The coronavirus disease 2019 (COVID-19) pandemic has impacted our lives more than we could imagine forcing most of us to stay at home and work (Amla & Amla, 2020; Ciuriak, 2020; Hamzelou, 2020; Pueyo, 2020; WHO, 2020). As we find our way through the COVID-19 crisis, some scientists are adjusting to the new routine of working from home (Burke et al., 2020). For example, clinical research not requiring patient contact is conducted remotely as per Food and Drug Administration (FDA) guidelines, while balancing the rights and safety of study participants (Padala, Jendro, & Padala, 2020). Additionally, activities such as writing grants, research articles, and peer-review are continued from home to maintain productivity while keeping researchers safe and engaged (Omary et al., 2020). At this emergent time, it is essential to recognise that the lack of access to research articles for the public to read could become a barrier to implementing evidence-based practice for healthcare professionals, policy makers, and government officials (ElSabry, 2017; Look & Marsh, 2012; Willinsky, 2003).
As pivotal as it seems, the lockdown has changed the business practices of major scientific publishers (Nadeem, 2020). In response to the COVID-19 crisis, various publishers and journals have started providing free access to research articles to encourage researchers to continue their work from home (Nadeem, 2020). As a result, the number of articles published on COVID-19 is increasing, which raises concern over the quality of research published (Peyrin-Biroulet, 2020). Nevertheless, there is an immediate need to conduct research on potential drugs and vaccine against COVID-19. One of the ways to make progress on this front is to make research articles relevant to potential drugs of COVID-19 available in the internet public domain.
The World Health Organization is now conducting a megatrial of the four most promising COVID-19 treatments (Kupferschmidt & Cohen, 2020), including Remdesivir (Cao, Deng, & Dai, 2020b), Chloroquine and hydroxychloroquine (Arnold & Buckner, 2020), and Ritonavir/lopinavir drug combinations (Cao et al., 2020a). More recently, researchers are conducting studies on Ribavirin (Khalili, Zhu, Mak, Yan, & Zhu, 2020), Favipiravir (Du & Chen, 2020), Sarilumab (Lu, Chen, & Chang, 2020), and Tocilizumab (Lu et al., 2020) in patients with COVID-19 infection. A systematic analysis of proteins encoded by severe acute respiratory syndrome coronavirus (SARS-CoV) genes using target-based virtual ligand screening has identified more than 10 drug compounds that might have anti-viral properties against COVID-19 (Wu et al., 2020). As of 12–17th April 2020, I analysed whether research articles related to potential drug candidates of COVID-19 were available on the internet for free to read.
As a first step, the drugs with potential anti-viral activity against COVID-19 were selected through a literature search on PubMed. The keywords from medical subject headings (MeSH) were used to conduct the search (Drug Therapy, Drug Development, Coronavirus, COVID-19) (Table 1). After removing duplicate records, a total of 486 research articles were identified from the literature search (Table 1). Next, title and abstract screening were conducted to select articles based on the inclusion criteria (1) patients with COVID-19 disease, (2) clinical studies involving treatment of COVID-19, and (3) clinical studies with specific endpoints of recovery from COVID-19, and exclusion criterion (1) studies on other coronavirus-related diseases such as Middle East Respiratory Syndrome (MERS). From a total of six studies (Arnold & Buckner, 2020; Cao et al., 2020a,b; Du & Chen, 2020; Khalili et al., 2020; Lu et al., 2020) which were chosen for full text review, seven potential drug candidates and combinations were selected to determine how many research articles were available for the public to read for free (Table 2). The availability of research articles containing search terms of seven potential COVID-19 drug candidates and combinations (Table 2) for the public to read for free from the internet as of 12–17th April 2020 were determined from online databases of four major publishers (Elsevier’s ScienceDirect, Taylor & Francis, SpringerLink, and Wiley) (see Screen-capture A1.1–A4.7)1 (Larivière, Haustein, & Mongeon, 2015; Rolnik, Binfield, & Graves, 2008). A similar search was conducted on the online database of the New England Journal of Medicine (NEJM) as several drug studies on human subjects with lower statistical errors related to the documentation, presentation, and interpretation of findings have been published in NEJM (see Screen-capture A5.1–A5.7) (Strasak, Zaman, Marinell, Pfeiffer, & Ulmer, 2007). The lack of access to research articles that were locked behind website paywalls was determined separately for all five databases (see Screen-capture B6.1).
