A comparative analysis of SARS-CoV-2 viral load across different altitudes

Ortíz-Prado, Esteban; Fernández-Naranjo, Raúl; Vásconez, Eduardo; Vallejo-Janeta, Alexander Paolo; Morales-Jadán, Diana; Rivera-Olivero, Ismar A.; Lozada, Tannya; Viscor, Ginés; García-Bereguiaín, Miguel Angel

doi:10.1038/s41598-022-20516-w

Cited by 4 publications

(3 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We conducted a novel analysis to investigate the incidence and mortality of CD at different altitudes. Ecuador’s unique topography, with 221 cities situated at varying elevations ranging from sea level to 4,300 m, provides an exceptional opportunity to study the burden of diseases at different altitudes ( 39 – 41 ). Our study found that the majority of CD cases ( n = 107) were concentrated at elevations below 2,500 m. To provide a more nuanced analysis, we also employed the International Society of Mountain Medicine classification, which classifies altitudes into different categories, and observed that the highest incidence and mortality rates were found at low and moderate altitudes.…”

Section: Discussionmentioning

confidence: 99%

Severe Chagas disease in Ecuador: a countrywide geodemographic epidemiological analysis from 2011 to 2021

Vásconez

Izquierdo-Condoy

Fernández-Naranjo

et al. 2023

Front. Public Health

Self Cite

View full text Add to dashboard Cite

BackgroundChagas disease is a neglected and often forgotten tropical disease caused by the Trypanosoma cruzi. This parasite can be transmitted through the direct contact of human skin with feces and urine of the triatomine insect. According to the World Health Organization (WHO), an estimated 6–7 million people are infected worldwide, killing at least 14,000 every year. The disease has been reported in 20 of the 24 provinces of Ecuador, with El Oro, Guayas, and Loja being the most affected.MethodologyWe analyzed the morbidity and mortality rates of severe Chagas disease in Ecuador on a nationwide, population-based level. Hospitalization cases and deaths were also examined based on altitude, including low (< 2,500 m) and high (> 2,500 m) altitudes, according to the International Society. Data was retrieved from the National Institute of Statistics and Census hospital admissions and in-hospital mortality databases from 2011 to 2021.ResultsA total of 118 patients have been hospitalized in Ecuador since 2011 due to Chagas disease. The overall in-hospital mortality rate was 69.4% (N = 82). Men have a higher incidence rate (4.8/1,000,000) than women, although women have a significantly higher mortality rate than men (6.9/1,000,000).ConclusionChagas disease is a severe parasitic condition that primarily affects rural and poorer areas of Ecuador. Men are more likely to be infected due to differences in work and sociocultural activities. Using average elevation data, we conducted a geodemographic analysis to assess incidence rates by altitude. Our findings indicate that the disease is more common at low and moderate altitudes, but recent increases in cases at higher altitudes suggest that environmental changes, such as global warming, could be driving the proliferation of disease-carrying vectors in previously unaffected areas.

show abstract

Section: Discussionmentioning

confidence: 99%

Severe Chagas disease in Ecuador: a countrywide geodemographic epidemiological analysis from 2011 to 2021

Vásconez

Izquierdo-Condoy

Fernández-Naranjo

et al. 2023

Front. Public Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, other conditions typical of high altitude, such as radiation and air humidity, must also be considered as variables of the protective role [ 37 ]. A study conducted in Ecuador did not find a lower viral load related to altitude perhaps because they did not consider the time of development of the disease or the peak of the viral load, the state of the immune system or the use of medication that can reduce the viral load [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

A U-shaped protection of altitude against mortality and infection of COVID-19 in Peru: an ecological study

et al. 2023

View full text Add to dashboard Cite

Background The COVID-19 pandemic has affected the world in multiple ways and has been a challenge for the health systems of each country. From the beginning, risk factors for the severity and mortality of the disease were considered, as the spread of the virus was related to the living conditions of each population. Methods In this ecological study we have evaluated the role of geography, precisely the altitude above sea level in the incidence and mortality of COVID-19 in Peru. Incidence and mortality data were taken from the open-access database of the government of Peru until March 2021. COVID-19 cases and COVID-19 mortality were treated as cases/density population and 1000 x cases/inhabitants while altitude was treated as continuous and as a categorical variable divided in 7 categories. The relationship between COVID-19 cases or deaths for COVID-19 and altitude as continuous variable was determined using Spearman correlation test. Meanwhile when altitude was considered as a categorical variable, Poisson regression or negative binomial analyses were applied. Results A significant inverse correlation was found between COVID-19 cases by population density and altitude (r=-0.37 p < 0.001). By altitude categories, the lowest risk for infection was observed between 3,000 and 3,500 m (IRR 0.08; 95% CI 0.05,0.12). Moreover, we found an inverse correlation between altitude and COVID-19 mortality (r=-0.39 p < 0.001). Also, the lowest risk for mortality was observed between 3,000 and 3,500 m (IRR 0.12; 95%CI 0.08; 0.18). Similar results were found when analyses were adjusted for inhabitants and stratified by sex. Conclusion This study reports an inverse relationship between COVID-19 incidence and mortality with respect to the altitude of residence, particularly, a u-shaped protection is shown, with a highest benefit between 3000 and 3500 m. The possibility of using hypoxia as an alternative treatment requires more complex studies that should allow knowing the physiological and environmental mechanisms of the protective role.

show abstract

“… 1 Before August 2022, there were relatively few cases of COVID-19 in the Tibetan Autonomous Region in China, which may be associated with high-altitude hypoxia, exposure to ultraviolet light (UV), and low atmospheric pressure. 2 However, an outbreak of the SARS-CoV-2 omicron sub-variant BA.2.76 throughout the Tibetan Autonomous Region after July 2022 contradicts the notion that Tibet has been exempt from COVID-19 for the past 3 years.…”

mentioning

confidence: 99%