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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 B Ventimilla; Novillo Cevallos, Juan F; Guanoquiza, Washington E Almache; Guevara, Silvio L Cedeño; Castro, Luis G Imba; Puerta, Nelson A Moran; Guayta Valladares, Alex W; Lister, Alex; Ortiz-Prado, Esteban.
  • Simbaña-Rivera K; One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador.
  • Jaramillo PRM; Hospital Los Ceibos, Unidad de Terapia Intensiva, Guayaquil, Ecuador.
  • Silva JVV; Hospital Quito Sur, Unidad de Terapia Intensiva, Quito, Ecuador.
  • Gómez-Barreno L; One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador.
  • Campoverde ABV; Hospital Quito Sur, Unidad de Terapia Intensiva, Quito, Ecuador.
  • Novillo Cevallos JF; Hospital Los Ceibos, Unidad de Terapia Intensiva, Guayaquil, Ecuador.
  • Guanoquiza WEA; Hospital Quito Sur, Unidad de Terapia Intensiva, Quito, Ecuador.
  • Guevara SLC; Hospital Los Ceibos, Unidad de Terapia Intensiva, Guayaquil, Ecuador.
  • Castro LGI; Hospital Los Ceibos, Unidad de Terapia Intensiva, Guayaquil, Ecuador.
  • Puerta NAM; Hospital Quito Sur, Unidad de Terapia Intensiva, Quito, Ecuador.
  • Guayta Valladares AW; Hospital Los Ceibos, Unidad de Terapia Intensiva, Guayaquil, Ecuador.
  • Lister A; University Hospital Southampton NHS FT, Southampton, United Kingdom.
  • Ortiz-Prado E; One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador.
PLoS One ; 17(3): e0262423, 2022.
Article in English | MEDLINE | ID: covidwho-1910489
ABSTRACT

BACKGROUND:

Multiple studies have attempted to elucidate the relationship between chronic hypoxia and SARS-CoV-2 infection. It seems that high-altitude is associated with lower COVID-19 related mortality and incidence rates; nevertheless, all the data came from observational studies, being this the first one looking into prospectively collected clinical data from severely ill patients residing at two significantly different altitudes.

METHODS:

A prospective cohort, a two-center study among COVID-19 confirmed adult patients admitted to a low (sea level) and high-altitude (2,850 m) ICU unit in Ecuador was conducted. Two hundred and thirty confirmed patients were enrolled from March 15th to July 15th, 2020.

RESULTS:

From 230 patients, 149 were men (64.8%) and 81 women (35.2%). The median age of all the patients was 60 years, and at least 105 (45.7%) of patients had at least one underlying comorbidity, including hypertension (33.5%), diabetes (16.5%), and chronic kidney failure (5.7%). The APACHE II scale (Score that estimates ICU mortality) at 72 hours was especially higher in the low altitude group with a median of 18 points (IQR 9.5-24.0), compared to 9 points (IQR 5.0-22.0) obtained in the high-altitude group. There is evidence of a difference in survival in favor of the high-altitude group (p = 0.006), the median survival being 39 days, compared to 21 days in the low altitude group.

CONCLUSION:

There has been a substantial improvement in survival amongst people admitted to the high-altitude ICU. Residing at high-altitudes was associated with improved survival, especially among patients with no comorbidities. COVID-19 patients admitted to the high-altitude ICU unit have improved severity-of-disease classification system scores at 72 hours.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0262423

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0262423