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

BACKGROUND: 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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970356/
https://www.ncbi.nlm.nih.gov/pubmed/35358185
http://dx.doi.org/10.1371/journal.pone.0262423
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author 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
author_facet 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
author_sort Simbaña-Rivera, Katherine
collection PubMed
description BACKGROUND: 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. METHODS: 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 15(th) to July 15(th), 2020. RESULTS: 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. CONCLUSION: 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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spelling pubmed-89703562022-04-01 High-altitude is associated with better short-term survival in critically ill COVID-19 patients admitted to the ICU 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 PLoS One Research Article BACKGROUND: 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. METHODS: 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 15(th) to July 15(th), 2020. RESULTS: 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. CONCLUSION: 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. Public Library of Science 2022-03-31 /pmc/articles/PMC8970356/ /pubmed/35358185 http://dx.doi.org/10.1371/journal.pone.0262423 Text en © 2022 Simbaña-Rivera et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
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
High-altitude is associated with better short-term survival in critically ill COVID-19 patients admitted to the ICU
title High-altitude is associated with better short-term survival in critically ill COVID-19 patients admitted to the ICU
title_full High-altitude is associated with better short-term survival in critically ill COVID-19 patients admitted to the ICU
title_fullStr High-altitude is associated with better short-term survival in critically ill COVID-19 patients admitted to the ICU
title_full_unstemmed High-altitude is associated with better short-term survival in critically ill COVID-19 patients admitted to the ICU
title_short High-altitude is associated with better short-term survival in critically ill COVID-19 patients admitted to the ICU
title_sort high-altitude is associated with better short-term survival in critically ill covid-19 patients admitted to the icu
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970356/
https://www.ncbi.nlm.nih.gov/pubmed/35358185
http://dx.doi.org/10.1371/journal.pone.0262423
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