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Vol. 31. Issue 2.
Pages 130-131 (March - April 2021)
Vol. 31. Issue 2.
Pages 130-131 (March - April 2021)
Letter to the Editor
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Adaptation to hypobaric hypoxia of residents at high altitude, to counteract COVID-19 disease
Adaptación a la hipoxia hipobárica de pobladores a gran altitud, para contrarrestar la enfermedad COVID-19
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Angel Canales-Gutiérreza,
Corresponding author
acanales@unap.edu.pe

Corresponding author.
, Gelvi Peali-Maro Canales-Manchuriab, Fabrizzio Canales-Manchuriac
a Facultad de Ciencias Biológicas, Programa de Ecología, Universidad Nacional del Altiplano, Puno, Peru
b Escuela Profesional de Ingeniería Ambiental, Universidad Nacional Jorge Basadre Grohmann, Tacna, Peru
c Escuela Profesional de Ingeniería Ambiental y Arquitectura, Universidad Católica Santa María, Arequipa, Peru
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Table 1. Statistic of the number of positive cases, age, deaths, sex, recovered and epidemiologically discharged patients due to COVID-19 on 29 May 2020 in 7 departments of Peru, located above 2500MASL.
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Dear Editor,

It seems that those who live at altitudes higher than 2500m above sea level (MASL) are less liable to develop severe hypoxic reactions in acute infections by the SARS-CoV-2 virus, due to an acclimatisation process and physiological adaption.1 Likewise, there is a mechanism in reaction to hypoxia through the angiotensin converting enzyme that counteracts SARS-CoV-22 by means of physiological systems which adapt to hypoxia through plasticity, natural selection,3 and genetic and physiological adaptation.4

In Peru there are 7 departments or cities (Ayacucho, Cajamarca, Cusco, Huancavelica, Junín, Pasco and Puno), which are located higher than 2500MASL. To date, 23 individuals have died because of COVID-19 in these regions, or 1.01% of the total for the country, with a mortality rate of 0.62%. For example, in the region of Puno, on 29 May 2020 only 6 deaths had been reported of a total of 304 positive cases, and the percentage of patients who had recovered and been discharged epidemiologically was higher than 96%5 (Table 1).

Table 1.

Statistic of the number of positive cases, age, deaths, sex, recovered and epidemiologically discharged patients due to COVID-19 on 29 May 2020 in 7 departments of Peru, located above 2500MASL.

Department  Total cases (+)  Deaths  Mortality (%)  Ages of the dead  Sex  Disease  No. of recovered patients  No. of patients discharged 
Ayacucho  639  0.94  74, 77, 75, 78, 43, 43  2W, 4Arterial hypertension  44 
Cajamarca  669  0.45  81, 36, 43  1W, 2Diabetes and obesity  10  15 
Cusco  904  0.88  76, 64, 68, 59, 61, 66  3Diabetes, gastric neoplasm, terminal cancer 
Huanca-velica  383  0.26  58  1No information     
Junín  1675  16  0.96  57, 60, 84, 51, 55, 16, 40, 63, 82, 61, 38, 71, 68, 22, 69, 94  2W, 14No information     
Pasco  426  1.88  57, 43, 82, 87, 86, 88, 53, 79  5W, 3No information     
Puno  304  1.97  64, 73, 73, 38, 74, 65  3W, 3TBC, arterial hypertension, cardiac problems, kidney failure  103  189 

M: Men; TBC: Tuberculosis; W: Women.

Those who live in the Andes Mountains have a plasticity mechanism in their bodily development which, thanks to their small bodies and large ribs,3 helps them to adapt and acclimatise to conditions of hypoxia. The populations in the high Andes in the region of Puno have also developed methods of physiological adaptation to the climate, as in the winter months temperatures may fall to −25°C in the area of Mazocruz in Puno (4100MASL). Bronchial infections are very frequent, so they consume infusions of the leaves of local medicinal plants.

In this region of Puno, the first 3 deaths as a result of COVID-19, according to reports dated 13 May 2020, were a male aged 64 years who died due to severe respiratory failure, a woman aged 75 years with a history of kidney failure and chronic heart disease, and a male aged 38 years with a history of pulmonary TBC and chronic anaemia.5

These data extracted from certain regions of Peru are therefore along the same line as current evidence, according to which those who live at more than 2500MASL are less susceptible to developing severe adverse effects in acute infection by COVID-19.1

References
[1]
C. Arias, N. Zubieta, L. Poma, F. Aliaga, F. Carvajal, M. Dutschmann, et al.
Does the pathogenesis of SARS-CoV-2 virus decrease at high-altitude?.
Respir Physiol Neurobiol, 277 (2020), pp. 103443
[2]
C. Huamaní, F. Miranda.
Propagation by COVID-19 at high altitude: cusco case.
Respir Physiol Neurobiol, 279 (2020), pp. 103448
[3]
K.J. Weinstein.
Morphological signatures of high-altitude adaptations in the Andean archaeological record: distinguishing developmental plasticity and natural selection.
Quat Int, 461 (2017), pp. 14-24
[4]
K.A. O’Brien, T.S. Simonson, A.J. Murray.
Metabolic adaptation to high altitude.
Curr Opin Endocr Metab Res, 11 (2020), pp. 3341
[5]
Dirección Regional de Salud de la Región de Puno. Mapa de casos COVID-19 Puno.
(2020),

Please cite this article as: Canales-Gutiérrez A, Peali-Maro Canales-Manchuria G, Canales-Manchuria F. Adaptación a la hipoxia hipobárica de pobladores a gran altitud, para contrarrestar la enfermedad COVID-19. Enferm Clin. 2021;31:130–131.

Copyright © 2020. Elsevier España, S.L.U.. All rights reserved
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