The association between the incidence of COVID-19 and the distance from the virus epicenter in Iran
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ORIGINAL ARTICLE
The association between the incidence of COVID‑19 and the distance from the virus epicenter in Iran Maryam Dadar1 · Yadolah Fakhri2 · Geir Bjørklund3 · Youcef Shahali1 Received: 12 May 2020 / Accepted: 13 July 2020 © Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Since the first official report of the spread of SARS-CoV-2 infections in the city of Qom in mid-February, Iran has become the country most affected by the COVID-19 epidemic in the Middle East. All Iranian provinces are now affected, although to a different extent. The aim of the present study was to evaluate whether the distance from the epicenter of the infection (Qom) or demographic factors such as population density and the ratio of the elderly population are associated with the incidence of COVID-19 in different Iranian provinces. For the purpose of determining whether the distance from the virus epicenter could be associated with the spread of infection, linear regression analysis was performed using STATA 12.0 software. The association of the incidence of COVID-19 with the population density and the ratio of the population over 65 years old in 31 Iranian provinces was also evaluated. According to our results, a strong association was found between the incidence of COVID-19 in Iranian provinces and their respective distance from Qom (p < 0.001; C = -0.68). The incidence of COVID19 in Iranian provinces was also positively associated with the ratio of the population over 65 years old (p = 0.002; C = 0.53), while no significant association with population density was found (p = 0.39; C = 0.16). These results suggest that the implementation of travel restrictions from highly affected areas to other provinces could considerably reduce the rate of transmission of the disease throughout the country. Also, provinces with a higher proportion of elderly people (over 65) were identified as particularly at risk for the spread of SARS-CoV-2 infections. These results will contribute to better management of the COVID-19 outbreak in Iran, taking into account demographic and geographic characteristics of different provinces.
Introduction With a population of about 83,075,000 inhabitants, Iran was the country most affected by the coronavirus disease 2019 (COVID-19) epidemic in the Middle East. Located in southwestern Asia and bounded by the Caspian Sea to the north Handling Editor: Tim Skern. * Geir Bjørklund [email protected] * Youcef Shahali [email protected] 1
Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
2
Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
3
Council for Nutritional and Environmental Medicine, Toften 24, 8610 Mo i Rana, Norway
and the Persian Gulf to the south, Iran is at the crossroads between Europe, the Middle East, and Asia. Its central location in Eurasia, spanning over an area of 1,648,000 square kilometers, acc
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