{
  "abstract": "The COVID-19 pandemic posed unprecedented challenges to healthcare systems worldwide. In densely populated urban areas such as Mexico City, hospital strain was amplified by high case volumes and limited resources. This study aims to characterize the spatial and temporal organization of hospital demand and its relationship to patient outcomes. We conducted a retrospective analysis of COVID-19 hospitalization data in Mexico City using line-list data from the SISVER surveillance system. Spatial dynamics were examined using the weighted centroid of hospitalizations, and patient–hospital interactions were modeled as a time-resolved bipartite network. The emergence of giant components was used as a proxy for system strain and evaluated in relation to patient outcomes. Hospital demand exhibited marked spatial shifts, including a northward displacement of the hospitalization centroid over time. A small group of 17 hospitals consistently managed the majority of cases. During periods of high demand, the network underwent structural transitions characterized by the emergence of large connected components spanning diverse neighborhoods. These periods of increased system-wide connectivity were associated with higher case fatality rates, particularly among patients over 40. Hospital demand reorganizes at the system level under stress, leading to loss of spatial structure and increased strain. The emergence of large connected components may serve as an early indicator of systemic overload. These findings provide a network-based perspective on healthcare system stress and may inform strategies for resource allocation and emergency response.",
  "abstract_shown": true,
  "affiliations": [
    "Population genomics, Instituto Nacional de Medicina Genómica, Mexico City, Mexico",
    "Investigadores e Investigadoras por México, Secretaría de Ciencia, Humanidades, Tecnología e Innovación, Mexico City, Mexico",
    "Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico",
    "Secretaría de Ciencia, Humanidades, Tecnología e Innovación, Mexico City, Mexico",
    "Secretaría de Educación, Ciencia, Tecnología e Innovación, Gobierno de la Ciudad de México, Mexico City, Mexico",
    "Dirección General de Cómputo y de Tecnologías de Información y Comunicación, Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas, Universidad Nacional Autónoma de México, Mexico City, Mexico",
    "Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico",
    "Instituto Tecnológico de Estudios Superiores de Monterrey, Monterrey, Mexico",
    "Secretaría de Salud de la Ciudad de México, Mexico City, Mexico",
    "Instituto de Geografía, Universidad Nacional Autónoma de México, Mexico City, Mexico",
    "Secretaría de Salud, Mexico City, Mexico"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Guillermo de Anda-Jáuregui"
    },
    {
      "affs": [
        1
      ],
      "name": "José Sifuentes-Osornio"
    },
    {
      "affs": [
        2
      ],
      "name": "Ofelia Angulo-Guerrero"
    },
    {
      "affs": [
        3
      ],
      "name": "Juan L. Díaz-De-León-Santiago"
    },
    {
      "affs": [
        4
      ],
      "name": "Héctor Benítez-Pérez"
    },
    {
      "affs": [
        5
      ],
      "name": "Luis A. Herrera"
    },
    {
      "affs": [
        6
      ],
      "name": "Oliva López-Arellano"
    },
    {
      "affs": [
        7
      ],
      "name": "Arturo Revuelta-Herrera"
    },
    {
      "affs": [
        8
      ],
      "name": "Ana R. Rosales-Tapia"
    },
    {
      "affs": [
        9
      ],
      "name": "Manuel Suárez-Lastra"
    },
    {
      "affs": [
        10
      ],
      "name": "David Kershenobich"
    },
    {
      "name": "Rosaura Ruiz-Gutiérrez"
    },
    {
      "name": "Enrique Hernández-Lemus"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fse8zzykw3vyf.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0358798",
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  "id": "fse8zzykw3vyf",
  "issns": [
    "1932-6203"
  ],
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  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2611|COVID-19 epidemiological studies"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Proteomics/Protein interaction networks"
    ],
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      "plos",
      "/Computer and information sciences/Network analysis/Protein interaction networks"
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      "plos",
      "/Medicine and health sciences/Health care/Health care facilities"
    ],
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      "plos",
      "/Medicine and health sciences/Health care/Health care facilities/Hospitals"
    ],
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      "plos",
      "/Medicine and health sciences/Health care/Health care facilities/Hospitals/Hospitalizations"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Viral diseases/COVID 19"
    ],
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      "plos",
      "/Medicine and health sciences/Public and occupational health"
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      "plos",
      "/People and places/Geographical locations/North America/Mexico"
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  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0358798&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-30",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/fse8zzykw3vyf.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:37Z",
      "native_id": "10.1371/journal.pone.0358798",
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      "url": "https://doi.org/10.1371/journal.pone.0358798"
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  "subjects": [
    {
      "field": "biochemistry",
      "origin": "plos:proteomics",
      "subfield": "proteomics-metabolomics"
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    {
      "field": "medicine",
      "origin": "plos:epidemiology",
      "subfield": "epidemiology-public-health"
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    {
      "field": "medicine",
      "origin": "plos:infectious diseases",
      "subfield": "infectious-disease"
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  "title": "Complexity of hospital demand during the COVID-19 pandemic in Mexico City",
  "title_text": "Complexity of hospital demand during the COVID-19 pandemic in Mexico City",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:37Z",
  "url": "https://research.draconitic.com/paper/fse8zzykw3vyf",
  "venue": "PLOS One",
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}