Analytical Study of the Geographical Distribution and Seasonality Patterns of COVID-19 Cases in Primary Care Units: A Descriptive Analytical Study
Authors: Castillo-Cruz Tania , Lopez-Hernandez Daniel , Mayoral-Ortiz Antonio , Brito-Aranda Leticia , Blanco-Osorio Nallely , Castro-Diaz Alaina Mariana , Aguilar-Cozatl Israel , Beltran-Lagunes Luis , Reyes-Perez Luis Manuel , Liceaga-Perez Liliana Grisel , Torres-García Edgar Esteban , Espinoza-Perdomo Abraham , Sanchez-Barcernas Ricardo Alejandro , Jimenez-Hernandez Rocio Liliana , Flores-Gonzalez Francisco Javier , Vazquez-Sanchez Alberto , Anguiano-Velazquez Tabata Gabriela , Melgarejo-Estefan Emmanuel , Olivares-Lopez Xochitl Liliana , Noguez-Alvarez Victor Hugo , Miranda Miriam Idalith Infante , Flores-Morales Guadalupe Jacqueline , Martinez-Castillo Nallely , Hernandez-Ramirez Geovanna Elizabeth 
Published: January 2025

Aims: To determine Geographic Distribution and Seasonality Patterns of COVID-19 Cases in Primary Care Units, in Puebla State, Mexico.
Study design:  A descriptive, analytical, multicentre and cross-sectional study was conducted.
Place and Duration of Study: Hospital and Ambulatory Care Medical Units. The study was conducted from July 1st to December 31st, 2024, with COVID-19 Mexican patients attending an outpatient consultation at several units in Puebla State, Mexico, from September 29th, 2022 to June 3rd, 2023.
Methodology: Data on health and sociodemographic variables were collected through a retrospective design, using the SINOLAVE system.
Results: We included 10,558 patients with COVID-19, mainly females (n=5,991; 56.7%, CI95% 55.8-57.7). COVID-19 activity displayed seasonal patterns, with primary peaks occurring in winter. The geographic distribution of COVID-19 cases across the municipalities in the state of Puebla, Mexico (n= 121 municipalities), reveals significant variation in the number of reported cases. Puebla City represents the primary hotspot of cases in the state. The mainly comorbidities in patients with COVID-19 were hypertension, type 2 diabetes and obesity.
Conclusion: The Geographic Distribution and Seasonality Patterns of COVID-19 Cases in Primary Care Units provides a comprehensive overview of epidemiological trends at the primary care level and highlights priority areas for intervention. The high prevalence of no communicable diseases such as hypertension, diabetes, and obesity require a comprehensive response focused on prevention and risk factor management. Seasonal variations and the variability in the case count across municipalities highlight the need for targeted public health interventions for managing COVID-19. Additionally, the variability in comorbidities across sexes underscores the need for personalized approaches to manage COVID-19. It is recommended that the public health system develop tailored health education programmes to address the specific needs of high-prevalence areas. Implementing initiatives for early screening and management of comorbidities may also mitigate the impact of COVID-19. Furthermore, ongoing surveillance of seasonal patterns and geographical distribution will be crucial for timely and effective public health responses.