The Effects of Post Coronavirus Disease 2019 Conditions on High Altitude Illness

Main Article Content

Chi Qian Tan
Ting-Yu Sun
Tso-Wei Ho
Yi-Jia Hsu
I-Lin Chin

Abstract





Introduction


High altitude illness (HAI) refers to cerebral and pulmonary syndromes related to hypoxemia during mountain trekking. Beyond symptoms and complications, people with long coronavirus disease 2019 (COVID-19) are resuming mountain trekking activities. Pooled prevalence data has shown that fatigue, breath shortness, and headache are common symptoms for both HAI and post-COVID-19.


 


Objective


This quantitative study design investigates the prevalence of HAI and post-COVID symptoms, identifying the body reactions of different group subjects.


 


Method


The targeted participants climbed Mount Xue or Mount Hehuan from May 1, 2022, to October 17, 2022. Upon receiving 236 effective responses, a chi-squared test and 2-sample t-Test were run through SAS Enterprise Guide (SAS EG) and Excel. Participants were then controlled under similar backgrounds, like normal BMI range, residency altitude, cardiopulmonary medical history, non-smokers, and no drug usage before climbing. The remaining 125 participants meeting our study criteria were grouped under four identical conditions.


 


Result


Significantly, more participants in Group Post COVID-19 experienced HAI symptoms during mountain trekking compared with participants in Group Normal, by 14.13% more in Mount Xue and 4.23% more in Mount Hehuan.


An increase is observed in females developing HAI symptoms after being diagnosed with COVID-19, an average of 13.96% higher than the prevalence in infected men. Besides, participating in mountain trekking one month after diagnosis of COVID-19 could reduce developing HAI symptoms by at least 44.44%.


 


Conclusion


The HAI incidence among post-COVID-19 participants was 8.95% statistically higher than normal participants, on average, during trekking in MountXue and MountHehuan. Symptoms were mostly mild, with “Tiredness or Fatigue” being the most common symptom. Our study analysis provided a direction for future studies of the relationship between post-COVID-19 conditions and HAI, such as the pathological mechanisms and prevention research.





Article Details

How to Cite
Tan, C. Q., Sun, T.-Y., Ho, T.-W., Chow, W. Y., Hung, D.-R., Lee, E. T., Hsu, Y.-J. and Chin, I.-L. (2023) “The Effects of Post Coronavirus Disease 2019 Conditions on High Altitude Illness”, Journal of Asian Medical Students’ Association. Kuala Lumpur, Malaysia. Available at: https://jamsa.amsa-international.org/index.php/main/article/view/504 (Accessed: 4February2023).
Section
Scientific Papers (EAMSC 2023 Nepal)

References

Fred F. Ferri. Ferri’s Clinical Advisor: 5 Books in 1 (Ferri’s Medical Solutions). Elsevier. 2017; 590. [https://books.google.com.tw/books?id=rRhCDAAAQBAJ&pg=PA590&redir_esc=y#v=onepage&q&f =false]

World Health Organization. Coronavirus (COVID-19) Dashboard; Overview. [https://covid19.who.int/]

Olalekan Lee Aiyegbusi, Sarah E Hughes, Grace Turner, Samantha Cruz Rivera, Christel McMullan, Joht Singh Chandan, Shamil Haroon, Gary Price, Elin Haf Davies, Krishnarajah Nirantharakumar, Elizabeth Sapey, Melanie J Calvert, and on behalf of the TLC Study Group. Symptoms, complications and management of long COVID: a review. Journal of the Royal Society of Medicine. 2021; 114(9):

-442. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450986/#bibr1-01410768211032850]

Robert C. Roach, Peter H. Hackett, Oswald Oelz, Peter Bartsch, Andrew M. Luks, Martin J. Maclnnis, J. Kenneth Baillie. The 2018 Lake Louise Acute Mountain Sickness Score. High Altitude Medicine &

Biology. 2018; 19(1): 4-6. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191821/]

Yi-Ming Weng, Yu-Hui Chiu, Jiun-Jen Lynn, Wen-Cheng Li, Shih-Hao Wang, Wei-Fong Kao, Tai-Yi Hsu, Te-Fa Chiu, Yu-Jr Lin, Chang-Wei Chan. Different duration of high-altitude pre-exposure associated with the incidence of acute mountain sickness on Jade Mountain. Am J Emerg Med. 2013;

(7):1113-7. [https://pubmed.ncbi.nlm.nih.gov/23688567/]

Hsu, Tai-Yi MD, Weng Yi-Ming MD, Chiu, Yu-HUi MD, Li, Wen-Cheng, MD, Chen, Pang-Yen MD,

