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COVID-19 in the city of Rio de Janeiro: spatial analysis of first confirmed cases and deaths. COVID-19 no município do Rio de Janeiro: análise espacial da ocorrência dos primeiros casos e óbitos confirmados. OBJECTIVE: to describe the spatial distribution of the first confirmed COVID-19 cases and deaths in Rio de Janeiro. METHODS: this was an ecological study of confirmed SARS-CoV-2 cases and deaths between March 6thand April 10th, 2020. Incidence, mortality, lethality, excess risk and global and local Moran rates were calculated. RESULTS: 1,808 confirmed cases and 92 confirmed deaths were recorded. The COVID-19 incidence rate was 26.8/100,000 inhab., the mortality rate was 1.36/100,000 inhab. and lethality rate 5%. The incidence rate in eight neighborhoods was 4-12 times higher than the overall rate for the municipality: Joá, in the city's Western Zone; Cosme Velho, Gávea, Ipanema, Jardim Botânico, Lagoa, Leblon and São Conrado, in its Southern Zone. CONCLUSION: high risk of COVID-19 infection and deaths was found in neighborhoods in the Southern Zone of the city of Rio de Janeiro. Neighborhoods in the Northern Zone of the city also stand out in relation to high risk of death.

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