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Twitter has considerable capacity for health education and proves to be an efficient and accessible communication tool in the coronavirus disease-19 (COVID-19) pandemic. Although many stakeholders saturate Twitter with COVID-19-related information, it remains unknown who disseminates information most efficaciously. COVID-19-related tweets were obtained from Twitter accounts of health agencies, governmental authorities, universities, scientific journals, medical associations, and celebrities. Posts\' impact was measured with the nominal and relative (%followers) number of likes and retweets. A sentiment analysis was conducted.We have identified 17,331 COVID-19-related tweets posted by 338 accounts in >4 months since the virus began to spread. The largest number of likes was received by tweets of celebrities (median nominal, relative likes; 14,918, 0.036 percent), politicians (259, 0.174 percent), and health agencies (231, 0.007 percent). Most retweeted messages were also posted by celebrities (2,366, 0.005 percent), health agencies (130, 0.004 percent), and politicians (55, 0.041 percent). Retweets and likes peaked in March 2020, and the overall sentiment of the tweets was growing steadily. Whereas celebrities and politicians posted positive messages, the scientific and health authorities often employed a negative vocabulary. The posts with positive sentiment gained more likes and relative likes than nonpositive. During the pandemic, the tweets of celebrities and politicians related to COVID-19 outperform those coming from health and scientific institutions. Active engagement of Twitter influencers may help key messages go viral.
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