<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1012-2966</journal-id>
<journal-title><![CDATA[Gaceta Médica Boliviana]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Med Bol]]></abbrev-journal-title>
<issn>1012-2966</issn>
<publisher>
<publisher-name><![CDATA[Facultad de Medicina de la Universidad Mayor de San Simón]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1012-29662025000200057</article-id>
<article-id pub-id-type="doi">10.47993/gmb.v48i2.1058</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Niñas, niños y jóvenes hospitalizados por COVID-19 a diferentes altitudes]]></article-title>
<article-title xml:lang="en"><![CDATA[Children and youth hospitalized for COVID-19 at different altitudes: a case series]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hilari]]></surname>
<given-names><![CDATA[Caroline H.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paz]]></surname>
<given-names><![CDATA[Wayra C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Johnson]]></surname>
<given-names><![CDATA[Brian B.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arce Chuquimia]]></surname>
<given-names><![CDATA[José C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ávalos]]></surname>
<given-names><![CDATA[Isabel L.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ)  ]]></institution>
<addr-line><![CDATA[La Paz ]]></addr-line>
<country>Bolivia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>48</volume>
<numero>2</numero>
<fpage>57</fpage>
<lpage>64</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_arttext&amp;pid=S1012-29662025000200057&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_abstract&amp;pid=S1012-29662025000200057&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_pdf&amp;pid=S1012-29662025000200057&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivos:  analizar la gravedad de la evolución clínica de la COVID-19 en niños, adolescentes y adultos jóvenes de ambos sexos hospitalizados en diferentes altitudes de Bolivia entre 2020 y 2023.  Método:  se realizó un estudio retrospectivo de serie de casos con 412 pacientes de ambos sexos de 0 a 24 años, hospitalizados con diagnóstico de COVID-19. Se describió el manejo clínico y se analizaron las variables sexo, edad, ola pandémica, altitud, enfermedades preexistentes y signos y síntomas al ingreso. Se utilizó un modelo de regresión logística multivariable para identificar los factores asociados con el desarrollo de una evolución severa o crítica de la COVID-19.  Resultados:  el 45,9% (n=189) de los pacientes presentó una evolución severa o crítica de la COVID-19 durante la hospitalización. Se observó un mayor riesgo en pacientes que vivían a gran altitud (OR: 3,05; p &lt; 0,001; IC del 95%: 1,65-5,62) y en aquellos con disnea al ingreso (OR: 3,39; p &lt; 0,001; IC del 95%: 2,03-5,66).  Conclusiones:  vivir a gran altitud se asoció con un mayor riesgo de desarrollar una evolución severa o crítica de COVID-19 en niños y jóvenes hospitalizados. Se necesitan más investigaciones para determinar de forma concluyente si el riesgo relacionado con la altitud se debe principalmente a factores biológicos o sociales.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective:  to analyze the severity of the clinical course of COVID-19 in children and youth, hospitalized across different altitudes in Bolivia between 2020 and 2023.  Methods:  A retrospective case series was conducted on 412 patients of both sexes between 0-24 years of age, hospitalized with a COVID-19 diagnosis. Clinical management was described, and the variables sex, age, pandemic wave, altitude level, preexisting conditions, and signs and symptoms at admission were analyzed. A multivariate logistic regression model was used to identify factors associated with the development of severe or critical course of COVID-19.  Results:  A severe or critical course of COVID-19 developed in 45.9% (n=189) of patients during hospitalization. Higher risk was found in patients living at very high altitudes (OR 3,05; p&lt;0,001; 95% CI 1,65-5,62) and those with dyspnea at admission (OR 3,39; p&lt;0,001; 95% CI 2.03-5.66).  Conclusions:  Living at very high altitudes was associated with an increased risk of developing a severe or critical course of COVID-19 in hospitalized children and youth. Further research is needed to conclusively determine whether the altitude-related risk is primarily due to biological or social factors.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[adolescente]]></kwd>
<kwd lng="es"><![CDATA[adulto joven]]></kwd>
<kwd lng="es"><![CDATA[altura sobre el nivel del mar]]></kwd>
<kwd lng="es"><![CDATA[atención hospitalaria]]></kwd>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[niño]]></kwd>
<kwd lng="en"><![CDATA[adolescent]]></kwd>
<kwd lng="en"><![CDATA[young adult]]></kwd>
<kwd lng="en"><![CDATA[altitude]]></kwd>
<kwd lng="en"><![CDATA[hospitalization]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[child]]></kwd>
</kwd-group>
</article-meta>
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