Objective:

The geospatial patterns of the temporal dynamics of the incidence of COVID-19 cases in Costa Rica are analyzed between March 2020 and May 2022, and explained from the perspective of the social determinants of health (DSS) in the territorial context, particularizing comparatively, in two periods of time or epidemic crests.

Materials and methods:

An ecological study was carried out over counting weeks until the maximum case report was reached during the first and fourth peaks of the epidemic. Cartograms were designed to identify and analyze geospatial patterns, and explanatory Poisson regression and Geographically Weighted Regression (GWR) models were built.

Results:

Hot geospatial clusters with high temporal dynamics of case incidence were identified, as well as cold clusters, which evidence the role of the territory. The regression models indicated explanatory factors in the first epidemic peak, such as population density, overcrowding of housing per bedroom, internet connection, and the percentage of the population over 65 years of age. In the fourth crest, the predictive importance of territorial social development in its economic dimension and the possible role of other factors, such as population mobility in coastal areas of the country, were identified.

Conclusions:

the temporal dynamics of the covid-19 epidemic, until May 2022, was spatially configured in clusters of socially determined hot and cold spots. The effects of DSS on temporal dynamics vary territorially and must be understood geographically.

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