Does the pathogenesis of SARS-CoV-2 virus decrease at high-altitude?

https://doi.org/10.1016/j.resp.2020.103443Get rights and content

Highlights

  • COVID-19 infection is decreased in populations living at an altitude of above 3000 masl.

  • Highland inhabitants may be less susceptible to SARS-CoV-2 virus infection due to physiological acclimatization to hypoxia.

  • High-altitude environmental factors may contribute to reduce the virulence of SARS-CoV-2.

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.

Keywords

COVID-19
Hypoxia
Lung remodeling
UV

Cited by (0)

1

Both senior authors contributed equally.

2

www.Altitudeclinic.com.

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