Identifying and Ranking Common COVID-19 Symptoms From Tweets in Arabic: Content Analysis

Background: A substantial amount of COVID-19-related data is generated by Twitter users every day. Self-reports of COVID-19 symptoms on Twitter can reveal a great deal about the disease and its prevalence in the community In particular, self-reports can be used as a valuable resource to learn more about common symptoms and whether their order of appearance differs among different groups in the community. These data may be used to develop a COVID-19 risk assessment system that is tailored toward a specific group of people. Objective: The aim of this study was to identify the most common symptoms reported by patients with COVID-19, as well as the order of symptom appearance, by examining tweets in Arabic. Methods: We searched Twitter posts in Arabic for personal reports of COVID-19 symptoms from March 1 to May 27, 2020. We identified 463 Arabic users who had tweeted about testing positive for COVID-19 and extracted the symptoms they associated with the disease. Furthermore, we asked them directly via personal messaging to rank the appearance of the first 3 symptoms they had experienced immediately before (or after) their COVID-19 diagnosis. Finally, we tracked their Twitter timeline to identify additional symptoms that were mentioned within +/- 5 days from the day of the first tweet on their COVID-19 diagnosis. In total, 270 COVID-19 self-reports were collected, and symptoms were (at least partially) ranked. Results: The collected self-reports contained 893 symptoms from 201 (74%) male and 69 (26%) female Twitter users. The majority (n=270, 82%) of the tracked users were living in Saudi Arabia (n=125, 46%) and Kuwait (n=98, 36%). Furthermore, 13% (n=36) of the collected reports were from asymptomatic individuals. Of the 234 users with symptoms, 66% (n=180) provided a chronological order of appearance for at least 3 symptoms. Fever (n=139, 59%), headache (n=101, 43%), and anosmia (n=91, 39%) were the top 3 symptoms mentioned in the self-reports. Additionally, 28% (n=65) reported that their COVID-19 experience started with a fever, 15% (n=34) with a headache, and 12% (n=28) with anosmia. Of the 110 symptomatic cases from Saudi Arabia, the most common 3 symptoms were fever (n=65, 59%), anosmia (n=46, 42%), and headache (n=42, 38%). Conclusions: This study identified the most common symptoms of COVID-19 from tweets in Arabic. These symptoms can be further analyzed in clinical settings and may be incorporated into a real-time COVID-19 risk estimator.