COVID-19: Multiple Diseases Simulating Extreme High-Altitude Exposure? Oxygen Transport Physiology and Scarce Need of Ventilators; Andean Condor’s-Eye-View

Abstract

The critical hypoxia in COVID-19 patients during this pandemic, has taken away many lives all around the globe. The mechanism has been poorly understood and initially, word got around that it was a SARS (Severe Acute Respiratory Syndrome) pneumonia. The atypical images in lung computerized axial tomography (CAT) scans were alarming. This immediately alerted everyone including poor countries to purchase lacking sophisticated ventilator equipment. However, in some countries, even 88% of the patients on ventilators lost their lives. New observations and pathological findings are gradually clarifying the disease. What seems evident is that it is not only one disease but several, with different responses in different countries and different altitudes. The critical hypoxia and «gasping» present in some patients are not totally understood. It was mentioned that it could be like a High-Altitude Pulmonary Edema (HAPE). Hereby, as high-altitude medicine and hypoxia physiology specialists, we compare the pathophysiology with that of high-altitude exposure in order to understand the mechanisms involved. Some differences in lung radiological images along with transmission and viral attack mechanisms are discussed. The oxygen transport triad used at high-altitude can be applied on this pathology in order to propose even the use of erythropoietin (EPO) early in the treatment. The immune system is the most important long-term survival tool, so we suggest a short-term strategy: the use of special Earth open-circuit astronaut-resembling suits with effective outside air filtering re-breathing mechanisms in order to return to work and daily activities, without contamination risk. Thereby, the curve can be flattened without quarantine and the economy could recover.

Profil clinique, biologique et radiologique des patients Algériens hospitalisés pour COVID-19: données préliminaires

“…Il est possible que la pathogenèse du virus et l’hyperaldostéronisme secondaire consécutive causée par une augmentation des niveaux des récepteurs d´angiotensine-II soient responsables du résultat [ 59 ]. La polyglobulie n´a pas été rapportée dans la littérature, mais une étude en cours avance l´hypothèse que les lésions du COVID-19 peuvent entraîner une polycythémie secondaire qui serait interprétée comme une pathologie chronique des montagnes [ 60 ]. Autrement dit, le COVID-19 est une pathologie qui simule une exposition extrême à haute altitude [ 60 ].…”

“…La polyglobulie n´a pas été rapportée dans la littérature, mais une étude en cours avance l´hypothèse que les lésions du COVID-19 peuvent entraîner une polycythémie secondaire qui serait interprétée comme une pathologie chronique des montagnes [ 60 ]. Autrement dit, le COVID-19 est une pathologie qui simule une exposition extrême à haute altitude [ 60 ]. D´autres anomalies biologiques, non évaluées dans cette étude, étaient rapportées dans la littérature [ 6 ].…”