High-altitude is associated with better short-term survival in critically ill COVID-19 patients admitted to the ICU

Simbaña-Rivera, Katherine; Jaramillo, Pablo R Morocho; Silva, Javier V Velastegui; Gómez-Barreno, Lenin; Campoverde, Ana; Cevallos, Juan F Novillo; Guanoquiza, Washington E. Almache; Guevara, Silvio L Cedeño; Castro, Luis Gonzalez; Puerta, Nelson A Moran; Valladares, Alex W Guayta; Lister, Alex; Ortíz-Prado, Esteban

doi:10.1371/journal.pone.0262423

Cited by 22 publications

(26 citation statements)

References 72 publications

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“…The study was carried out in Ecuador, one of the smallest Latin American countries, located in the equatorial line and bordering the Pacific Ocean. Ecuador shares borders with Peru and Colombia, and its current population is estimated to be 17,577,116 inhabitants [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

“…Likewise, within the study of the physiopathology of Long-COVID, the role of hypobaric hypoxia to which high-altitude residents are exposed has not been addressed [ 22 , 23 ]. In this regard, it has been speculated that living at high altitudes is associated with lower mortality due to COVID-19 [ 24 ]. We believe that the phenotypic and adaptive differences that populations with a high degree of mestizos possess may cause differences in the characteristics that Long-COVID has been shown to have in previous studies.…”

Section: Introductionmentioning

confidence: 99%

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Long COVID at Different Altitudes: A Countrywide Epidemiological Analysis

Izquierdo-Condoy

Fernandez-Naranjo

Vásconez

et al. 2022

IJERPH

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Background: Several reports from around the world have reported that some patients who have recovered from COVID-19 have experienced a range of persistent or new clinical symptoms after a SARS-CoV-2 infection. These symptoms can last from weeks to months, impacting everyday functioning to a significant number of patients. Methods: A cross-sectional analysis based on an online, self-reporting questionnaire was conducted in Ecuador from April to July 2022. Participants were invited by social media, radio, and TV to voluntarily participate in our study. A total of 2103 surveys were included in this study. We compared socio-demographic variables and long-term persisting symptoms at low (<2500 m) and high altitude (>2500 m). Results: Overall, 1100 (52.3%) responders claimed to have Long-COVID symptoms after SARS-CoV-2 infection. Most of these were reported by women (64.0%); the most affected group was young adults between 21 to 40 years (68.5%), and most long-haulers were mestizos (91.6%). We found that high altitude residents were more likely to report persisting symptoms (71.7%) versus those living at lower altitudes (29.3%). The most common symptoms were fatigue or tiredness (8.4%), hair loss (5.1%) and difficulty concentrating (5.0%). The highest proportion of symptoms was observed in the group that received less than 2 doses. Conclusions: This is the first study describing post-COVID symptoms’ persistence in low and high-altitude residents. Our findings demonstrate that women, especially those aging between 21–40, are more likely to describe Long-COVID. We also found that living at a high altitude was associated with higher reports of mood changes, tachycardia, decreased libido, insomnia, and palpitations compared to lowlanders. Finally, we found a greater risk to report Long-COVID symptoms among women, those with previous comorbidities and those who had a severer acute SARS-CoV-2 infection.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long COVID at Different Altitudes: A Countrywide Epidemiological Analysis

Izquierdo-Condoy

Fernandez-Naranjo

Vásconez

et al. 2022

IJERPH

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“…All the available studies showed that the more severe the infection was, the greatest the lung capacity alteration [19]. Although earlier mechanical ventilation has been associated with better survival among severely ill COVID-19 patients, it also behaves as a predictor of radiological and spirometric abnormalities [21,23,24].…”

Section: Pulmonary Sequelaementioning

confidence: 99%

A Systematic Review and Quality Evaluation of Studies on Long-Term Sequelae of COVID-19

Vásconez¹,

Izquierdo-Condoy²,

Fernández-Naranjo³

et al. 2022

Preprint

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Background: COVID-19 made its debut as a pandemic in 2020; since then, more than 607 million cases and at least 6.5 million deaths have been reported worldwide. While the burden of disease has been described, the long-term effects or chronic sequelae are still being described. Objective: To describe the findings of a current systematic review of the long-term effects related to post-COVID-19 sequelae. Design: A systematic review was carried out in which cohort studies, case series, clinical case reports were included, and the PubMed, Scielo, SCOPUS and Web of Science databases were extracted. Information published 2020 to June 1, 2022, was sought. Results: We reviewed 300 manuscripts during the first step of the literature review process. Then 260 abstracts were analyzed. In the end, we included 32 manuscripts: 9 for pulmonary, 6 for cardiac, 2 for renal, 9 for neurological and psychiatric, and 8 for cutaneous sequelae. Conclusion: Studies show that the most common sequelae are those linked to the lungs, followed by skin, cutaneous and psychiatric alterations. Women report a higher incidence of the sequelae, as well as those with comorbidities and severer COVID-19 history. The COVID-19 pandemic has not only caused death and disease since its apparition but has also sickened millions of people around the globe who potentially suffer from serious illnesses that will continue to add to the list of health problems and further burden healthcare systems around the world.

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“…population density, overcrowding activities or migration) and lastly, (3) the direct or indirect consequences of the environment on virulence or viral transmission (i.e. ozone, UV exposure or cold) 8 , 9 , 12 , 13 , 17 , 20 .…”

Section: Introductionmentioning

confidence: 99%

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

Ortíz-Prado

Fernández-Naranjo

Vásconez

et al. 2022

Sci Rep

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SARS-CoV-2 has spread throughout the world, including areas located at high or very high altitudes. There is a debate about the role of high altitude hypoxia on viral transmission, incidence, and COVID-19 related mortality. This is the first comparison of SARS-CoV-2 viral load across elevations ranging from 0 to 4300 m. To describe the SARS-CoV-2 viral load across samples coming from 62 cities located at low, moderate, high, and very high altitudes in Ecuador. An observational analysis of viral loads among nasopharyngeal swap samples coming from a cohort of 4929 patients with a RT-qPCR test positive for SARS-CoV-2. The relationship between high and low altitude only considering our sample of 4929 persons is equal in both cases and not significative (p-value 0.19). In the case of low altitude, adding the sex variable to the analysis, it was possible to find a significative difference between men and women (p-value < 0.05). Considering initially sex and then altitude, it was possible to find a significative difference between high and low altitude for men (p-value 0.05). There is not enough evidence to state that viral load is affected directly by altitude range but adding a new variable as sex in the analysis shows that the presence of new variables influences the relationship of altitude range and viral load. There is no evidence that viral loads (Ct and copies/ml) differ at low or high altitude. Using sex as a co-factor, we found that men have higher viral loads than women at low and moderate altitude locations, while living at high altitude, no differences were found. When Ct values were aggregated by low, moderate, and high viral load, we found no significant differences when sex was excluded from the analysis. We conclude that viral load is not directly affected by altitude, but COVID-19 incidence and mortality are rather affected by socio-demographic and idiosyncratic dynamics.

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High-altitude is associated with better short-term survival in critically ill COVID-19 patients admitted to the ICU

Cited by 22 publications

References 72 publications

Long COVID at Different Altitudes: A Countrywide Epidemiological Analysis

Long COVID at Different Altitudes: A Countrywide Epidemiological Analysis

A Systematic Review and Quality Evaluation of Studies on Long-Term Sequelae of COVID-19

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

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