Open AccessCOVID-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
Author(s) -
Gustavo Zubieta-Calleja,
Natalia Zubieta-DeUrioste,
Thuppil Venkatesh,
Kusal K Das,
Jorge Soliz
Publication year - 2021
Publication title -
reviews on recent clinical trials
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.509
H-Index - 31
eISSN - 1876-1038
pISSN - 1574-8871
DOI - 10.2174/1574887115666200925141108
Subject(s) - medicine , effects of high altitude on humans , hypoxia (environmental) , intensive care medicine , covid-19 , disease , pandemic , oxygen therapy , respiratory physiology , pathophysiology , high altitude pulmonary edema , pneumonia , physiology , lung , pulmonary edema , pathology , infectious disease (medical specialty) , oxygen , chemistry , organic chemistry , anatomy
Background: Critical hypoxia in this COVID-19 pandemic results in high mortality andeconomic loss worldwide. Initially, this disease’ pathophysiology was poorly understood and interpretedas a SARS (Severe Acute Respiratory Syndrome) pneumonia. The severe atypical lung CATscan 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 thatCOVID-19 could be similar to a High-Altitude Pulmonary Edema (HAPE). New observations andpathological findings are gradually clarifying the disease. Methods: As high-altitude medicine and hypoxia physiology specialists working and living in thehighlands for over 50 years, we perform a perspective analysis of hypoxic diseases treated at highaltitudes 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 clinicalsigns and symptoms, are discussed. Results: High-altitude oxygen transport physiology has been systematically ignored. COVID-19signs 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 severaldiseases, 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, andother 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 usecan be counterproductive. Immunity development is the only feasible long-term survival tool.