Impact of altitude on COVID-19 infection and death in the United States: A modeling and observational study.

<h4>Background</h4>COVID-19, the disease caused by SARS-CoV-2, has caused a pandemic, sparing few regions. However, limited reports suggest differing infection and death rates across geographic areas including populations that reside at higher elevations (HE). We aimed to determine if CO...

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Main Authors: Kenton E Stephens, Pavel Chernyavskiy, Danielle R Bruns
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0245055&type=printable
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author Kenton E Stephens
Pavel Chernyavskiy
Danielle R Bruns
author_facet Kenton E Stephens
Pavel Chernyavskiy
Danielle R Bruns
author_sort Kenton E Stephens
collection DOAJ
description <h4>Background</h4>COVID-19, the disease caused by SARS-CoV-2, has caused a pandemic, sparing few regions. However, limited reports suggest differing infection and death rates across geographic areas including populations that reside at higher elevations (HE). We aimed to determine if COVID-19 infection, death, and case mortality rates differed in higher versus low elevation (LE) U.S. counties.<h4>Methods</h4>Using publicly available geographic and COVID-19 data, we calculated per capita infection and death rates and case mortality in population density matched HE and LE U.S. counties. We also performed population-scale regression analysis to investigate the association between county elevation and COVID-19 infection rates.<h4>Findings</h4>Population density matching of LA (< 914m, n = 58) and HE (>2133m, n = 58) counties yielded significantly lower COVID-19 cases at HE versus LE (615 versus 905, p = 0.034). HE per capita deaths were significantly lower than LE (9.4 versus 19.5, p = 0.017). However, case mortality did not differ between HE and LE (1.78% versus 1.46%, p = 0.27). Regression analysis, adjusted for relevant covariates, demonstrated decreased COVID-19 infection rates by 12.82%, 12.01%, and 11.72% per 495m of county centroid elevation, for cases recorded over the previous 30, 90, and 120 days, respectively.<h4>Conclusions</h4>This population-adjusted, controlled analysis suggests that higher elevation attenuates infection and death. Ongoing work from our group aims to identify the environmental, biological, and social factors of residence at HE that impact infection, transmission, and pathogenesis of COVID-19 in an effort to harness these mechanisms for future public health and/or treatment interventions.
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spelling doaj-art-36bc71f3fedb456d99980fbac0194aad2025-08-20T02:55:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01161e024505510.1371/journal.pone.0245055Impact of altitude on COVID-19 infection and death in the United States: A modeling and observational study.Kenton E StephensPavel ChernyavskiyDanielle R Bruns<h4>Background</h4>COVID-19, the disease caused by SARS-CoV-2, has caused a pandemic, sparing few regions. However, limited reports suggest differing infection and death rates across geographic areas including populations that reside at higher elevations (HE). We aimed to determine if COVID-19 infection, death, and case mortality rates differed in higher versus low elevation (LE) U.S. counties.<h4>Methods</h4>Using publicly available geographic and COVID-19 data, we calculated per capita infection and death rates and case mortality in population density matched HE and LE U.S. counties. We also performed population-scale regression analysis to investigate the association between county elevation and COVID-19 infection rates.<h4>Findings</h4>Population density matching of LA (< 914m, n = 58) and HE (>2133m, n = 58) counties yielded significantly lower COVID-19 cases at HE versus LE (615 versus 905, p = 0.034). HE per capita deaths were significantly lower than LE (9.4 versus 19.5, p = 0.017). However, case mortality did not differ between HE and LE (1.78% versus 1.46%, p = 0.27). Regression analysis, adjusted for relevant covariates, demonstrated decreased COVID-19 infection rates by 12.82%, 12.01%, and 11.72% per 495m of county centroid elevation, for cases recorded over the previous 30, 90, and 120 days, respectively.<h4>Conclusions</h4>This population-adjusted, controlled analysis suggests that higher elevation attenuates infection and death. Ongoing work from our group aims to identify the environmental, biological, and social factors of residence at HE that impact infection, transmission, and pathogenesis of COVID-19 in an effort to harness these mechanisms for future public health and/or treatment interventions.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0245055&type=printable
spellingShingle Kenton E Stephens
Pavel Chernyavskiy
Danielle R Bruns
Impact of altitude on COVID-19 infection and death in the United States: A modeling and observational study.
PLoS ONE
title Impact of altitude on COVID-19 infection and death in the United States: A modeling and observational study.
title_full Impact of altitude on COVID-19 infection and death in the United States: A modeling and observational study.
title_fullStr Impact of altitude on COVID-19 infection and death in the United States: A modeling and observational study.
title_full_unstemmed Impact of altitude on COVID-19 infection and death in the United States: A modeling and observational study.
title_short Impact of altitude on COVID-19 infection and death in the United States: A modeling and observational study.
title_sort impact of altitude on covid 19 infection and death in the united states a modeling and observational study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0245055&type=printable
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AT pavelchernyavskiy impactofaltitudeoncovid19infectionanddeathintheunitedstatesamodelingandobservationalstudy
AT daniellerbruns impactofaltitudeoncovid19infectionanddeathintheunitedstatesamodelingandobservationalstudy