|Step||Search Query||Items found|
|7||Search (((Drug Therapy[MeSH Terms]) OR Drug Development[MeSH Terms])) AND ((Coronavirus[MeSH Terms]) OR COVID-19[Supplementary Concept])||486|
|6||Search (Coronavirus[MeSH Terms]) OR COVID-19[Supplementary Concept]||12,819|
|5||Search COVID-19[Supplementary Concept]||1,545|
|4||Search Coronavirus[MeSH Terms]||12,598|
|3||Search (Drug Therapy[MeSH Terms]) OR Drug Development[MeSH Terms]||1,469,432|
|2||Search Drug Development[MeSH Terms]||157,950|
|1||Search Drug Therapy[MeSH Terms]||1,344,112|
|MeSH: Medical Subject Headings|
|COVID-19 candidate treatments||Elsevier’s ScienceDirect||Taylor & Francis Online||SpringerLink||Wiley Online Library||NEJM|
|“Ribavirin” (Khalili et al., 2020)||Total=7,547||Total=2,321||Total=7,869||Total=10,818||Total=93|
|Open access=1,032||Open access=354|
|Available in first 6,000 articles listed=1,130*||Available=443||Available=1,746||Available in first 2,000 articles listed=818**||Available=86|
|“Remdesivir” (Cao et al., 2020b)||Total=56||Total=16||Total=38||Total=65||Total=6|
|Open access=8||Open access=13|
|“Hydroxychloroquine” OR “Chloroquine” (Arnold & Buckner, 2020)||Total=19,099||Total=6,166||Total=15,877||Total=18,644||Total=131|
|Open access=2,372||Open access=460|
|Available in first 6,000 articles listed=858*||Available=1,213||Available=5,004||Available in first 2,000 articles listed=771**||Available=56|
|“Favipiravir” (Du & Chen, 2020)||Total=169||Total=75||Total=131||Total=84||Total=5|
|Open access=38||Open access=12|
|“Lopinavir” OR “Ritonavir” (Cao et al., 2020a)||Total=4,460||Total=2,916||Total=7,202||Total=5,981||Total=70|
|Open access=594||Open access=475|
|Available=948||Available=216||Available=1,661||Available in first 2,000 articles listed=1,093**||Available=69|
|“Sarilumab” (Lu et al., 2020)||Total=46||Total=100||Total=199||Total=92||Total=0|
|Open access=4||Open access=12|
|“Tocilizumab” (Lu et al., 2020)||Total=1,420||Total=1,405||Total=4,015||Total=2,049||Total=15|
|Open access=242||Open access=166|
|Available=349||Available=162||Available=1,322||Available in first 2,000 articles listed=1,222**||Available=13|
The maximum number of research articles accessible from the journals in Elsevier’s ScienceDirect database is 6,000 per search query (from a total of 60 webpages with each containing 100 research items). The terms ‘Ribavirin’ and ‘Hydroxychloroquine OR Chloroquine’ returned more than 6,000 research articles each during the search (Table 2).The number of research articles that were available for free in the first 6,000 articles accessible from Elsevier’s ScienceDirect database were counted and reported (Table 2). The total number of research articles containing search terms of potential COVID-19 drug candidates such as Ribavirin, Remdesivir, Hydroxychloroquine OR Chloroquine, Favipiravir, Lopinavir OR Ritonavir, Sarilumab, and Tocilizumab, available for the public to read for free on 17th April 2020 in Elsevier’s ScienceDirect database was 1,130, 51, 858, 66, 948, 12, and 349 respectively (Table 2).
The total number of research articles containing search terms listed consecutively as above (on Table 2) available for the public to read for free on 12th April 2020 in Taylor & Francis Online database was 443, 12, 1,213, 32, 216, 18, and 162 respectively (Table 2). The total number of research articles containing search terms listed consecutively on Table 2 available for the public to read for free on 12th April 2020 in SpringerLink database was 1,746, 36, 5,004, 73, 1,661, 82, and 1,322 respectively (Table 2).
