ALTITUD Y LETALIDAD POR COVID-19 DURANTE LA PANDEMIA EN EL PERÚ, 2020-2022.

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Bibliographic Details
Title:	ALTITUD Y LETALIDAD POR COVID-19 DURANTE LA PANDEMIA EN EL PERÚ, 2020-2022.
Alternate Title:	ALTITUDE AND COVID-19 CASE FATALITY DURING THE PANDEMIC IN PERU, 2020-2022.
Authors:	Robles-Mariños, Rodrigo^1,2 rodrigo.robles.m@upch.pe, Fano-Sizgorich, Diego^1,2, Alvarado, Germán F.¹, Gonzales, Gustavo F.³
Source:	Revista Peruana de Medicina Experimental y Salud Pública. 2026, Vol. 43 Issue 1, p1-14. 14p.
Subjects:	COVID-19, COHORT analysis, PANDEMICS, DEATH rate, EPIDEMIOLOGY, PERU. Ministerio de Salud, ALTITUDES, MORTALITY risk factors
Geographic Terms:	PERU
Abstract (English):	Objectives. To evaluate the functional form of the association between district-level altitude of residence and COVID-19 case fatality in Peru during the period 2020-2022. Materials and methods. A retrospective cohort study was conducted using secondary data from the Peruvian Ministry of Health on COVID-19 cases and deaths. District-level altitude of residence was categorized into four groups (0-500; 501-2000; 2001-3500; and =3501 meters above sea level). The outcome was death due to COVID-19, as recorded in the official national mortality registry. Poisson regression was used to estimate relative risks adjusted for individual- and contextual level-variables, applying robust variance clustered at the district level. Analyses were repeated according to the five epidemic waves that occurred between March 2020 and December 2022. Results. A non-linear association between altitude of residence and COVID-19 mortality was observed, consistent with a U-shaped pattern, characterized by a lower risk of death among cases residing between 2001 and 3500 meters above sea level compared with those residing between 0 and 500 meters above sea level. This pattern remained consistent in analyses stratified by epidemic waves. Conclusions. In Peru, during the 2020-2022 period, the data do not support a monotonic decrease in the risk of death from COVID-19 with increasing altitude of residence. Instead, the results suggest a non-linear relationship, with lower case fatality at intermediate altitudes (2001-3500 meters above sea level). [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Objetivos. Evaluar la forma funcional de la asociación entre la altitud distrital de residencia y la letalidad de los casos de la COVID-19 en Perú durante el periodo 2020-2022. Materiales y métodos. Se realizó un estudio de cohorte retrospectivo utilizando datos secundarios del Ministerio de Salud del Perú sobre casos y muertes por COVID-19. La altitud distrital de residencia se categorizó en cuatro grupos (0-500; 501-2000; 2001-3500; y =3501 msnm). El desenlace fue la muerte por COVID-19 según el registro oficial de defunciones. Se empleó regresión de Poisson para estimar riesgos relativos ajustados por variables individuales y contextuales, utilizando varianza robusta agrupada por distrito. Los análisis se repitieron según las cinco olas epidémicas ocurridas entre marzo de 2020 y diciembre de 2022. Resultados. Se observó una asociación no lineal entre la altitud de residencia y la muerte por COVID-19, compatible con un patrón en forma de "U", caracterizada por un menor riesgo de muerte en los casos residentes entre 2001 y 3500 msnm en comparación con aquellos que residían entre 0 y 500 msnm. Este patrón se mantuvo de forma consistente en los análisis estratificados por ola epidémica. Conclusiones. En Perú, durante el periodo 2020-2022, los datos no respaldan una disminución monotónica del riesgo de muerte por COVID-19 con el aumento de la altitud de residencia. Por el contrario, los resultados sugieren una relación no lineal, con menor letalidad en altitudes intermedias (2001-3500 msnm). [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Objectives. To evaluate the functional form of the association between district-level altitude of residence and COVID-19 case fatality in Peru during the period 2020-2022. Materials and methods. A retrospective cohort study was conducted using secondary data from the Peruvian Ministry of Health on COVID-19 cases and deaths. District-level altitude of residence was categorized into four groups (0-500; 501-2000; 2001-3500; and =3501 meters above sea level). The outcome was death due to COVID-19, as recorded in the official national mortality registry. Poisson regression was used to estimate relative risks adjusted for individual- and contextual level-variables, applying robust variance clustered at the district level. Analyses were repeated according to the five epidemic waves that occurred between March 2020 and December 2022. Results. A non-linear association between altitude of residence and COVID-19 mortality was observed, consistent with a U-shaped pattern, characterized by a lower risk of death among cases residing between 2001 and 3500 meters above sea level compared with those residing between 0 and 500 meters above sea level. This pattern remained consistent in analyses stratified by epidemic waves. Conclusions. In Peru, during the 2020-2022 period, the data do not support a monotonic decrease in the risk of death from COVID-19 with increasing altitude of residence. Instead, the results suggest a non-linear relationship, with lower case fatality at intermediate altitudes (2001-3500 meters above sea level). [ABSTRACT FROM AUTHOR]
ISSN:	17264634
DOI:	10.17843/rpmesp.2026.431.14979.