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Revista de la Facultad de Medicina
Print version ISSN 0120-0011
Abstract
CHILIPIO-CHICLLA, Marco Antonio and CAMPOS-CORREA, Karen Elizabeth. Altitude and its correlation with COVID-19 incidence, case fatality, and mortality rates in Peru: 2020-2021. rev.fac.med. [online]. 2023, vol.71, n.2, e8. Epub July 08, 2024. ISSN 0120-0011. https://doi.org/10.15446/revfacmed.v71n2.101180.
Introduction:
Incidence, case fatality, and mortality rates of COVID-19 are not the same in the different regions of Peru, a situation that may be related to factors that have been little studied, such as altitude. Likewise, environmental characteristics typical of altitude (atmospheric pressure, relative humidity, etc.) could explain the dynamics of COVID-19 transmission.
Objective:
To determine the correlation between altitude and COVID-19 incidence, case fatality, and mortality rates in Peru.
Materials and methods:
Multiple-group ecological study. A secondary analysis of official COVID-19 data from 1 874 districts of Peru reported until February 2021 was performed. The variable altitude was categorized as low (0-999 m.a.s.l.), medium (1 000-2 499 m.a.s.l.), and high (>2 500 m.a.s.l.). Cumulative incidence, case fatality, and mortality rates of COVID-19 were calculated as the number of cases among the total population of each district multiplied by 10 000, the number of deaths among the number of cases multiplied by 100, and the number of deaths among the total population of each district multiplied by 100 000, respectively. Bivariate (Spearman's rank correlation and Kruskal-Wallis test) and multivariate analyses (multiple linear regression) were used for data analysis, with a confidence level of 95%.
Results:
An inverse correlation between cumulative incidence rate (1 823 districts) and altitude (Rho: -0.355; p<0.001) was observed, i.e., it decreased at a higher altitude. In turn, there was a direct correlation between case fatality rate (1 526 districts) and altitude (Rho: 0.131; p<0.001), i.e., it increased at a higher altitude. Although mortality rate showed an inverse correlation with altitude (Rho: -0.310; p<0.000), it varied heterogeneously depending on altitude levels. In the multivariate analysis, after adjusting the model for poverty and population density, altitude was associated with incidence (p<0.001) and case fatality rates (p=0.009), but not with mortality rate (p=0.179).
Conclusion:
During the study period, an inverse correlation between altitude and COVID-19 cumulative incidence rate, as well as a direct correlation between altitude and case fatality rate, were observed in Peru.
Keywords : Coronavirus Infections; Mortality; Incidence; Altitude (MeSH).
