High altitudes, population density, and poverty: Unraveling the complexities of COVID-19 in Peru during the years 2020–2022

Abstract

BackgroundSeveral factors related to hospitalizations, morbidity, and mortality from COVID-19 have been identified. However, limited exploration has been done on geographic and socioeconomic factors that could significantly impact these outcomes. ObjectivesThis study aimed to determine whether altitude, population density, and percentage of population in total poverty are associated with COVID-19 incidence per 1000 inhabitants and COVID-19 case-fatality rate in Peru, from 2020 to 2022. MethodsThis study utilized a multiple group ecological design and relied on secondary databases containing daily records of COVID-19 positive cases and deaths due to COVID-19. An epidemiological analysis was performed, subsequently processed using a random effects model. ResultsAs of August 2022, Peru had recorded a total of 3,838,028 COVID-19 positive cases and 215,023 deaths due to COVID-19. Our analysis revealed a statistically significant negative association between altitude and COVID-19 incidence (aBETA: −0.004; Standard Error: 0.001; p < 0.05). Moreover, we observed a positive association between population density and incidence (aBETA: 0.006; Standard Error: 0.001; p < 0.05). However, we found no significant association between the percentage of population in total poverty and COVID-19 incidence. ConclusionOur study found that an increase in altitude was associated with a decrease in COVID-19 incidence, while an increase in population density was associated with an increase in COVID-19 incidence. High altitude, population density and percentage of population in total poverty does not change case-fatality rate due to COVID-19.