Acid base disorders in patients with COVID-19

Area of Science:

• Critical care medicine
• Pulmonology
• Nephrology

Background:

• Acid-base derangements are not well-documented in coronavirus disease 2019 (COVID-19).
• Given the high incidence of pneumonia and kidney injury in COVID-19, frequent acid-base disturbances are anticipated in patients with SARS-CoV-2 infection.

Purpose of the Study:

• To determine the prevalence of acid-base disorders in symptomatic patients diagnosed with COVID-19.

Main Methods:

• A retrospective analysis of 211 hospitalized COVID-19 patients at the University Hospital of Modena.
• Arterial blood gas (ABG) analysis was performed, with the first measurement selected for subjects with multiple samples.
• Acidemia was defined as pH < 7.37 and alkalemia as pH > 7.43.

Main Results:

• Low arterial partial pressure of oxygen (PO2) and oxygen saturation (SO2) were observed.
• Acid-base alterations were present in 79.7% of patients.
• Metabolic alkalosis (33.6%) and respiratory alkalosis (30.3%) were the most common findings, followed by combined alkalosis (9.4%). Respiratory acidosis (3.3%) and metabolic acidosis (2.8%) were less frequent. All six patients with metabolic acidosis did not survive.

Conclusions:

• The majority of hospitalized COVID-19 patients (79.7%) exhibited acid-base variations.
• All types of acid-base disorders were observed, with metabolic and respiratory alkalosis being the most prevalent in this cohort.