Detecting the Seasonal and Spatial Patterns of COVID-19 Hospitalization and Deaths in Iran: Insights from a Spatiotemporal and Hotspot Analysis

Abstract

Background: Understanding the seasonal and spatial patterns of COVID-19 hospitalization and deaths is crucial for effective hospital management, resource allocation, and public health interventions. The current study conducts a spatiotemporal hotspot analysis that explores the seasonal and geographical patterns of high-risk areas of COVID-19 hospitalizations and deaths in Iran.

Methods: Provincial-level data on laboratory-confirmed COVID-19 cases with acute respiratory symptoms in Iran (February 2019-March 30, 2022) were collected. Hotspot analyses mapped seasonal incidence risks, and Global Moran's spatial autocorrelation analysis identified COVID-19 clusters.

Results: Over the 2 years, 26 hotspots and 11 cold spots were identified (P < 0.05). Western and central provinces showed the highest hospitalization hotspots, while the west and north had the most death hotspots. South and southeast provinces exhibited low incidence and the highest number of cold spots. High-risk areas were prevalent in spring and autumn, mainly in the west, north, and central regions.

Conclusions: This research unveils the clustering patterns of COVID-19 hospitalizations and fatalities in Iran during the most severe pandemic. Spatial clusters and dynamic hotspots varied across regions and time. Prioritizing high-risk areas during critical epidemic waves, devising seasonal care strategies, and implementing preventive measures can significantly improve health outcomes.

Keywords: Covid-19; Iran; hospitalization; incidence; spatiotemporal analysis.

Figure 1

The geographical distribution of hospitals across different provinces in Iran

Figure 2

The map displays the provincial-level geography of Iran and highlights the COVID-19 hospitalization (a) and death (b) hot and cold spots from 2020 to 2022. The map uses a color-coded system to indicate the level of clustering, with seven confidence levels ranging from red for high-incidence hotspots to blue for low-incidence hotspots (cold spots). Two relatively hot spots (west) and one relatively cold spot (southeast) were identified for hospitalizations, while one relatively hot spot (north) and two cold spots (southeast) were identified for deaths

Figure 3

(a–i): Hotspot analysis of COVID-19 hospitalizations by season from epidemic onset to March 20, 2022. The first figure (a) relates to the first month of the epidemic, and the other figures (b–i) show for the eight seasons during 2 years The map is color-coded to represent the level of clustering (with 7 confidence levels), with red indicating high-incidence hotspots and blue indicating low-incidence hotspots (cold spots)

Figure 4

(a–i): Hotspot analysis of COVID-19 deaths by season from epidemic onset to March 20, 2022. The first figure (a) relates to the first month of the epidemic, and the other figures (b–i) show for the eight seasons during 2 years. The map is color-coded to represent the level of clustering (with 7 confidence levels), with red indicating high-incidence hotspots and blue indicating low-incidence hotspots (cold spots)