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).
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 | 6 | 0.94 | 74, 77, 75, 78, 43, 43 | 2W, 4M | Arterial hypertension | 44 | 9 |
Cajamarca | 669 | 3 | 0.45 | 81, 36, 43 | 1W, 2M | Diabetes and obesity | 10 | 15 |
Cusco | 904 | 8 | 0.88 | 76, 64, 68, 59, 61, 66 | 3M | Diabetes, gastric neoplasm, terminal cancer | 6 | 6 |
Huanca-velica | 383 | 1 | 0.26 | 58 | 1M | No information | ||
Junín | 1675 | 16 | 0.96 | 57, 60, 84, 51, 55, 16, 40, 63, 82, 61, 38, 71, 68, 22, 69, 94 | 2W, 14M | No information | ||
Pasco | 426 | 8 | 1.88 | 57, 43, 82, 87, 86, 88, 53, 79 | 5W, 3M | No information | ||
Puno | 304 | 6 | 1.97 | 64, 73, 73, 38, 74, 65 | 3W, 3M | TBC, 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
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.