Negative Correlation between Altitude and COVID-19 Pandemic in Colombia: A Preliminary Report

Cano-Pérez, Eder; Torres-Pacheco, Jaison; Fragozo-Ramos, María C.; García-Díaz, Génesis; Montalvo, Eduardo A.; Pozo-Palacios, Juan  Carlos

doi:10.4269/ajtmh.20-1027

Cited by 47 publications

(45 citation statements)

References 14 publications

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“…Therefore, these data may have a low weight in the statistical evaluation. In agreement with our results, a negative correlation between altitude and the incidence of COVID-19 has been found in Colombia by August 1 st , 2020 [39], also the excess mortality, indicator of mortality due to COVID-19, reduces while altitude increases in Peru [40].…”

Section: Plos Onesupporting

confidence: 92%

Decreased incidence, virus transmission capacity, and severity of COVID-19 at altitude on the American continent

et al. 2021

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The coronavirus disease 2019 (COVID-19) outbreak in North, Central, and South America has become the epicenter of the current pandemic. We have suggested previously that the infection rate of this virus might be lower in people living at high altitude (over 2,500 m) compared to that in the lowlands. Based on data from official sources, we performed a new epidemiological analysis of the development of the pandemic in 23 countries on the American continent as of May 23, 2020. Our results confirm our previous finding, further showing that the incidence of COVID-19 on the American continent decreases significantly starting at 1,000 m above sea level (masl). Moreover, epidemiological modeling indicates that the virus transmission rate is lower in the highlands (>1,000 masl) than in the lowlands (<1,000 masl). Finally, evaluating the differences in the recovery percentage of patients, the death-to-case ratio, and the theoretical fraction of undiagnosed cases, we found that the severity of COVID-19 is also decreased above 1,000 m. We conclude that the impact of the COVID-19 decreases significantly with altitude.

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Section: Plos Onesupporting

confidence: 92%

Decreased incidence, virus transmission capacity, and severity of COVID-19 at altitude on the American continent

et al. 2021

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“…Several works ( Cano-Pérez et al, 2020 ; Quevedo-Ramirez et al, 2020 ), including ours ( Arias-Reyes et al, 2021 ; Arias-Reyes et al, 2020 ; Zubieta-Calleja et al, 2020 ) clearly suggested that the virulence of SARS-CoV-2 decreases significantly with altitude. In a first report, we showed that at global and region specific scale (Tibetan Autonomous Region of China, Bolivia and Ecuador) COVID-19 cases were notably decreased at high altitudes (above 2,500 masl) ( Arias-Reyes et al, 2020 ).…”

Section: Discussionmentioning

confidence: 57%

Low serum erythropoietin levels are associated with fatal COVID-19 cases at 4,150 meters above sea level

Viruez-Soto

López-Dávalos

Rada-Barrera

et al. 2021

Respiratory Physiology & Neurobiology

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Previous studies suggested that erythropoietin (EPO) may protect against severe COVID-19-induced injuries, ultimately preventing mortality. This hypothesis is based on the fact that, in addition to promoting the increase in red blood cells, EPO is an anti-inflammatory, anti-apoptotic and protective factor in several non-erythropoietic tissues. Furthermore, EPO promotes nitric oxide production in the hypoxic lung and stimulates ventilation by interacting with the respiratory centers of the brainstem. Given that EPO in the blood is increased at high-altitude, we evaluated the serum levels of EPO in critical patients with COVID-19 at “Hospital Agramont” in the city of El Alto (4,150 masl) in Bolivia. A total of 16 patients, 15 men, one woman, with a mean age of 55.8 ± 8.49 years, admitted to the Intensive Care Unit were studied. All patients were permanent residents of El Alto, with no travel history below 3,000 masl for at least one year. Blood samples were collected upon admission to the ICU. Serum EPO concentration was assessed using an ELISA kit, and a standard technique determined hemoglobin concentration. Only half of the observed patients survived the disease. Remarkably, fatal cases showed 2.5 times lower serum EPO than survivors (2.78 ± 0.8643 mU/ml vs 7.06 ± 2.713 mU/ml; p = 0.0096), and 1.24 times lower hemoglobin levels (13.96 ± 2.56 g/dL vs 17.41 ± 1.61 g/dL; p = 0.0159). While the number of cases evaluated in this work is low, our findings strongly warrant further investigation of EPO levels in COVID-19 patients at high and low altitudes. Our results also support the hypothesis that exogenous EPO administration could help critically ill COVID-19 patients overcome the disease.

