Effect of Altitude on Covid-19 Mortality in Ecuador: an Ecological Study

Abstract

BackgroundThe SARS-CoV-2/COVID-19 pandemic has claimed nearly 900,000 lives worldwide and infected more than 27 million people. Researchers worldwide are studying ways to decrease SARS-CoV-2 transmission and COVID-19 related deaths. Several studies found altitude having a negative association with both COVID-19 incidence and deaths. Ecuadorian data was used to explore the relationship between altitude and COVID-19. MethodsThis is an ecological study examining province-level data. To explore a relationship between altitude and COVID-19, this study utilized publicly available COVID-19 data and population statistics. ANOVA, correlation statistics, and a multivariate linear model explored the relationship between different Ecuadorian altitudes against incidence, mortality, and case-fatality rates. Populations statistics attributed to COVID-19 were included in the linear model to control for confounding factors. ResultsRegional differences were observed for incidence, mortality, and case fatality rate suggesting an association between altitude and SARS-CoV-2 transmission and COVID-19 disease severity. In both the correlation analysis and linear model altitude showed a statistically significant negative correlation between altitude and COVID-19 mortality. ConclusionAltitude may have an effect on COVID-19 mortality rates. More research is needed to understand why altitude may have a protective effect against COVID-19 mortality and how this may be applicable in a clinical setting.