Temporal trends in within-city inequities in COVID-19 incidence rate by area-level deprivation in Madrid, Spain

Patterns of exposure and policies aiming at reducing physical contact might have changed the social distribution of COVID-19 incidence over the course of the pandemic. Thus, we studied the temporal trends in the association between area-level deprivation and COVID-19 incidence rate by Basic Health Zone (minimum administration division for health service provision) in Madrid, Spain, from March 2020 to September 2021. We found an overall association between deprivation and COVID-19 incidence. This association varied over time; areas with higher deprivation showed higher COVID-19 incidence rates from July to November 2020 and August–September 2021, while, by contrast, higher deprivation areas showed lower COVID-19 incidence rates in December 2020 and July 2021. •There is existing evidence that there is an unequal distribution of COVID-19 incidence by neighborhood deprivation.•We found that inequities by deprivation in COVID-19 incidence were dynamic in Madrid.•Wider inequities were found from August to November 2020 and August–September 2021.•Inverse inequities in COVID-19 were found in December 2020 and July 2021.•The specific causes of this variability should be further explored.