• Jia Xue, Junxiang Chen, Ran Hu, Chen Chen, Chengda Zheng, Yue Su, and Tingshao Zhu.
• Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
• J. Med. Internet Res. 2020 Nov 25; 22 (11): e20550.

BackgroundIt is important to measure the public response to the COVID-19 pandemic. Twitter is an important data source for infodemiology studies involving public response monitoring.ObjectiveThe objective of this study is to examine COVID-19-related discussions, concerns, and sentiments using tweets posted by Twitter users.MethodsWe analyzed 4 million Twitter messages related to the COVID-19 pandemic using a list of 20 hashtags (eg, "coronavirus," "COVID-19," "quarantine") from March 7 to April 21, 2020. We used a machine learning approach, Latent Dirichlet Allocation (LDA), to identify popular unigrams and bigrams, salient topics and themes, and sentiments in the collected tweets.ResultsPopular unigrams included "virus," "lockdown," and "quarantine." Popular bigrams included "COVID-19," "stay home," "corona virus," "social distancing," and "new cases." We identified 13 discussion topics and categorized them into 5 different themes: (1) public health measures to slow the spread of COVID-19, (2) social stigma associated with COVID-19, (3) COVID-19 news, cases, and deaths, (4) COVID-19 in the United States, and (5) COVID-19 in the rest of the world. Across all identified topics, the dominant sentiments for the spread of COVID-19 were anticipation that measures can be taken, followed by mixed feelings of trust, anger, and fear related to different topics. The public tweets revealed a significant feeling of fear when people discussed new COVID-19 cases and deaths compared to other topics.ConclusionsThis study showed that Twitter data and machine learning approaches can be leveraged for an infodemiology study, enabling research into evolving public discussions and sentiments during the COVID-19 pandemic. As the situation rapidly evolves, several topics are consistently dominant on Twitter, such as confirmed cases and death rates, preventive measures, health authorities and government policies, COVID-19 stigma, and negative psychological reactions (eg, fear). Real-time monitoring and assessment of Twitter discussions and concerns could provide useful data for public health emergency responses and planning. Pandemic-related fear, stigma, and mental health concerns are already evident and may continue to influence public trust when a second wave of COVID-19 occurs or there is a new surge of the current pandemic.©Jia Xue, Junxiang Chen, Ran Hu, Chen Chen, Chengda Zheng, Yue Su, Tingshao Zhu. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 25.11.2020.

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