Unveiling the narrative: Italian media’s role in shaping public health messaging during COVID-19 - A corpus-assisted discourse analysis

Background Effective public health communication during emergencies is critical for influencing behaviour and maintaining trust. Newspapers remain a key channel for disseminating institutional guidance, yet the extent to which their coverage aligns with international recommendations (e.g., World Health Organisation, WHO and Pan American Health Organisation, PAHO guidance) is not well established. Italy, the first European country to experience major COVID-19 outbreaks, provides a useful case for assessing the extent to which mainstream newspaper coverage aligned with WHO and PAHO recommendations for COVID-19 reporting. Methods A quali-quantitative, corpus-assisted discourse analysis was conducted on 5,621 articles (over 2.7 million words) published in seven major Italian newspapers and included in the national press review of the Italian National Institute of Health. Lexical and discursive patterns were examined using SketchEngine, combining quantitative keyword, collocation, and concordance analyses with qualitative close reading. Findings were compared against reporting recommendations issued by the WHO and the PAHO. Results Italian newspapers largely reflected key elements of WHO/PAHO guidance, emphasizing preventive measures, vaccine-related content, and reliance on expert and institutional sources (e.g., scientists, researchers, and public health professionals). However, recurrent use of non-people-first labels for affected individuals and occasional instances of “false balance” in vaccine coverage were also identified. Conclusions Mixed corpus-based and qualitative approaches can support systematic assessment of newspaper reporting against WHO and PAHO recommendations for COVID-19 coverage. While many aspects of guidelineconsistent reporting were observed, gaps remain in the use of non-stigmatising, people-first language and in evidence-weighted framing of scientific disagreement. Strengthening collaboration between journalists and public health institutions may support clear, ethical, and trustworthy communication in future emergencies.