COVID-19 and Pneumolysis Simulating Extreme High-altitude Exposure with Altered Oxygen Transport Physiology; Multiple Diseases, and Scarce Need of Ventilators: Andean Condor's-eye-view.

Abstract

BACKGROUND:

Critical hypoxia in this COVID-19 pandemic results in high mortality and economic loss worldwide. Initially, this disease' pathophysiology was poorly understood and interpreted as a SARS (Severe Acute Respiratory Syndrome) pneumonia. The severe atypical lung CAT scan images alerted all countries, including the poorest, to purchase lacking sophisticated ventilators. However, up to 88% of the patients on ventilators lost their lives. It was suggested that COVID-19 could be similar to a High-Altitude Pulmonary Edema (HAPE). New observations and pathological findings are gradually clarifying the disease.

METHODS:

As high-altitude medicine and hypoxia physiology specialists working and living in the highlands for over 50 years, we perform a perspective analysis of hypoxic diseases treated at high altitudes and compare them to Covid-19. Oxygen transport physiology, SARS-Cov-2 characteristics, and its transmission, lung imaging in COVID-19, and HAPE, as well as the causes of clinical signs and symptoms, are discussed.

RESULTS:

High-altitude oxygen transport physiology has been systematically ignored. COVID-19 signs and symptoms indicate a progressive and irreversible failure in the oxygen transport system, secondary to pneumolysis produced by SARS-Cov-2's alveolar-capillary membrane "attack". HAPE's pulmonary compromise is treatable and reversible. COVID-19 is associated with several diseases, with different individual outcomes, in different countries, and at different altitudes.

CONCLUSIONS:

The pathophysiology of High-altitude illnesses can help explain COVID-19 pathophysiology, severity, and management. Early diagnosis and use of EPO, acetylsalicylic-acid, and other anti-inflammatories, oxygen therapy, antitussives, antibiotics, and the use of Earth open-circuit- astronaut-resembling suits to return to daily activities, should all be considered. Ventilator use can be counterproductive. Immunity development is the only feasible long-term survival tool.

• Authors: Gustavo Zubieta-Calleja, Natalia Zubieta-DeUrioste, Thuppil Venkatesh, Kusal K Das, Jorge Soliz
• Journal: Reviews on recent clinical trials (Rev Recent Clin Trials) Vol. 15 Issue 4 Pg. 347-359 ( 2020) ISSN: 1876-1038 [Electronic] United Arab Emirates
• PMID: 32981508 (Publication Type: Comparative Study, Journal Article, Review)
• Copyright: Copyright© Bentham Science Publishers; For any queries, please email at [email protected].

Chemical References

• Oxygen

Topics

• Altitude Sickness (diagnosis, metabolism, physiopathology)
• COVID-19 (diagnosis, metabolism, physiopathology, therapy)
• Diagnosis, Differential
• Humans
• Hypertension, Pulmonary (diagnosis, metabolism, physiopathology)
• Oxygen (metabolism)
• Ventilators, Mechanical