大流行本身。在欧洲和北美，皮肤科医生报告称，2020 年 4 月，出现了大量的肢端皮肤病变（如冻疮样病变）。然而，公众宣传等外部因素也可能会阻碍 Google Trends 作为传染病监测工具的使用。
本研究旨在评估媒体公告和封锁执行对 2020 年 COVID-19 爆发期间与肢端皮肤病变相关的互联网搜索的影响。
从 2020 年 1 月 1 日至 5 月 16 日，我们在 Google Trends 上进行了两次搜索，包括对（1）“脚趾”或“冻疮”和（2）“冠状病毒”的每日相对搜索量进行搜索，选择了美国、英国、法国、意大利、西班牙和德国作为研究国家。绘制“冻疮”和“冠状病毒”随时间的兴趣比。为了评估封锁执行和媒体报道对这些互联网搜索的影响，我们对每个国家进行了中断时间序列分析。
“冻疮”与“冠状病毒”的兴趣比随时间呈持续上升趋势。在法国、意大利和英国，封锁执行与“冻疮”搜索的斜率变化显著相关，变化系数分别为 1.06（SE 0.42）（P=0.01）、1.04（SE 0.28）（P<.01）和 1.21（SE 0.44）（P=0.01）。在媒体发布公告后，法国、西班牙、意大利和美国的这些比率显著增加，变化系数分别为 18.95（SE 5.77）（P=.001）、31.31（SE 6.31）（P<.001）、14.57（SE 6.33）（P=.02）和 11.24（SE 4.93）（P=.02），随后法国（-1.82 [SE 0.45]）、西班牙（-1.10 [SE 0.38]）和意大利（-0.93 [SE 0.33]）的比率显著下降（P<.001、P=0.004 和 P<.001）。法国、西班牙、意大利和美国的调整 R 值分别为 0.311、0.351、0.325 和 0.305，这表明时间与搜索量之间存在平均相关性；然而，德国和英国的相关性较弱。
迄今为止，冻疮样病变与 COVID-19 之间的关联仍存在争议；然而，我们的结果表明，“冻疮”的谷歌查询受到媒体报道和政府政策的高度影响，这表明在将 Google Trends 用作新兴疾病监测工具时应谨慎行事。
