Geographic components of SARS-CoV-2 expansion: a hypothesis

Research output: Contribution to journalReview articlepeer-review

2 Citations (Scopus)


The emergence of COVID-19 infection (caused by the SARS-CoV-2 virus) in Wuhan, China in the latter part of 2019 has, within a relatively short time, led to a global pandemic. Amidst the initial spread of SARS-CoV-2 across Asia, an epidemiologic trend emerged in relation to high altitude (HA) populations. Compared with the rest of Asia, SARS-CoV-2 exhibited attenuated rates of expansion with limited COVID-19 infection severity along the Tibetan plateau. These characteristics were soon evident in additional HA regions across Bolivia, central Ecuador, Nepal, Bhutan, and the Sichuan province of mainland China. This mini-review presents a discussion surrounding attributes of the HA environment, aspects of HA physiology, as well as, genetic variations among HA populations which may provide clues for this pattern of SARS-CoV-2 expansion and COVID-19 infection severity. Explanations are provided in the hypothetical, albeit relevant historical evidence is provided to create a foundation for future research.

Original languageEnglish
Pages (from-to)257-262
Number of pages6
JournalJournal of Applied Physiology
Issue number2
Early online date23 Jul 2020
Publication statusPublished - 1 Aug 2020

Bibliographical note

Publisher Copyright:
© 2020 the American Physiological Society


  • COVID-19
  • High altitude
  • Hypoxia
  • SARS-CoV-2
  • Peptidyl-Dipeptidase A/metabolism
  • Humans
  • Bolivia/epidemiology
  • Coronavirus Infections/diagnosis
  • Nepal/epidemiology
  • Angiotensin-Converting Enzyme 2
  • Betacoronavirus
  • Pandemics/statistics & numerical data
  • China/epidemiology
  • Pneumonia, Viral/diagnosis
  • Altitude

ASJC Scopus subject areas

  • Physiology (medical)
  • Physiology


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