key: cord-337493-8yhd697t
authors: Choquenaira-Quispe, Celia; Saldaña-Bobadilla, Vanessa; Kenedy Ramirez, J.
title: Factors involved in low susceptibility to covid-19: an adaptation of high altitude inhabitants
date: 2020-07-02
journal: Med Hypotheses
DOI: 10.1016/j.mehy.2020.110068
sha: 
doc_id: 337493
cord_uid: 8yhd697t

nan

Master of Science  Hypoxia inducible factor regulation: High altitude inhabitants have the hypoxia-inducible factor activated, leading to a subsequent gene overexpression on erythropoietin-erythropoiesis production [6] . In addition, this signaling pathway decreases ACE-2 expression [7] . Consequently, populations from high altitude areas would be less susceptible to hypoxia during the infection.

 Pulmonary adaptation in high-altitude areas: Low partial pressure of oxygen in the environment and lower inspired partial pressure of oxygen leads to pulmonary physiological and anatomical adaptations [8] , improving the pulmonary perfusion and capacity. Consequently, SARS-CoV-2 infected populations from high altitude areas have greater lung adaptive capacity than those that live at low altitude.

The three factors above would perform an important role in high altitude inhabitants, because they decrease the susceptibility to develop severe symptoms in SARS-CoV-2 infection. It is worth mentioning that it is possible to quantify the ACE-2 receptor expression, interleukins and elucidate the molecular mechanisms involved.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Immunology of COVID-19: Current state of the science

Hepcidin and anemia: A tight relationship

Does the pathogenesis of SARS-CoV-2 virus decrease at high-altitude?

HIF stabilizers in the management of renal anemia: from bench to bedside to pediatrics

Hypoxia inducible factor-1 protects against COVID-19: A hypothesis

High altitude genetic adaptation in Tibetans: No role of increased hemoglobin-oxygen affinity

The authors declare that there is no conflict of interest.

The authors declare that there is no conflict of interest.
