COVID-19 case fatality rate is significantly reduced in high-altitude Andean populations of Bolivia, Colombia, Ecuador, Perú; and México in an ecological study

Previous epidemiological studies have shown that the incidence and severity of COVID-19 decrease significantly with high altitude. To date, the impact of high altitude on mortality caused by COVID-19 remains debated. This work evaluated the impact of high altitude residency on COVID-19 mortality and recovery rates in several Andean countries and México. For this purpose, a multinational ecological study of official data from Bolivia, Peru, Colombia, Ecuador, and Mexico was performed from the beginning of the pandemic until the end of 2020. The case fatality rate (CFR) of populations above 2,500 m and below 1,000 m was compared. Our results show that CFR decreases, and there is a higher recovery rate in populations located above 2,500 m in all five countries. Based on this study and multiple other references, we conclude that mortality caused by COVID-19 is lower in high-altitude Andean populations, and in the high-altitude municipalities of Mexico than in the lowlands of all these countries.