High-Altitude Pulmonary Edema in the Context of COVID-19

Abstract

High-altitude pulmonary edema (HAPE) and COVID-19 pneumonia are different diseases, but HAPE-susceptible individuals (whose susceptibility often has a genetic basis) can also suffer from severe COVID-19. We hypothesized that certain pathogenic mechanisms might overlap if such a coincidence occurs, since these patients could react to alveolar hypoxia with a more intense and heterogeneously distributed pulmonary vasoconstriction than non-HAPE-susceptible patients. It is also not known how future altitude acclimatization might affect lowlanders with COVID-19 pulmonary sequelae, and how the loss of adaptation to chronic hypoxia might differ by genetic lineage among highland natives who have recovered from severe COVID-19 around the world. Although the incidence of CoV-2 in high-altitude locations seems to be lower, a correct differential diagnosis of both conditions is essential, especially in high-altitude areas where health resources are scarce, considering that there is sometimes a similarity between COVID-19 pneumonia and HAPE.