No Relevant Analogy Between COVID-19 and Acute Mountain Sickness

Berger, Marc Moritz; Hackett, Peter H.; Bärtsch, Peter

doi:10.1089/ham.2020.0147

Cited by 4 publications

(3 citation statements)

References 47 publications

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“… 70 – 72 ) suggest application of erythropoietin not only because of its stimulation of erythropoiesis but also due to suggested additional effects (improved respiration, counteracting inflammation, neuroprotection, and neuroregeneration) similar as against high-altitude disease. High-altitude physiologists ( 73 ), however, heavily contradict to this “mistaken analogy” and mention that it is “associated with an increased risk of thrombotic cardiovascular events.” Similarly, clinicians warn against the application of erythropoietin because of this danger ( 74 ). Additionally, erythropoiesis-stimulating agents (ESAs) are considered as possibly dangerous, too ( 75 ), instead blood transfusion is recommended.…”

Section: Therapy Of Anemia and Oxygen Affinity Disturbancesmentioning

confidence: 99%

The oxygen dissociation curve of blood in COVID-19

Böning

Kuebler

Bloch

2021

American Journal of Physiology-Lung Cellular and Molecular Phys

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COVID-19 hinders oxygen transport to the consuming tissues by at least 2 mechanisms: In the injured lung saturation of hemoglobin is compromised, in the tissues an associated anemia reduces the volume of delivered oxygen. For the first problem increased hemoglobin oxygen affinity (left shift of the oxygen dissociation curve ODC) is of advantage, for the 2nd, however, the contrary is the case. Indeed a right shift of the ODC has been found in former studies for anemia caused by reduced cell production or hemolysis. This resulted from increased 2,3-biphosphglycerate (2,3-BPG) concentration. In 3 investigations in COVID-19, however, no change of hemoglobin affinity was detected in spite of probably high [2,3-BPG]. The most plausible cause for this finding is formation of methemoglobin, which increases the oxygen affinity and thus apparently compensates for the 2,3-BPG effect. But this "useful effect" is cancelled by the concomitant reduction of functional hemoglobin. In the largest study on COVID-19 even a clear left shift of the ODC was detected when calculated from measurements in fresh blood rather than after equilibration with gases outside the body. This additional „in vivo" left shift possibly results from various factors (e. g. concentration changes of Cl-, 2,3-BPG, ATP, lactate, nitrocompounds, glutathione, glutamate, because of time delay between blood sampling and end of equilibration, or enlarged distribution space including interstitial fluid and is useful for O2 uptake in the lungs. Under discussion for therapy are the affinity-increasing 5-hydroxymethyl-2-furfural (5-HMF), erythropoiesis stimulating substances like erythropoietin, and methylene blue against MetHb formation.

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Section: Therapy Of Anemia and Oxygen Affinity Disturbancesmentioning

confidence: 99%

The oxygen dissociation curve of blood in COVID-19

Böning

Kuebler

Bloch

2021

American Journal of Physiology-Lung Cellular and Molecular Phys

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“…Due to the similarity of hypoxia-induced symptoms in COVID-19 and high-altitude disorders such as acute mountain sickness and high-altitude pulmonary edema, some initial studies had also suggested using drugs like nifedipine, phosphodiesterase inhibitors, erythropoietin, and dexamethasone ( Soliz et al, 2020 ; Solaimanzadeh, 2019 ). However, experts rejected the claim and debunked the analogy of high-altitude illnesses with the COVID-19 ( Luks et al, 2020 ; Strapazzon et al, 2020 ; Archer, Sharp & Weir, 2020 ; Berger, Hackett & Bärtsch, 2020 ). Thus the best option remained the vaccines that eventually overtook the market, and a good number of the world population, including the high-altitude, have been vaccinated.…”

Section: Discussionmentioning

confidence: 99%

Disparities in COVID-19 incidence and fatality rates at high-altitude

Abbasi

Chanana

Palmo

et al. 2023

PeerJ

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Background SARS-CoV-2 has affected every demography disproportionately, including even the native highland populations. Hypobaric-hypoxic settings at high-altitude (HA, >2,500 masl) present an extreme environment that impacts the survival of permanent residents, possibly including SARS-CoV-2. Conflicting hypotheses have been presented for COVID-19 incidence and fatality at HA. Objectives To evaluate protection or risk against COVID-19 incidence and fatality in humans under hypobaric-hypoxic environment of high-altitude (>2,501 masl). Methods Global COVID-19 data of March 2020-21, employed from official websites of the Indian Government, John Hopkins University, and Worldometer were clustered into 6 altitude categories. Clinical cofactors and comorbidities data were evaluated with COVID-19 incidence and fatality. Extensive comparisons and correlations using several statistical tools estimated the risk and protection. Results Of relevance, data analyses revealed four distinct responses, namely, partial risk, total risk, partial protection, and total protection from COVID-19 at high-altitude indicating a mixed baggage and complexity of the infection. Surprisingly, it included the countries within the same geographic region. Moreover, body mass index, hypertension, and diabetes correlated significantly with COVID-19 incidence and fatality rate (P ≤ 0.05). Conclusions Varied patterns of protection and risk against COVID-19 incidence and fatality were observed among the high-altitude populations. It is though premature to generalize COVID-19 effects on any particular demography without further extensive studies.

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“…Along the same line, during the initial stages of the pandemic, it was erroneously proposed that acute mountain sickness (AMS), a condition that brings together a wide range of symptoms including headache, loss of appetite, nausea, vomiting, fatigue, sleep disturbances and COVID-19 infection may share some pathophysiological mechanisms that are involved in the development of these conditions [ 46 ]. In this context, much of the symptoms of acute mountain sickness are attributed to the acute exposure to high-altitude that is often quick and sustained among not adapted or no acclimatized subjects [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

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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No Relevant Analogy Between COVID-19 and Acute Mountain Sickness

Cited by 4 publications

References 47 publications

The oxygen dissociation curve of blood in COVID-19

The oxygen dissociation curve of blood in COVID-19

Disparities in COVID-19 incidence and fatality rates at high-altitude

Long COVID at Different Altitudes: A Countrywide Epidemiological Analysis

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