Alireza Zangeneh ¹ Nasim Hamidipour ² Zahra Khazir ³ Arash Ziapour ^4* Homa Molavi ⁵ Zeinab G. Kiaee ⁶ Raziyeh Teimouri ⁷ Fatemeh Khosravi ¹

• ¹ Kermanshah University of Medical Sciences, Kermanshah, Kerman, Iran
• ² Dezful University of Medical Sciences (DUMS), Dezful, Khuzestan, Iran
• ³ Birjand University of Medical Sciences, Birjand, South Khorasan, Iran
• ⁴ Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
• ⁵ The University of Manchester, Manchester, England, United Kingdom
• ⁶ Amir Kabir Hospital, Arak, Iran
• ⁷ University of South Australia, Adelaide, Australia

Presenting ongoing outbreaks and the potential for their spread to nearby neighborhoods and social classes may offer a deeper understanding, enable a more efficient reaction to outbreaks, and enable a comprehensive understanding of intricate details for strategic response planning. Hence, this study explored the spatiotemporal spread of COVID-19 outbreaks and prioritization of the risk areas among social classes in the Kermanshah metropolis. Methods: In this cross-sectional study, the data of 58.951 COVID-19-infected patients were analyzed. In 2020, out of 24.849 infected patients, 10.423 were females, 14,426 were males, and in 2021, 15.714 were females, and 18,388 were males. To categorize social classes (working, middle, and upper), we utilized economic, social, cultural, and physical indicators. Our analysis utilized Arc/GIS 10.6 software along with statistical tests, including standard distance (SD), mean center (MC), standard deviational ellipse (SDE), and Moran's I.The results revealed that the average epicenter of the disease shifted from the city center in 2020-2021 to the eastern part of the city in 2021. The results related to the SD of the disease showed that more than 70% of the patients were concentrated in this area of the city. The SD of COVID-19 in 2020 compared to 2021 also indicated an increased spread throughout the city. Moran's I test and the hotspot test results showed the emergence of a clustered pattern of the disease. In the Kermanshah metropolis, 58,951 COVID-19 cases were recorded, with 55.76% males and 44.24% females. Social class distribution showed 28.86% upper class, 55.95% middle class, and 15.19% working class. A higher disease prevalence among both males and females in the upper class compared to others. Discussion: Our study designed a spatiotemporal disease spread model, specifically tailored for a densely populated urban area. This model allows for the observation of how COVID-19 propagates both spatially and temporally, offering a deeper understanding of outbreak dynamics in different neighborhoods and social classes of the city.