Spatial and temporal analysis of the COVID-19 incidence pattern in Iran

In the present paper, province-level variations of novel coronavirus (COVID-19) disease incidence across Iran were investigated. To this end, a geo-database from infected cases, deaths, total population, death-to-population ratio, and infected case-to-death ratio for 31 provinces of Iran and during seven successive periods of February 18-March 19 (P1), March 20-April 8 (P2), April 9-April 28 (P3), April 29-May 20 (P4), May 21-June 20 (P5), June 21-September 21 (P6), and September 22-October 21 (P7) of 2020 was built. Based on the last reports of the population and housing census (2018), Iran is home to 81.8 million people. Nationwide case series of 536,181 and 29,403 infected cases and deaths respectively with COVID-19 were reported to Iran's Minister of Health from February 18 to October 21, 2020. Of the infected cases, 5.48% have died. The spatiotemporal patterns of COVID-19 were different throughout the 31 study provinces. Firstly, the central, north, and northwest of Iran were the main hosts of this virus. Shortly after, other parts of Iran, most notably the west and southwest regions, experienced a momentous rise in the numeral of infected cases and deaths. In the first study period, Tehran, West Azerbaijan, Mazandaran, Qom, and Gilan had the most infected cases (> 1000). In the second to fourth periods, the number of provinces with higher than 1000 infected cases, respectively, reached 12, 10, and 17. For the last three periods (P5-P7), 31 provinces were assigned higher than 1000 infected cases. Tehran had the most deaths with an increasing trend for all study periods among other provinces. The areas around Kohgiluyeh and Boyer-Ahmad, Bushehr, Chaharmahal and Bakhtiari, South Khorasan, and Ilam had the least death cases. The numbers of infected (death) cases in Iran for the first to seventh periods (P1-P7) respectively were 16,730 (1208), 41,285 (1595), 28,530 (1876), 16,366 (1856), 80,694 (6588), 201,585 (6232), and 128,336 (6953). The location quotient (LQ) index showed that most provinces of Iran have the LQ > 1 indicating a high degree of COVID-19 concentration in most of the province's area in comparison with the nation, especially in the last study period (P7).