Observational studyRespiratory physiology & neurobiology2021
Low serum erythropoietin levels are associated with fatal COVID-19 cases at 4,150 meters above sea level.
Observational study in Respiratory physiology & neurobiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 27 citations in OpenAlex.
- Chronic hypoxia adaptation at high altitude: a perspective on Its potential role in mortality in viral pneumonia-associated ARDS and implications for personalized critical care.Critical care (London, England) · 2026Review
- Mechanisms Underlying Altitude-Induced and Group 3 Pulmonary Hypertension.International journal of molecular sciences · 2026Review
- MicroRNA-155 modulation by renin-angiotensin system inhibitors may underlie their enigmatic role in COVID-19.World journal of experimental medicine · 2025Article
- Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients.Geriatrics (Basel, Switzerland) · 2025Article
- Redefining chronic mountain sickness: insights from high-altitude research and clinical experience.Medical review (2021) · 2025Review
- Precision nutrition to reset virus-induced human metabolic reprogramming and dysregulation (HMRD) in long-COVID.NPJ science of food · 2024Review
- Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs.Frontiers in physiology · 2024Article
- Targeting 2-Oxoglutarate-Dependent Dioxygenases Promotes Metabolic Reprogramming That Protects against Lethal SARS-CoV-2 Infection in the K18-hACE2 Transgenic Mouse Model.ImmunoHorizons · 2023Article
- Biomarkers as predictors of mortality in critically ill obese patients with COVID-19 at high altitude.BMC pulmonary medicine · 2023Article
- An epidemiological evaluation of COVID-19 in La paz, Bolivia.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2023Article
- Ameliorating effect of erythropoietin in a severe case of COVID-19: case report.The Pan African medical journal · 2022Article
- Age and genotype dependent erythropoietin protection in COVID-19.World journal of stem cells · 2021Review
- Addressing the 'hypoxia paradox' in severe COVID-19: literature review and report of four cases treated with erythropoietin analogues.Molecular medicine (Cambridge, Mass.) · 2021Review
- The Impact of Recombinant Human Erythropoietin Administration in Critically ill COVID-19 Patients: A Multicenter Cohort Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Previous studies suggested that erythropoietin (EPO) may protect against severe COVID-19-induced injuries, ultimately preventing mortality. This hypothesis is based on the fact that, in addition to promoting the increase in red blood cells, EPO is an anti-inflammatory, anti-apoptotic and protective factor in several non-erythropoietic tissues. Furthermore, EPO promotes nitric oxide production in the hypoxic lung and stimulates ventilation by interacting with the respiratory centers of the brainstem. Given that EPO in the blood is increased at high-altitude, we evaluated the serum levels of EPO in critical patients with COVID-19 at "Hospital Agramont" in the city of El Alto (4150 masl) in Bolivia. A total of 16 patients, 15 men, one woman, with a mean age of 55.8 ± 8.49 years, admitted to the Intensive Care Unit were studied. All patients were permanent residents of El Alto, with no travel history below 3000 masl for at least one year. Blood samples were collected upon admission to the ICU. Serum EPO concentration was assessed using an ELISA kit, and a standard technique determined hemoglobin concentration. Only half of the observed patients survived the disease. Remarkably, fatal cases showed 2.5 times lower serum EPO than survivors (2.78 ± 0.8643 mU/mL vs 7.06 ± 2.713 mU/mL; p = 0.0096), and 1.24 times lower hemoglobin levels (13.96 ± 2.56 g/dL vs 17.41 ± 1.61 g/dL; p = 0.0159). While the number of cases evaluated in this work is low, our findings strongly warrant further investigation of EPO levels in COVID-19 patients at high and low altitudes. Our results also support the hypothesis that exogenous EPO administration could help critically ill COVID-19 patients overcome the disease.
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