Acid base disorders in patients with COVID-19

• Published in: International urology and nephrology Vol. 54; no. 2; pp. 405 - 410
• Main Authors: Alfano, Gaetano, Fontana, Francesco, Mori, Giacomo, Giaroni, Francesco, Ferrari, Annachiara, Giovanella, Silvia, Ligabue, Giulia, Ascione, Elisabetta, Cazzato, Silvia, Ballestri, Marco, Di Gaetano, Margherita, Meschiari, Marianna, Menozzi, Marianna, Milic, Jovana, Andrea, Bedini, Franceschini, Erica, Cuomo, Gianluca, Magistroni, Riccardo, Mussini, Cristina, Cappelli, Gianni, Guaraldi, Giovanni
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.02.2022; Springer Nature B.V
• Subjects: Acid-Base Imbalance - diagnosis; Acid-Base Imbalance - epidemiology; Acid-Base Imbalance - virology; Acidosis; Acids; Aged; Aged, 80 and over; Alkalosis; Blood Gas Analysis; Blood pressure; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - metabolism; COVID-19 - mortality; Female; Hospitalization; Humans; Italy; Male; Medicine; Medicine & Public Health; Metabolic acidosis; Metabolism; Middle Aged; Nephrology; Nephrology - Original Paper; Oxygen; Patients; pH effects; Retrospective Studies; Risk Factors; Severe acute respiratory syndrome coronavirus 2; Survival Rate; Urology; Italy; Kidney disease; SARS-CoV-2; Acid–base equilibrium; Acid lactic; Metabolic acidosis; Alkalosis
• ISSN: 0301-1623; 1573-2584; 1573-2584
• DOI: 10.1007/s11255-021-02855-1

Purpose Acid–base derangement has been poorly described in patients with coronavirus disease 2019 (COVID-19). Considering the high prevalence of pneumonia and kidneys injury in COVID-19, frequent acid–base alterations are expected in patients admitted with SARS-Cov-2 infection. The study aimed to assess the prevalence of acid–base disorders in symptomatic patients with a diagnosis of COVID-19. Methods The retrospective study enrolled COVID-19 patients hospitalized at the University Hospital of Modena from 4 March to 20 June 2020. Baseline arterial blood gas (ABG) analysis was collected in 211 patients. In subjects with multiple ABG analysis, we selected only the first measurement. A pH of less than 7.37 was categorized as acidemia and a pH of more than 7.43 was categorized as alkalemia. Results ABG analyses revealed a low arterial partial pressure of oxygen (PO 2 , 70.2 ± 25.1 mmHg), oxygen saturation (SO 2 , 92%) and a mild reduction of PO 2 /FiO 2 ratio (231 ± 129). Acid–base alterations were found in 79.7% of the patient. Metabolic alkalosis (33.6%) was the main alteration followed by respiratory alkalosis (30.3%), combined alkalosis (9.4%), respiratory acidosis (3.3%), metabolic acidosis (2.8%) and other compensated acid–base disturbances (3.6%). All six patients with metabolic acidosis died at the end of the follow-up. Conclusion Variations of pH occurred in the majority (79.7%) of patients admitted with COVID-19. The patients experienced all the type of acid–base disorders, notably metabolic and respiratory alkalosis were the most common alterations in this group of patients.