Romil Singh, MD
Resident
n/a
Rochester, Minnesota, United States
Disclosure information not submitted.
Vikas Bansal, MPH, MBBS
Research Fellow
Mayo Clinic
Rochester, Minnesota
Disclosure information not submitted.
Mayank Sharma, MBBS
Research Fellow
n/a, Minnesota, United States
Disclosure information not submitted.
Marija Bogojevic, MD,
Resident Physician
Montefiore New Rochelle Hospital, Minnesota, United States
Disclosure information not submitted.
Neha Deo, BS
Medical Student
Mayo Clinic Alix School of Medicine
Disclosure information not submitted.
Simon Zec, MD (he/him/his)
Research Fellow, Pulmonary and Critical Care Medicine
Mayo Clinic
Rochester, Minnesota, United States
Disclosure information not submitted.
Diana Valencia Morales, MD
Dr.
Mayo Clinic Rochester
Rochester, Minnesota, United States
Disclosure information not submitted.
Allison LeMahieu, BS, MS
Biostatistician
Mayo Clinic
Rochester, Minnesota, United States
Disclosure information not submitted.
Andrew Hanson, MS
Biostatistician
Mayo Clinic
Rochester, Minnesota, United States
Disclosure information not submitted.
Phillip Schulte, MD
Senior Associate Consultant II
n/a
Rochester, Minnesota, United States
Disclosure information not submitted.
Katherine Belden, MD
Physician
Jefferson University, United States
Disclosure information not submitted.
Smith Heavner, PhD, RN (he/they)
Scientific Director
Critical Path Institute
Simpsonville, SC, United States
Disclosure information not submitted.
Margit Kaufman, MD
Dr.
Englewood Health, Englewood, NJ., United States
Disclosure information not submitted.
Vishakha Kumar, MD, MBA
Society of Critical Care Medicine
Mount Prospect, Illinois
Disclosure information not submitted.
Allan Walkey, MD (he/him/his)
Professor of Medicine
Boston University
Boston, Massachusetts, United States
Disclosure information not submitted.
Ognjen Gajic, MD
Professor
Mayo Clinic
Rochester, Minnesota, United States
Disclosure information not submitted.
Juan Pablo Domecq Garces, MD
Assistant Professor of Medicine
Mayo Clinic College of Medicine
North Mankato, Minnesota, United States
Disclosure information not submitted.
Rahul Kashyap, MD, MBA,
Medical Director Research
Wellspan Health-York Hospital
York, Pennsylvania
Disclosure information not submitted.
Title: Association of Latitude & Altitude with Outcomes of COVID-19: SCCM Discovery VIRUS Registry Analysis
Introduction:
The severity of COVID-19 may be affected by environmental factors. We aimed to investigate the association of altitude and latitude with adverse outcomes in the COVID-19 course.
Methods:
In this observational cohort analysis of the SCCM Discovery VIRUS: COVID-19 Registry, latitudes, and altitudes, which were determined according to hospital locations, were analyzed as a covariate for outcomes, i.e., 28-day mortality and hospital length of stay. To minimize the impact of missing data, institutions that had < 65% of patients with outcome data available were excluded. Multivariable regression modeling was used, adjusting for baseline characteristics and timing of the admission. Models were fitted using generalized estimating equations to account for the clustering of patients within sites.
Conclusions:
22,108 patients from 21 countries were included, with a median age of 62 (49-74) years and 54% males. The median age and percentage of patients with comorbidities increased with higher latitude. Conversely, patients with comorbidities decreased with elevated altitudes. 28-day mortality was 25%, while the number of median hospital-free days (HFD) was 20 days. Although there was a significant linear relationship between mortality and HFD, suggesting that unfavorable outcomes were more frequent at higher latitudes; the association did not remain significant when adjusted for baseline differences (adjusted odds ratio (aOR)=1.32, p=0.051; aOR=-1.07, p=0.050 for 28-day mortality and HFD, respectively). While considering the altitude level, we found that it had a non-linear relationship with 28-day mortality (p=0.001, odds ratios for altitudes 75, 125, 400, and 600 m.a.s.l were: 0.96, 1.04, 0.49, and 0.51, respectively).
Within this global project, we showed an association of 28-day mortality and hospital-free days with latitude, however, this did not remain significant when adjusted for baseline characteristics. Our results suggest that variations in COVID-19 outcomes reported in earlier epidemiological studies might be subject to ecological fallacy, rather than indicating an individual-level causal relationship.
Within this global project, we showed an association of 28-day mortality and hospital-free days with latitude, however, this did not remain significant when adjusted for baseline characteristics. Our results suggest that variations in COVID-19 outcomes reported in earlier epidemiological studies might be subject to ecological fallacy, rather than indicating an individual-level causal relationship.