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1.
PLoS One ; 16(3): e0237294, 2021.
Article in English | MEDLINE | ID: covidwho-1156076

ABSTRACT

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.


Subject(s)
Altitude , COVID-19/pathology , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Central America/epidemiology , Humans , Incidence , North America/epidemiology , SARS-CoV-2/isolation & purification , Severity of Illness Index , South America/epidemiology
2.
Respir Physiol Neurobiol ; 279: 103476, 2020 08.
Article in English | MEDLINE | ID: covidwho-548157

ABSTRACT

A very recent epidemiological study provides preliminary evidence that living in habitats located at 2500 m above sea level (masl) might protect from the development of severe respiratory symptoms following infection with the novel SARS-CoV-2 virus. This epidemiological finding raises the question of whether physiological mechanisms underlying the acclimatization to high altitude identifies therapeutic targets for the effective treatment of severe acute respiratory syndrome pivotal to the reduction of global mortality during the COVID-19 pandemic. This article compares the symptoms of acute mountain sickness (AMS) with those of SARS-CoV-2 infection and explores overlapping patho-physiological mechanisms of the respiratory system including impaired oxygen transport, pulmonary gas exchange and brainstem circuits controlling respiration. In this context, we also discuss the potential impact of SARS-CoV-2 infection on oxygen sensing in the carotid body. Finally, since erythropoietin (EPO) is an effective prophylactic treatment for AMS, this article reviews the potential benefits of implementing FDA-approved erythropoietin-based (EPO) drug therapies to counteract a variety of acute respiratory and non-respiratory (e.g. excessive inflammation of vascular beds) symptoms of SARS-CoV-2 infection.


Subject(s)
Acclimatization/physiology , Altitude Sickness/physiopathology , Coronavirus Infections/drug therapy , Coronavirus Infections/physiopathology , Erythropoietin/pharmacology , Hypoxia/physiopathology , Pneumonia, Viral/drug therapy , Pneumonia, Viral/physiopathology , COVID-19 , Coronavirus Infections/immunology , Coronavirus Infections/metabolism , Humans , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/metabolism
3.
Respir Physiol Neurobiol ; 277: 103443, 2020 06.
Article in English | MEDLINE | ID: covidwho-164993

ABSTRACT

In the present study we analyze the epidemiological data of COVID-19 of Tibet and high-altitude regions of Bolivia and Ecuador, and compare to lowland data, to test the hypothesis that high-altitude inhabitants (+2,500 m above sea-level) are less susceptible to develop severe adverse effects in acute SARS-CoV-2 virus infection. Analysis of available epidemiological data suggest that physiological acclimatization/adaptation that counterbalance the hypoxic environment in high-altitude may protect from severe impact of acute SARS-CoV-2 virus infection. Potential underlying mechanisms such as: (i) a compromised half-live of the virus caused by the high-altitude environment, and (ii) a hypoxia mediated down regulation of angiotensin-converting enzyme 2 (ACE2), which is the main binding target of SARS-CoV-2 virus in the pulmonary epithelium are discussed.


Subject(s)
Betacoronavirus/physiology , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Altitude , Betacoronavirus/pathogenicity , Bolivia/epidemiology , COVID-19 , Disease Susceptibility , Ecuador/epidemiology , Humans , Oxygen , Pandemics , SARS-CoV-2 , Tibet/epidemiology , Virulence
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