During the normalization stage of the COVID-19 epidemic prevention and control, the safety threats caused by improper epidemic prevention measures of airlines have become the primary concern for air passengers. Negative e-WOM related to safety perception obtained based on online multimodal reviews of travel websites has become an important decision-making basis for potential air passengers when making airline choices. This study aims to examine the relationship between potential air passengers’ negative safety perception and the usefulness of online reviews, as well as to test the moderating effect of review modality and airline type. It also further explores the effectiveness and feasibility of applying big data sentiment analysis to e-WOM management. To this end, the theoretical model of negative safety perception, review modality, and airline type affecting review usefulness was constructed. Then we select 10 low-cost airlines and 10 full-service airlines, respectively, according to the number of reviews sorted by the TripAdvisor website, and use crawling techniques to obtain 10,485 reviews related to COVID-19 safety of the above companies from December 2019 to date, and conduct safety perception sentiment analysis based on Python’s Textblob library. Finally, to avoid data overdispersion, the model is empirically analyzed by negative binomial regression using R software. The results indicate that (1) Negative safety perception significantly and negatively affects review usefulness, that is, extreme negative safety perception can provide higher review usefulness for potential air passengers. (2) Review modality and airline type have a significant moderating effect on the relationship between negative safety perception and review usefulness, in which multimodal reviews and full-service airlines both weakened the negative impact of negative safety perception on review usefulness. The theoretical model in this paper is both an extension of the application of big data sentiment analysis techniques and a beneficial supplement to current research findings of e-WOM, providing an important reference for potential air passengers to identify useful reviews accurately and thus reduce safety risks in online decision-making.