Factors involved in low susceptibility to COVID-19: An adaptation of high altitude inhabitants

Choquenaira-Quispe, Celia; Saldaña-Bobadilla, Vanessa; Ramirez, J-Kenedy

doi:10.1016/j.mehy.2020.110068

Cited by 17 publications

(17 citation statements)

References 8 publications

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“…In this way, it is possible that the expression of ACE2 can be down-regulated due to the high altitude and favour a lower incidence of COVID-19 infection. Other studies speculate in this direction and suggest different paths for an ACE2 down-regulation 3 , 29 , but future studies need to clarify this hypothesis.…”

Section: Discussionmentioning

confidence: 93%

Altitude conditions seem to determine the evolution of COVID-19 in Brazil

Fernandes

Silva

et al. 2021

Sci Rep

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COVID-19 is spreading rapidly in Brazil, a country of continental dimensions, but the incidence of the disease is showing to be very heterogeneous, affecting cities and regions differently. Thus, there is a gap regarding what factors would contribute to accentuate the differences in the incidence of COVID-19 among Brazilian cities. This work aimed to evaluate the effect of altitude on the incidence of COVID-19 in Brazilian cities. We analyzed the relative incidence (RI), the relative death rate (RDR) of COVID-19, and air relative humidity (RH) in all 154 cities in Brazil with a population above 200 thousand inhabitants, located between 5 and 1135 m in altitude. Pearson's correlation analysis was performed to compare a relationship between altitude with RI and RDR, and between RH with RI and RDR. Altitudes were classified into three classes [low (altitude ≤ 97 m a. s. l), middle (97 < altitude ≤ 795 m a. s. l), high (795 < altitude ≤ 1135 m a. s. l)] for the RI, RDR, and RH variables. To compare the three classes of altitude, analysis of variance (ANOVA) and Tukey test were used to compare averages (p < 0.05). Our epidemiological analysis found that the RI, RDR, and RH were lower in cities located in high altitudes (795 < altitude ≤ 1135 m a. s. l) when compared to the middle (97 < altitude ≤ 795 m a. s. l) and low (altitude ≤ 97 m a. s. l) cities altitudes. Furthermore, our study shows that there is a negative correlation between the incidence of COVID-19 with altitude and a positive correlation with RH in the cities analyzed. Brazilian cities with high altitude and low RH have lower RI and RDR from COVID-19. Thus, high altitude cities may be favorable to shelter people at risk. This study may be useful for understanding the behavior of SARS-CoV2, and start point for future studies to establish causality of environmental conditions with SARS-CoV2 contributing to the implementation of measures to prevent and control the spread of COVID-19.

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Section: Discussionmentioning

confidence: 93%

Altitude conditions seem to determine the evolution of COVID-19 in Brazil

Fernandes

Silva

et al. 2021

Sci Rep

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“… 3 Angiotensin-converting enzyme 2 receptors are widely expressed in the pulmonary alveolar epithelium, making these organs the main targets for SARS-CoV-2 infection and facilitating the development of complications such as pneumonia, acute respiratory distress syndrome, and death. 4 Therefore, these receptors play a vital role in the progression and prognosis of the disease.…”

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confidence: 99%

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

Cano-Pérez

Torres-Pacheco

Fragozo-Ramos

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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It has been suggested that high altitude can reduce the infectivity and case fatality rate of COVID-19. We investigated the relationship between altitude and the COVID-19 pandemic in Colombia. Epidemiological data included the number of positive cases, deaths, and the case fatality rate of COVID-19. In particular, we analyzed data from 70 cities with altitudes between 1 and 3,180 m. Correlations and linear regression models adjusted to population density were performed to examine the relationship and contribution of altitude to epidemiological variables. The case fatality rate was negatively correlated with the altitude of the cities. The incidence of cases and deaths from COVID-19 had an apparent correlation with altitude; however, these variables were better explained by population density. In general, these findings suggest that living at high altitude can reduce the impact of COVID-19, especially the case fatality rate.

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“…Although prior studies have suggested that altitude may be a protective factor from COVID-19 (ref. 27,30-32,36-40), our analysis is the first to employ a large longitudinal database encompassing all COVID-19 cases and deaths registered in Peru through July 17, 2020 (https://www.datosabiertos.gob.pe/group/datos-abiertos-de-covid-19). In order to correct for population density, which tends to be significantly higher on the coastal lowlands, we have normalized case and death counts by population density and per million people in all districts.…”

Section: Discussionmentioning

confidence: 99%

Altitude as a protective factor from COVID-19

Thomson

Casas

Guerrero

et al. 2020

Preprint

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The COVID-19 pandemic had a delayed onset in South America compared to Asia (outside of China), Europe or North America. In spite of the presumed time advantage for the implementation of preventive measures to help contain its spread, the pandemic in that region followed growth rates that paralleled, and currently exceed, those observed several weeks before in Europe. Indeed, in early August, 2020, many countries in South and Central America presented among the highest rates in the world of COVID-19 confirmed cases and deaths per million inhabitants. Here, we have taken an ecological approach to describe the current state of the pandemic in Peru and its dynamics. Our analysis supports a protective effect of altitude from COVID-19 incidence and mortality. Further, we provide circumstantial evidence that internal migration through a specific land route is a significant factor progressively overriding the protection from COVID-19 afforded by high altitude. Finally, we show that protection by altitude is independent of poverty indexes and is inversely correlated with the prevalence in the population of risk factors associated with severe COVID-19, including hypertension and hypercholesterolemia. We discuss long-term multisystemic adaptations to hypobaric hypoxia as possible mechanisms that may explain the observed protective effect of high altitude from death from COVID-19.

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Factors involved in low susceptibility to COVID-19: An adaptation of high altitude inhabitants

Cited by 17 publications

References 8 publications

Altitude conditions seem to determine the evolution of COVID-19 in Brazil

Altitude conditions seem to determine the evolution of COVID-19 in Brazil

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

Altitude as a protective factor from COVID-19

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