en Epidemiology Epidemiology Original Research Original Research <strong>Background: </strong>Analyzing and monitoring the spatial-temporal patterns of the new coronavirus disease (COVID-19) pandemic can assist local authorities and researchers in detecting disease outbreaks in the early stages. Because of different socioeconomic profiles in Tehran&#39;s areas, we will provide a clear picture of the pandemic distribution in Tehran&#39;s neighbourhoods during the first months of its spread from February to July 2020, employing a spatial-temporal analysis applying the geographical information system (GIS). Disease rates were estimated by location during the 5 months, and hot spots and cold spots were highlighted.<br> &nbsp;&nbsp; <strong>Methods:</strong> This study was performed using the COVID-19 incident cases and deaths recorded in the Medical Care Monitoring Centre from February 20, to July 20, 2020. The local Getis-Ord Gi* method was applied to identify the hotspots where the infectious disease distribution had significantly clustered spatially. A statistical analysis for incidence and mortality rates and hot spots was conducted using ArcGIS 10.7 software.<br> &nbsp;&nbsp; <strong>Results:</strong>&nbsp; The addresses of 43,000 Tehrani patients (15,514 confirmed COVID-19 cases and 27,486 diagnosed as probable cases) were changed in its Geo-codes in the GIS. The highest incidence rate from February to July 2020 was 48 per 10,000 and the highest 5-month incidence rate belonged to central and eastern neighbourhoods.&nbsp; According to the Cumulative Population density of patients, the higher number is estimated by more than 2500 people in the area; however, the lower number is highlighted by about 500 people in the neighborhood. Also, the results from the local Getis-Ord Gi* method indicate that COVID-19 has formed a hotspot in the eastern, southeast, and central districts in Tehran since February. We also observed a death rate hot spot in eastern areas.<br> &nbsp;&nbsp; <strong>Conclusion:</strong> Because of the spread of COVID-19 disease throughout Tehran&#39;s neighborhoods with different socioeconomic status, it seems essential to pay attention to health behaviors to prevent the next waves of the disease. The findings suggest that disease distribution has formed a hot spot in Tehran&#39;s eastern and central regions. Spatial-temporal analysis, COVID-19 outbreak, Hotspot cases, GIS, Tehran, Iran 954 961 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-5209-2&slc_lang=en&sid=1 Azadeh Lak A_Lak@sbu.ac.ir 200319475328460068923 200319475328460068923 No Faculty of Architecture and Urban Planning, Shahid Beheshti University, Tehran, Iran Ali Maher dralimaher@Sbmu.ac.ir 200319475328460068924 200319475328460068924 Yes School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran Alireza Zali alirezazali@sbmu.ac.ir 200319475328460068925 200319475328460068925 No Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran Siamak Badr S_badr@sbu.ac.ir 200319475328460068926 200319475328460068926 No Faculty of Architecture and Urban Planning, Shahid Beheshti University, Tehran, Iran Ehsan Mostafavi mostafavi@pasteur.ac.ir 200319475328460068927 200319475328460068927 No Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging infectious diseases, Pasteur Institute of Iran, Tehran, Iran Hamid R Baradaran baradaran.hr@iums.ac.ir 200319475328460068928 200319475328460068928 No Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Khatereh Hanani K.hanani@sbmu.ac.ir 200319475328460068929 200319475328460068929 No Statistics & Information Technology Managment, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ara Toomanian a.toomanian@ut.ac.ir 200319475328460068930 200319475328460068930 No Department of GIS and Remote Sensing, Faculty of Geography, University of Tehran, Tehran, Iran Davood Khalili dkhalili@endocrine.ac.ir 200319475328460068931 200319475328460068931 No Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran