PubMed Medline database was used for the research, with only articles in English language, using the following terms: “COVID-19,” “geo-epidemiology” and “spatial epidemiology.” Articles included in this review were both, original research, review, viewpoint, and case reports. Literature was searched from inception to 2023.

By analyzing the relationship between COVID-19 pandemic and various risk factors, geoepidemiology has provided valuable insights into the disease's dynamics (62, 63). Studies have shown that age, gender, and underlying health conditions significantly affect vulnerability to infection and disease severity (64, 65). Additionally, socioeconomic factors, such as poverty, overcrowding, and access to healthcare, have been identified as determinants of COVID-19 outcomes (66).

Age has emerged as a significant risk factor in the transmission and severity of COVID-19. Older individuals, particularly those over the age of 65, are more susceptible to severe illness and mortality (67). Age-related physiological changes weakened immune systems, and a higher prevalence of underlying health conditions contribute to increased vulnerability (67). This ensures targeted protection measures for older populations, including prioritized vaccination campaigns and enhanced healthcare support (68, 69).

Socioeconomic determinants have a crucial role in the determination of COVID-19 risk (70). Individuals from lower socioeconomic backgrounds, who may have limited access to healthcare, live in crowded housing, or have occupations that do not allow for remote work, face heightened exposure risks (71, 72). They may also have challenges in accessing testing, treatment, and adhering to preventive measures due to economic constraints.

Certain occupations, such as healthcare workers, frontline workers, and those in essential services, face an increased risk of exposure to COVID-19 due to close contact with infected individuals or the public (73, 74). Workplaces that involve enclosed spaces, limited ventilation, and crowded conditions, such as factories, meatpacking plants, and prisons, have been associated with outbreaks (75–77). Thus, recent studies have highlighted the importance of workplace safety measures, including personal protective equipment (PPE) (78), physical distancing, and regular testing, to mitigate transmission risks (79, 80).

Demographic determinants, such as gender and ethnicity, have been observed to influence COVID-19 outcomes (81, 82). Men have been found to be more susceptible to severe illness and higher mortality rates compared to women (83). Furthermore, certain ethnic and racial groups, including Black, Indigenous, and minority populations, have experienced higher infection rates and worse outcomes due to systemic health disparities, socioeconomic factors, and structural inequities (84).

Individual behaviors have significant roles in COVID-19 transmission (85, 86). Determinants such as adherence to preventive measures (mask-wearing, hand hygiene, physical distancing), participation in social gatherings, travel, and compliance with public health guidelines influence the risk of COVID-19 infection and transmission (87–89). This knowledge can inform targeted public health messaging, community engagement strategies, and interventions to promote safe behaviors.

The COVID-19 pandemic has had far-reaching effects on mental health, livelihoods, and food security, pushing many individuals and families into poverty (90, 91). As the pandemic unfolded, it brought about a surge in stress, anxiety, and depression among people worldwide. The uncertainty surrounding the virus, fear of infection, isolation due to lockdowns, and loss of loved ones have taken a toll on mental wellbeing (92).

At the same time, the pandemic led to widespread job losses, reduced work hours, and business closures, particularly in sectors heavily affected by restrictions and social distancing measures. Many people found themselves without income or faced significant reductions in earnings, making it challenging to meet basic needs and maintain their livelihoods (93).

As the economic situation worsened, food security became a major concern. Disruptions in supply chains, rising food prices, and limited access to food resources exacerbated existing vulnerabilities, especially among low-income and marginalized populations (93).

The combination of mental health challenges, economic hardships, and food insecurity has forced many individuals and families into poverty (94). People living on the brink of poverty before the pandemic found themselves pushed over the edge due to the loss of income and access to essential resources (95).

The impact has been particularly severe in developing countries and marginalized communities, where the social safety net may be inadequate to address the growing needs (96). Vulnerable populations have been disproportionately affected, as they lack job security, social protection, and access to healthcare (97). Thus, addressing the mental health implications of the pandemic is crucial to mitigating its impact on livelihoods and food security. Providing mental health support and resources can help individuals cope with stress and anxiety, enabling them to better navigate the challenges posed by the pandemic.

Geoepidemiological investigations have shed light on the transmission dynamics of COVID-19 pandemic, elucidating how the virus spreads within and between communities (98, 99). By examining patterns of mobility, social interactions, and travel, researchers have quantified the impact of human behavior on virus transmission (100, 101). Furthermore, the integration of geographic information systems (GIS) and mathematical modeling has facilitated the prediction of future outbreaks and the evaluation of the effectiveness of control measures (62, 102). These insights have been instrumental in guiding public health responses and policy decisions (5, 103).

COVID-19 pandemic can be transmitted by individuals who are either asymptomatic (showing no symptoms throughout the infection) or pre-symptomatic (infected but not yet showing symptoms) (104). This characteristic of the virus poses challenges in identifying and containing transmission chains. This type of research has highlighted the significance of widespread testing, contact tracing, and quarantine measures to control the spread, even among individuals who do not exhibit symptoms (105).

COVID-19 pandemic has exhibited a pattern of super-spreading events, where a small number of individuals infect a disproportionately large number of people (106, 107). These events typically occur in crowded settings, such as social gatherings, religious ceremonies, and mass gatherings, where close contact and inadequate preventive measures facilitate rapid transmission (108). Thus, underscoring the importance of avoiding large gatherings is major for implementing targeted interventions in high-risk settings.

