Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 8;19(22):14673.
doi: 10.3390/ijerph192214673.

Long COVID at Different Altitudes: A Countrywide Epidemiological Analysis

Juan S Izquierdo-Condoy  1   2 , Raul Fernandez-Naranjo  1 , Eduardo Vasconez-González  1 , Simone Cordovez  1 , Andrea Tello-De-la-Torre  1 , Clara Paz  1 , Karen Delgado-Moreira  1 , Sarah Carrington  3 , Ginés Viscor  4 , Esteban Ortiz-Prado  1
Affiliations

Long COVID at Different Altitudes: A Countrywide Epidemiological Analysis

Juan S Izquierdo-Condoy et al. Int J Environ Res Public Health. .

Abstract

Background: Several reports from around the world have reported that some patients who have recovered from COVID-19 have experienced a range of persistent or new clinical symptoms after a SARS-CoV-2 infection. These symptoms can last from weeks to months, impacting everyday functioning to a significant number of patients.

Methods: A cross-sectional analysis based on an online, self-reporting questionnaire was conducted in Ecuador from April to July 2022. Participants were invited by social media, radio, and TV to voluntarily participate in our study. A total of 2103 surveys were included in this study. We compared socio-demographic variables and long-term persisting symptoms at low (<2500 m) and high altitude (>2500 m).

Results: Overall, 1100 (52.3%) responders claimed to have Long-COVID symptoms after SARS-CoV-2 infection. Most of these were reported by women (64.0%); the most affected group was young adults between 21 to 40 years (68.5%), and most long-haulers were mestizos (91.6%). We found that high altitude residents were more likely to report persisting symptoms (71.7%) versus those living at lower altitudes (29.3%). The most common symptoms were fatigue or tiredness (8.4%), hair loss (5.1%) and difficulty concentrating (5.0%). The highest proportion of symptoms was observed in the group that received less than 2 doses.

Conclusions: This is the first study describing post-COVID symptoms' persistence in low and high-altitude residents. Our findings demonstrate that women, especially those aging between 21-40, are more likely to describe Long-COVID. We also found that living at a high altitude was associated with higher reports of mood changes, tachycardia, decreased libido, insomnia, and palpitations compared to lowlanders. Finally, we found a greater risk to report Long-COVID symptoms among women, those with previous comorbidities and those who had a severer acute SARS-CoV-2 infection.

Keywords: COVID-19; Latin America; SARS-CoV-2; high altitude; long-COVID; sequalae; symptoms.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Breakdown of included and excluded surveys.
Figure 2
Figure 2
Prevalence of most frequent Long-COVID symptoms in Ecuadorian participants according to sex.
Figure 3
Figure 3
t-test between number of Long-COVID symptoms and age groups of participants.
Figure 4
Figure 4
Effect of vaccination on Long-COVID symptoms in Ecuadorian participants. (A). t-test between number of Long-COVID symptoms and vaccine received doses. (B). t-test between number of symptoms and vaccine doses received according to the time of infection (left: infection before vaccine; right: infection after vaccine).
Figure 5
Figure 5
Multicomponent analysis of Long-COVID symptoms and vaccines received. (A). Side effects (Long-COVID symptoms) behave symmetrically in participants with at least two doses of vaccines. (B). The clustered symptoms affected participants regardless of the vaccination schedule.
Figure 6
Figure 6
Differences in Long-COVID symptoms according to altitude. (A) t-test between the number of long-COVID symptoms and altitude. (B) t-test between the number of long-COVID symptoms and altitude according to sex.
See this image and copyright information in PMC

References

    1. Worobey M., Levy J.I., Serrano L.M., Crits-Christoph A., Pekar J.E., Goldstein S.A., Rasmussen A.L., Kraemer M.U., Newman C., Koopmans M.P., et al. The Huanan Seafood Wholesale Market in Wuhan was the early epicenter of the COVID-19 pandemic. Science. 2022;377:951–959. doi: 10.1126/science.abp8715. - DOI - PMC - PubMed
    1. Chippa V., Aleem A., Anjum F. StatPearls. StatPearls Publishing; Treasure Island, FL, USA: 2021. [(accessed on 22 July 2022)]. Post Acute Coronavirus (COVID-19) Syndrome. Available online: https://www.ncbi.nlm.nih.gov/books/NBK570608/
    1. Ortiz-Prado E., Simbaña-Rivera K., Gómez-Barreno L., Rubio-Neira M., Guaman L.P., Kyriakidis N.C., Muslin C., Gómez A.M., Barba-Ostria C., Cevallos-Robalino D., et al. Clinical, molecular and epidemiological characterization of the SARS-CoV2 virus and the Coronavirus disease 2019 (COVID-19), a comprehensive literature review. Diagn. Microbiol. Infect. Dis. 2020;98:115094. doi: 10.1016/j.diagmicrobio.2020.115094. - DOI - PMC - PubMed
    1. PAHO PAHO Weekly COVID-19 Epidemiological Update-27 September 2022-PAHO/WHO|Pan American Health Organization. [(accessed on 6 October 2022)]. Available online: https://www.paho.org/en/documents/paho-weekly-covid-19-epidemiological-u....
    1. Wu Z., McGoogan J.M. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72,314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323:1239–1242. doi: 10.1001/jama.2020.2648. - DOI - PubMed