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 COVID-19 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.

自2月中旬在库姆市首次发布SARS-CoV-2感染的正式报告以来，伊朗已成为受COVID-19流行病影响最严重的中东国家。现在，伊朗所有省份都受到了影响，尽管程度不同。本研究的目的是评估距感染中心（Qom）的距离或人口密度（例如人口密度和老年人口比例）等人口因素是否与伊朗不同省份的COVID-19发生率相关。为了确定与病毒震中的距离是否可能与感染的传播有关，使用STATA 12.0软件进行了线性回归分析。还评估了伊朗31个省的COVID-19发病率与人口密度和65岁以上人口比例的关系。根据我们的结果，在伊朗各省中，COVID-19的发生率与它们与库姆（Qom）的距离（p <0.001；C = -0.68）。伊朗各省的COVID-19发病率也与65岁以上人口的比例呈正相关（p = 0.002; C = 0.53），而与人口密度没有显着相关（p= 0.39; C = 0.16）。这些结果表明，实施从重灾区到其他省份的旅行限制可能会大大降低该疾病在全国的传播速度。此外，老年人（占65岁以上）比例较高的省被确定为SARS-CoV-2感染传播的特别危险地区。考虑到不同省份的人口统计和地理特征，这些结果将有助于更好地管理伊朗的COVID-19疫情。