Coronavirus disease (COVID-19) infection, after the first case reported in Wuhan, China, on December 31, 2019 and declared a pandemic by the World Health Organization in March 2020, has climbed by September 2nd to 26,076,572 cases and 864,162 deaths worldwide. Although it has been suggested that living at high altitude could decrease the rate of coronavirus transmission and mortality from COVID-19 (Arias-Reyes et al., 2020), new studies have not confirmed this protective effect. In fact, the case–fatality rate in Peru did not change with altitude (Segovia-Juarez et al., 2020).

Coronavirus disease 19 (COVID-19) is a pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It is suggested that life at high altitude may reduce COVID-19 infections and case-fatality rates (cases/deaths). We study data from Peru COVID-19 pandemics, which first case was recorded on March 6th, 2020. By June 13, 2020 there were 6498 deaths, and 224,132 SARS-CoV-2 positives. Using data from 185 capitals of provinces with altitudes ranging from 3 to 4342 m, we confirm previous reports that infection with COVID-19 at high altitude is reduced. However, case-fatality rate is not dependent of altitude. We have also presented first evidence that female protection towards death by COVID-19 is reduced as altitude of residence increases. © 2020 Elsevier B.V.