Incidence of COVID-19 infection and prevalence of diabetes, obesity and hypertension according to altitude in Peruvian population

Segundo N. Seclén, Eloisa Nunez-Robles, Marlon Yovera-Aldana, Arturo Arias- Chumpitaz

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11 Scopus citations

Abstract

To investigate the cumulative incidence and mortality of COVID-19 and the prevalence of comorbidities such as diabetes, obesity and hypertension in regions with different altitude levels ranging from sea level to high altitude. Methodology: Analytical study in which we correlated secondary data obtained from reports of the Ministry of Health and National Institute for Statistics and Informatic. The cumulative incidence and mortality of COVID-19 in 25 peruvian regions is reported, together with its relationnship with altitude levels during March-July 2020 using Pearsońs correlation. We also aiming to assess the prevalence of diabetes, obesity and hypertension with altitude according to the ENDES 2018 data using Gamma statistics. Results: COVID-19 maintained an inverse correlation with higher rates in the coastal regions and lower rates with increasing altitude in the cumulative incidence (Pearson = −0.8, p < 0.000) and mortality (Pearson = −0.77, p < 0.000), adjusted gender and age. The prevalence of diabetes and obesity showed the same inverse correlation trend with altitude (Gamma p < 0.000) but not hypertension (Gamma p = 0.13) Conclusions: The data in Peru it is suggested that physiological adaptation in a hypoxic environment at high altitude may protect persons from the severe impact of acute infection caused by SARS-CoV-2. The reduction in cumulative incidence and mortality rates with increasing altitude is the main finding. Possible mechanisms such as a decreased expression of angiotensin-converting enzyme 2 (ACE2) and a lower virulence because of a high altitude environment, may explain this epidemiological features. In addition, the lower prevalence of diabetes, obesity and hypertension may establish a protective epidemiology against these disease.

Original languageEnglish
Article number108463
JournalDiabetes Research and Clinical Practice
Volume169
DOIs
StatePublished - Nov 2020

Keywords

  • ACE2
  • Altitude
  • COVID-19
  • Diabetes
  • ENDES 2018
  • Hypertension
  • Incidence
  • Mortality
  • Obesity
  • Prevalence

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