The short answer is: Yes, this can be done by analysing the logs generated by Nextcloud with a product such as Splunk (Splunk is a commercial product but does have a free version with some limitations which may or may not be an issue in your case).
Slightly longer answer: There is a Splunk app which can already provide a lot of analysis of the Nextcloud log files. The app has some dashboards that almost meet your requirements. See this post for a description and screenshots of the available dashboards:
I wrote that the currently available dashboards possibly don’t quite do what I think you are after, but a dashboard could no doubt be created which does do what you are after, but for that I’d need to better understand your requirement. So:
Are the downloads done by named users or are they done from public shares?
If the downloads are done by named users, is it a count of how many and which files have been downloaded you are after?
Or is the above “Klinik Bellevue/Department physio therapy" a file path? If so, should the count be of individual files accessed?