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Establishment of an Extracellular Acidic pH Culture System
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Bicarbonate concentration as a predictor of prognosis in moderately severe COVID-19 patients: A multicenter

Ken-Ei Sada1,2,3, Ryohei Yamamoto4, Akihiko Yano3

  • 1Department of Clinical Epidemiology, Kochi Medical School, Kochi University, Nankoku, Japan.

Plos One
|June 24, 2022
PubMed

Insights

High or low bicarbonate levels in Coronavirus disease 2019 (COVID-19) patients are linked to increased clinical worsening, including intubation or death. Monitoring bicarbonate may help predict COVID-19 patient prognosis.

Area of Science:

  • Clinical Medicine
  • Biochemistry
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) patients exhibit elevated bicarbonate concentrations.
  • The precise relationship between bicarbonate levels and COVID-19 disease progression remains unclear.

Purpose of the Study:

  • To investigate the association between bicarbonate concentrations and clinical worsening in COVID-19 patients.
  • To determine if bicarbonate levels can serve as a prognostic marker for COVID-19 severity.

Main Methods:

  • A retrospective study involving 60 moderate-severity COVID-19 patients between March 2020 and May 2021.
  • Patients were categorized into high (>27 mEq/L), normal (21-27 mEq/L), and low (<21 mEq/L) bicarbonate groups.
  • Multivariable Cox proportional hazard models assessed the primary outcome: time to clinical worsening (intubation or death within 90 days).

Main Results:

  • Clinical worsening occurred in 54% of the high bicarbonate group, 23% of the normal group, and 65% of the low bicarbonate group.
  • Both high (HR: 3.02) and low (HR: 3.49) bicarbonate concentrations were significantly associated with increased rates of clinical worsening.
  • The study included 60 participants with a median age of 72 years, 60% of whom were male.

Conclusions:

  • Both elevated and reduced bicarbonate levels are associated with a higher risk of clinical worsening in COVID-19 patients.
  • Bicarbonate concentration monitoring could be a valuable tool for predicting prognosis in COVID-19 patients.
Abstract

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