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

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

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 lo...

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Bibliographic Details
Published in:PloS one Vol. 17; no. 3; p. e0262423
Main Authors: 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
Format: Journal Article
Language:English
Published: United States Public Library of Science 31-03-2022
Public Library of Science (PLoS)
Subjects:
Adult
Altitude
Altitudes
Biology and life sciences
Chronic infection
Coronaviruses
COVID-19
Critical Illness
Diabetes mellitus
Female
Health aspects
Health risks
High altitude
High-altitude environments
Humans
Hypertension
Hypoxia
Intensive Care Units
Low altitude
Male
Medical research
Medicine and Health Sciences
Middle Aged
Mortality
Patients
Physical Sciences
Prospective Studies
Renal failure
SARS-CoV-2
Sea level
Severe acute respiratory syndrome coronavirus 2
Survival
Viral diseases
Ecuador
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Summary: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. 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. 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. 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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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0262423