The maximum number of research articles accessible from the journals in Wiley Online Library is 2,000 per search query (from a total of 100 webpages with each containing 20 research items). The terms ‘Ribavirin,’ ‘Hydroxychloroquine OR Chloroquine,’ ‘Lopinavir OR Ritonavir,’ and ‘Tocilizumab’ returned more than 2,000 research articles each during the search (Table 2). The number of research articles that were available for free in the first 2,000 articles accessible from Wiley Online Library database were counted and reported (Table 2). The total number of research articles containing search terms listed consecutively on Table 2 available for the public to read for free on 12th April 2020 from the journals listed in Wiley Online Library was 818, 59, 771, 61, 1,093, 70, and 1,222 respectively (Table 2).
The research articles containing search terms of potential COVID-19 drug candidates such as Ribavirin, Remdesivir, Hydroxychloroquine OR Chloroquine, Favipiravir, Lopinavir OR Ritonavir, and Tocilizumab, available for the public to read for free on 12th April 2020 in NEJM database was 86, 6, 56, 5, 69, and 13 (Table 2). The term ‘Sarilumab’ did not return search results in the NEJM database. In this study, there was a lack of full access to research articles relevant to potential drugs of COVID-19 (Figure 1).
4. Discussion and Conclusions
In this study, the availability of research articles relevant to potential drugs of COVID-19 disease for the public to read for free was determined. At the time of this study when the pandemic was increasing, many research articles containing terms ‘Ribavirin,’ ‘Remdesivir,’ ‘Hydroxychloroquine OR Chloroquine,’ ‘Favipiravir,’ ‘Lopinavir OR Ritonavir,’ ‘Sarilumab,’ and ‘Tocilizumab’ from online databases of Elsevier’s ScienceDirect, Taylor & Francis, SpringerLink, and Wiley were not available for the public to read for free (Table 2). For search terms ‘Remdesivir’ (n=6) and ‘Favipiravir’ (n=5), the online database of NEJM provided all available articles to read for free (Table 2).
Since the start of this pandemic, many academic publishers promised to make research articles relevant to COVID-19 virus free to read from the internet. For example, Elsevier’s ScienceDirect database returned 21,000+ articles free to read following the search using “COVID-19” OR Coronavirus OR “Corona virus” OR “2019-nCoV” OR “SARS-CoV” OR “MERS-CoV” OR “Severe Acute Respiratory Syndrome” OR “Middle East Respiratory Syndrome” terms. The NEJM has provided all journal content related to COVID-19 pandemic free to read from the internet. However, in this case study, it was found that articles relevant to potential drugs for COVID-19 infection were not entirely free to read (Figure 1). At this time of crisis, it is not only essential to provide free access to research articles related to the search terms ‘COVID-19’ or ‘SARS-CoV’ but also the allied content necessary to conduct research and develop health policies.
Since the turn of this century, there were massive changes in scholarly communication due to digitalisation and therefore, scientific material was easily accessible from the internet (Baffy et al., 2020). As a consequence, free access to research articles through the internet has increased the scientific output from developing countries (Mueller-Langer, Scheufen, & Waelbroeck, 2020). This has raised a serious concern about the quality of research articles published through online open access journal systems (Bohannon, 2013). It is indeed necessary to have quality checking measures in place through open science initiatives to improve the standard of research output (Walther & van den Bosch, 2012). Although there are concerns over the quality of research articles published rapidly during this pandemic, we should realize that scientific progress depends on real time response to the pandemic through research conducted both in laboratory and at home (Kaplan, 2014). For example, some researchers might be more effective writing their manuscripts at home (Bažant, 1993). It is therefore necessary to make sure that researchers have free and easy access to academic databases at this emergent time. As stated by Zdenek P. Bažant (Bažant, 1993), “the only thing that matters in research is what is achieved.” To overcome the COVID-19 emergency, it is essential for the publishers to provide free access to research articles, facilitate data sharing, and support the position of the World Health Organization on Open Science (Moorthy, Restrepo, Preziosi, & Swaminathand, 2020).
Availability of research data: The full video screen captures of the performed searches are available from the LIBER Quarterly Dataverse at https://doi.org/10.7910/DVN/IZ3VAU.