Revisiting the COVID-19 fatality rate and altitude association through a comprehensive analysis

The emergence of COVID-19 virus has led to a pandemic with staggering morbidity and mortality. There is evidence showing that pre-existing conditions and environmental factors are associated with worse COVID-19 outcomes. Among these conditions, altitude is of particular interest. Altitude has been s...

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Bibliographic Details
Published in:Scientific reports 2022-10, Vol.12 (1), p.18048-18048, Article 18048
Main Authors: Bridgman, Carson, Gerken, Jacob, Vincent, Joshua, Brooks, Amanda E., Zapata, Isain
Format: Article
Language:English
Subjects:
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Altitude
Cardiovascular diseases
Chronic obstructive pulmonary disease
Comorbidity
Coronaviruses
COVID-19
Demography
Environmental factors
Fatalities
High-altitude environments
Humanities and Social Sciences
Humans
Lung cancer
Lung diseases
Morbidity
Mortality
Mountain regions
multidisciplinary
Obstructive lung disease
Pandemics
Population density
Pre-existing conditions
SARS-CoV-2
Science
Science (multidisciplinary)
United States - epidemiology
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Summary:The emergence of COVID-19 virus has led to a pandemic with staggering morbidity and mortality. There is evidence showing that pre-existing conditions and environmental factors are associated with worse COVID-19 outcomes. Among these conditions, altitude is of particular interest. Altitude has been shown to influence the morbidity and mortality of multiple chronic pathologies such as cardiovascular disease, chronic obstructive pulmonary disease and lung cancer. COVID-19 fatality rate has been associated with as altitude as well, but findings are disputed. Therefore, we revisit this assessment with a comprehensive analysis of the relationship between COVID-19 fatality rates and altitude for the Mountain region of the United States while considering the effect of additional comorbidities and sociodemographic factors. A Generalized Additive Model (GAM) approach using one year of county data adjusted by population density was performed to evaluate associations within states and for the whole region. Our analysis revealed a consistent effect where COVID-19 case-fatality rate is decreased with higher altitude, even when controlling for pre-existing conditions and certain demographic variables. In summary, the work presented provides evidence that suggests that the protective effects of high altitude are likely to be influenced by physiologic factors but demographic trends that are associated with life at high altitude must also be considered.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-022-21787-z