ArticlePloS one2021
Decreased incidence, virus transmission capacity, and severity of COVID-19 at altitude on the American continent.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Altitude and case fatality rate from COVID-19 during the pandemic in Peru, 2020-2022.Revista peruana de medicina experimental y salud publica · 2026Article
- Prognosis of Patients with Breast Cancer Following Delayed Diagnosis During the COVID-19 Pandemic: A Real-World Cohort Study.Annals of surgical oncology · 2025Article
- Death Risk Response of High-Altitude Resident Populations to COVID-19 Vaccine: A Retrospective Cohort Study.High altitude medicine & biology · 2025Article
- Assessing eco-geographic influences on COVID-19 transmission: a global analysis.Scientific reports · 2024Article
- Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs.Frontiers in physiology · 2024Article
- High altitudes, population density, and poverty: Unraveling the complexities of COVID-19 in Peru during the years 2020-2022.Preventive medicine reports · 2023Article
- Receiver operating characteristic (ROC) to determine cut-off points of clinical and biomolecular markers to discriminate mortality in severe COVID-19 living at high altitude.BMC pulmonary medicine · 2023Article
- A U-shaped protection of altitude against mortality and infection of COVID-19 in Peru: an ecological study.BMC public health · 2023Article
- Factors Associated with COVID-19 Death in a High-Altitude Peruvian Setting during the First 14 Months of the Pandemic: A Retrospective Multicenter Cohort Study in Hospitalized Patients.Tropical medicine and infectious disease · 2023Article
- Efficacy of Nirmatrelvir-Ritonavir versus Azvudine for COVID-19 Treatment in Tibet: A Retrospective Study.Infection and drug resistance · 2023Article
- Review
- Mathematical modeling to study the impact of immigration on the dynamics of the COVID-19 pandemic: A case study for Venezuela.Spatial and spatio-temporal epidemiology · 2022Article
- A comparative analysis of SARS-CoV-2 viral load across different altitudes.Scientific reports · 2022Article
- Assisting individuals with diabetes in the COVID-19 pandemic period: Examining the role of religious factors and faith communities.World journal of clinical cases · 2022Review
- Effect of High Altitude on the Survival of COVID-19 Patients in Intensive Care Unit: A Cohort Study.Journal of intensive care medicine · 2022Article
- High altitude Relieves transmission risks of COVID-19 through meteorological and environmental factors: Evidence from China.Environmental research · 2022Article
- Assessing the impact of long-term exposure to nine outdoor air pollutants on COVID-19 spatial spread and related mortality in 107 Italian provinces.Scientific reports · 2022Article
- SARS-CoV-2 Viral Load Analysis at Low and High Altitude: A Case Study from Ecuador.International journal of environmental research and public health · 2022Article
- Living at High Altitude and COVID-19 Mortality in Peru.High altitude medicine & biology · 2022Article
- Association of latitude and altitude with adverse outcomes in patients with COVID-19: The VIRUS registry.World journal of critical care medicine · 2022Article
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Authors and funding
11 authors.
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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.
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