Wang, Shih-Hao MD, Huang, Kuo-Feng MS, Kao, Wei-Fong MD, Chiu-Te=Fa MD, Chen, Jih-Chang MD. Rate of Ascent and Acute Mountain Sicknesss at High Altitude. Clinical Journal of Sport Medicine. 2015; 25(2); 95-104. [https://journals.lww.com/cjsportsmed/Fulltext/2015/03000/Rate_of_Ascent_and_Acute_Mountain_Sic kness_at_High.4.aspx]

Jack A. Loeppky, Milton V. Icenogle, Damon Maes, Katrina Riboni, Helmut Hinghofer-Szalkay, and Robert C. Roach. Early Fluid Retention and Severe Acute Mountain Sickness. Journal of Applied

Physiology. 1999; 87(3): 1016-25. [https://journals.physiology.org/doi/full/10.1152/japplphysiol.00527.2004]

Yun-Peng Hou, Jia-Lin Wu, Chao Tan, Yu Chen, Rui Guo, Yong-Jun Luo. Sex-based differences in the prevalence of acute mountain sickness: a meta-analysis. Military Medical Research; 2019; 6(38). [https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-019-0228-3]

Alan Richardson, Peter Watt, Neil Maxwell. Hydration and the physiological responses to acute normobaric hypoxia. Wilderness Environmental Medicine. 2009; 20(3); 212-20. [https://pubmed.ncbi.nlm.nih.gov/19737046/]

Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS, Cook JR, Nordvig AS, Shalev D, Sehrawat TS, Ahluwalia N, Bikdeli B, Dietz D, Der-Nigoghossian C, Liyanage-Don N, Rosner GF, Bernstein EJ, Mohan S, Beckley AA, Seres DS, Choueiri TK, Uriel N, Ausiello JC, Accili D, Freedberg DE, Baldwin M, Schwartz A, Brodie D, Garcia CK, Elkind MSV, Connors JM, Bilezikian

JP, Landry DW, Wan EY. Post-acute COVID-19 syndrome. Nat Med. 2021 Apr;27(4):601-615.

[https://pubmed.ncbi.nlm.nih.gov/33753937/]

Jimeno-Almazán A, Pallarés JG, Buendía-Romero Á, Martínez-Cava A, Franco-López F,

Sánchez-Alcaraz Martínez BJ, Bernal-Morel E, Courel-Ibáñez J. Post-COVID-19 Syndrome and the Potential Benefits of Exercise. International Journal of Environmental Research and Public Health. 2021; 18(10):5329.

[https://doi.org/10.3390/ijerph18105329]

Savioli G, Ceresa IF, Gori G, Fumoso F, Gri N, Floris V, Varesi A, Martuscelli E, Marchisio S, Longhitano Y, Ricevuti G, Esposito C, Caironi G, Giardini G, Zanza C. Pathophysiology and Therapy of High-Altitude Sickness: Practical Approach in Emergency and Critical Care. J Clin Med. 2022 Jul 6;11(14):3937.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325098/]

Visco V, Vitale C, Rispoli A, Izzo C, Virtuoso N, Ferruzzi GJ, Santopietro M, Melfi A, Rusciano MR,

Maglio A, Di Pietro P, Carrizzo A, Galasso G, Vatrella A, Vecchione C, Ciccarelli M. Post-COVID-19 Syndrome: Involvement and Interactions between Respiratory, Cardiovascular and Nervous Systems. Journal of Clinical Medicine. 2022; 11(3):524. [https://doi.org/10.3390/jcm11030524]

Mallet RT, Burtscher J, Richalet JP, Millet GP, Burtscher M. Impact of High Altitude on Cardiovascular Health: Current Perspectives. Vasc Health Risk Manag. 2021 Jun 8;17:317-335. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197622/]

Lawley JS, Levine BD, Williams MA, Malm J, Eklund A, Polaner DM, Subudhi AW, Hackett PH, Roach RC. Cerebral spinal fluid dynamics: effect of hypoxia and implications for high-altitude illness. J Appl Physiol (1985). 2016 Jan 15;120(2):251-62.

[https://pubmed.ncbi.nlm.nih.gov/26494441/]

Fischer R. Reiseziel Hochgebirge. Höhenmedizinische Tipps für Gesunde und Risikopatienten. Visiting high altitudes--healthy persons and patients with risk diseases. MMW Fortschr Med. 2004 Feb 19;146(8):33-4, 36-7. German. [https://pubmed.ncbi.nlm.nih.gov/15346935/]

Andrew M. Luks, Paul S. Auerbach, Luanne Freer, Colin K. Grissom, Linda E. Keyes, Scott E. McIntosh, George W. Rodway, Robert B. Schoene, Ken Zafren, Peter H. Hackett. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019

Update. Wilderness & Environmental Medicine; 2019; 30(4).[https://www.wemjournal.org/article/S1080-6032(19)30090-0/fulltext ]