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“…Observational studies have been suggested that high-altitude is associated with infectivity and case fatality rate of COVID-19, due to factors such as adaptation to chronic hypobaric hypoxia, angiotensin-converting enzyme 2 expression, ultraviolet radiation and vitamin D production (22). However, results are con icting and may be explained by differences in population density, underreporting of cases and barriers of access to healthcare among populations (23)(24)(25). Although altitude does not affect the mortality rate in general patients undergoing invasive mechanical ventilation, speci c features of subgroups of patients with acute respiratory distress syndrome in COVID-19 may in uence the need of ventilatory support at high-altitude (26).…”

Section: Resultsmentioning

confidence: 99%

Characteristics and Clinical Course of Adult in-Patients With SARS-CoV-2 Pneumonia in Bogotá, Colombia.

Galindo¹,

Peña²,

Izquierdo³

et al. 2021

Preprint

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Background: SARS-CoV-2 virus has spread worldwide causing a crisis in healthcare systems. We aimed to describe the clinical characteristics and to explore risk factors of death, critical care admission and use of invasive mechanical ventilation in hospitalized patients with SARS-CoV-2 pneumonia in Bogotá, Colombia.Methods: We conducted a cross-sectional study of adult patients with laboratory-confirmed SARS-CoV-2 pneumonia. Demographic, clinical, and treatment data were extracted from electronic records. Univariate and multivariable methods were performed to investigate the relationship between each variable and clinical outcomes at 28 days of follow-up.Results: Between March 20 and June 30, 2020, 377 adults (56.8% male) were included in the study, of whom 85 (22.6%) died. Non-survivors were older on average than survivors (mean age, 56.7 years [SD 15.8] vs. 70.1 years [SD 13.9]) and more likely male (28 [32.9%] vs. 57 [67.1%]). Most patients had at least one underlying disease (333 [88.3%]), including arterial hypertension (149 [39.5%]), overweight (145 [38.5%]), obesity (114 [30.2%]) and diabetes mellitus (82 [21.8%]). Frequency of critical care admission (158 [41.9%]) and invasive mechanical ventilation (123 [32.6%]) was high. Age over 65 years (OR 9.26, 95% CI 3.29-26.01; p=0.00), ICU admission (OR 12.37, 95% CI 6.08-25.18; p=0.00), and arterial pH higher than 7.47 (OR 0.25, 95% CI 0.08-0.74; p=0.01) were independently associated with in-hospital mortality.Conclusions: In this study of in-hospital patients with SARS-CoV-2 pneumonia frequency of death was similar to what has been reported. ICU admission and use of invasive mechanical ventilation was high. Risk factors as older age, ICU admission, and arterial pH were associated with mortality.

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Negative Correlation between Altitude and COVID-19 Pandemic in Colombia: A Preliminary Report

Cited by 47 publications

References 14 publications

Decreased incidence, virus transmission capacity, and severity of COVID-19 at altitude on the American continent

Decreased incidence, virus transmission capacity, and severity of COVID-19 at altitude on the American continent

Low serum erythropoietin levels are associated with fatal COVID-19 cases at 4,150 meters above sea level

Characteristics and Clinical Course of Adult in-Patients With SARS-CoV-2 Pneumonia in Bogotá, Colombia.

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