Travel restrictions, quarantine measures, and testing protocols have been implemented to mitigate travel-related spread (109). Additionally, contact tracing of individuals with travel history has played a crucial role in identifying and containing clusters of cases (110).

The emergence and spread of SARS-CoV-2 variants have further influenced the transmissibility and spread of COVID-19 (111). Variants with increased transmissibility, such as the Alpha, Beta, Gamma, and Delta variants, have led to more rapid spread in certain regions (112). Recent studies have monitored the circulation and impact of these variants, highlighting the need for genomic surveillance, early detection, and adaptive public health strategies to address emerging viral evolution (113, 114).

The spatio-temporal tracking of changed COVID dynamics based on genomic analysis is a cutting-edge approach in understanding the evolving nature of the SARS-CoV-2 virus (115). By analyzing the genetic sequences of the virus collected from different regions and at different time points, scientists can identify genetic mutations and variations that occur over time (116). This allows them to track the spread and transmission patterns of specific viral lineages across geographic areas. Moreover, the identification of new variants and their prevalence in different regions helps to assess their potential impact on disease severity, transmissibility, and vaccine effectiveness (117). This valuable information aids public health authorities in tailoring targeted interventions, optimizing testing strategies, and guiding vaccination efforts to effectively control and respond to the changing dynamics of the COVID-19 pandemic. The spatio-temporal genomic analysis could become an indispensable tool in the global effort to combat the pandemic and mitigate its effects on communities worldwide (118, 119). Nevertheless, this type of analysis needs to access of open and comprehensive data (120).

During the initial stages of the pandemic, the number of COVID-19 cases in African countries closely correlated with the volume of international flights into the continent. South Africa and Egypt, with their busiest international airports, experienced the highest case numbers (121). Conversely, countries with limited business and tourism connections to other continents reported lower case numbers.

A significant contributing factor to the relatively lower-case numbers in Africa was the early closure of airports in many countries, particularly those with prior experience in managing epidemic infectious diseases such as Ebola, Tuberculosis, and Lassa fever (122). These nations-initiated disease surveillance and contact tracing at airports much earlier than many other countries, thereby limiting the introduction of COVID-19 cases into the continent. Consequently, the “seeding” of cases was restrained, leading to a delayed onset and slower growth of infections, effectively “flattening the curve” in many African countries (123).

Testing capacity played a crucial role in shaping the reported case numbers. The top testing countries, e.g., USA and Europe, globally conducted significantly higher numbers of RT-PCR tests compared to African nations (57, 124). Limited testing resources, high costs, and the scarcity of necessary equipment and trained personnel hampered extensive testing in Africa. As a result, many cases might have been missed, and some antibody testing suggested that a substantial portion of the population may have already contracted and recovered from the disease (57). Furthermore, the absence of widespread testing might have resulted in some deaths being erroneously attributed to other causes when they were, in fact, due to COVID-19.

The lower population density in Africa compared to other continents played a favorable role in slowing the spread of the virus (125). Rural and widely dispersed communities contributed to limiting the rapid transmission of the disease, as observed in USA (126).

The youthfulness of the African population was also a protective factor. With a less median age in Sub-Saharan Africa compared to Europe, younger individuals were four times less likely to acquire severe symptoms or fatalities from COVID-19 (127). Conversely, countries with slightly older populations, like Egypt and South Africa, had higher case numbers and greater case fatality rates, partially due to higher prevalence of comorbidities associated with severe illness and mortality (128).

Exposure to previous infections, including other coronaviruses and endemic diseases like malaria, tuberculosis, and HIV, may have conferred relative immunity, and contributed to milder COVID-19 presentations in Africa (129, 130). Countries with higher Human Development Index tended to have higher case numbers and worse outcomes, suggesting that healthcare development and access influenced the pandemic's impact in countries (131).

Recently it has been highlighted the importance of global collaboration in responding to a pandemic (132, 133). Through the sharing of data, expertise, and best practices, researchers and policymakers have been able to develop a more comprehensive understanding of the COVID-19 pandemic (134). Moreover, investigations have shown the need for improved surveillance systems, data harmonization, and standardized reporting methods for effective global monitoring and response (135).

The complexity of the COVID-19 pandemic has underscored the need for multidisciplinary collaboration (136) (Table 1). Thus, geoepidemiology brings together experts from various fields, including epidemiology, geography, data science, and public health, to analyze spatial patterns, risk factors, and transmission dynamics (137). By integrating diverse perspectives and expertise, researchers have been able to generate comprehensive insights, develop innovative methodologies, and formulate evidence-based strategies to combat the pandemic.

The COVID-19 pandemic has emphasized the critical role of rapid information dissemination in effective response efforts (138). Studies have relied on real-time data sharing, open-access publications, and online platforms to disseminate findings promptly (139). Rapid dissemination of accurate information is crucial for guiding public health decision-making, enabling policymakers and healthcare professionals to implement evidence-based interventions, and fostering public trust and compliance with preventive measures (140, 141).

The development and distribution of vaccines against COVID-19 have shown the importance of global solidarity and equitable access (142). Global collaboration has emphasized the need for fair vaccine distribution, support for low-income countries, and collaborative efforts to ensure that no one is left behind in the global vaccination campaign (143).