The higher the altitude the less COVID-19: Decreased incidence, transmission capacity of the virus and severity at altitude in the American continent

The higher the altitude the less COVID-19: Decreased incidence, transmission capacity of the virus and severity at altitude in the American continent

Christian Arias-Reyes, Liliana Poma-Machicao, Fernanda Aliaga-Raudan, Favio Carvajal-Rodriguez, Jorge Soliz

Institute Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Faculty of Medicine, Université Laval, Québec, QC, Canada.

The coronavirus disease 19 (COVID-19) outbreak in North-, Central-, and South-America has become an epicenter of the current pandemic. It has been previously suggested that the infection rate of this virus might be lower in highlands compared to lowlands. Based on data from official sources, we perform an epidemiological analysis of the development of the pandemic in 23 countries of the American continent as of May 23, 2020. Our results showed that the incidence of COVID-19 reduces gradually at altitudes above 1,000 m. Subsequently, epidemiological analysis of transmission rate at highlands (>1,000 m) and lowlands (<1,000 m), indicated a lower transmission capacity in highlands than in lowlands. Finally, we also calculated the severity of COVID-19 at high and low altitude. This analysis showed that the percentage of recovered patients is significantly higher in the highlands than in the lowlands, and the Death-to-case ratio is no statistically different between both zones. Therefore, we conclude that the severity of COVID-19 decreases significantly with the altitude. Altogether, our data strongly support the hypothesis that the impact of the COVID-19 decreases significantly with altitude in the American continent.