tetano
Editor, Senior Moderator
Int Urol Nephrol
. 2021 Jun 11.
doi: 10.1007/s11255-021-02855-1. Online ahead of print.
Acid base disorders in patients with COVID-19
Gaetano Alfano[SUP] 1 2 3 [/SUP], Francesco Fontana[SUP] 4 [/SUP], Giacomo Mori[SUP] 4 [/SUP], Francesco Giaroni[SUP] 5 [/SUP], Annachiara Ferrari[SUP] 5 [/SUP], Silvia Giovanella[SUP] 5 6 [/SUP], Giulia Ligabue[SUP] 5 [/SUP], Elisabetta Ascione[SUP] 4 [/SUP], Silvia Cazzato[SUP] 5 [/SUP], Marco Ballestri[SUP] 4 [/SUP], Margherita Di Gaetano[SUP] 7 [/SUP], Marianna Meschiari[SUP] 7 [/SUP], Marianna Menozzi[SUP] 7 [/SUP], Jovana Milic[SUP] 6 7 [/SUP], Bedini Andrea[SUP] 7 [/SUP], Erica Franceschini[SUP] 7 [/SUP], Gianluca Cuomo[SUP] 7 [/SUP], Riccardo Magistroni[SUP] 5 4 [/SUP], Cristina Mussini[SUP] 7 [/SUP], Gianni Cappelli[SUP] 5 4 [/SUP], Giovanni Guaraldi[SUP] 7 [/SUP], Modena Covid-19 Working Group (MoCo19)
Collaborators, Affiliations
Abstract
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[SUB]2[/SUB], 70.2 ± 25.1 mmHg), oxygen saturation (SO[SUB]2[/SUB], 92%) and a mild reduction of PO[SUB]2[/SUB]/FiO[SUB]2[/SUB] 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.
Keywords: Acid lactic; Acid–base equilibrium; Alkalosis; Kidney disease; Metabolic acidosis; SARS-CoV-2.
. 2021 Jun 11.
doi: 10.1007/s11255-021-02855-1. Online ahead of print.
Acid base disorders in patients with COVID-19
Gaetano Alfano[SUP] 1 2 3 [/SUP], Francesco Fontana[SUP] 4 [/SUP], Giacomo Mori[SUP] 4 [/SUP], Francesco Giaroni[SUP] 5 [/SUP], Annachiara Ferrari[SUP] 5 [/SUP], Silvia Giovanella[SUP] 5 6 [/SUP], Giulia Ligabue[SUP] 5 [/SUP], Elisabetta Ascione[SUP] 4 [/SUP], Silvia Cazzato[SUP] 5 [/SUP], Marco Ballestri[SUP] 4 [/SUP], Margherita Di Gaetano[SUP] 7 [/SUP], Marianna Meschiari[SUP] 7 [/SUP], Marianna Menozzi[SUP] 7 [/SUP], Jovana Milic[SUP] 6 7 [/SUP], Bedini Andrea[SUP] 7 [/SUP], Erica Franceschini[SUP] 7 [/SUP], Gianluca Cuomo[SUP] 7 [/SUP], Riccardo Magistroni[SUP] 5 4 [/SUP], Cristina Mussini[SUP] 7 [/SUP], Gianni Cappelli[SUP] 5 4 [/SUP], Giovanni Guaraldi[SUP] 7 [/SUP], Modena Covid-19 Working Group (MoCo19)
Collaborators, Affiliations
- PMID: 34115260
- DOI: 10.1007/s11255-021-02855-1
Abstract
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[SUB]2[/SUB], 70.2 ± 25.1 mmHg), oxygen saturation (SO[SUB]2[/SUB], 92%) and a mild reduction of PO[SUB]2[/SUB]/FiO[SUB]2[/SUB] 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.
Keywords: Acid lactic; Acid–base equilibrium; Alkalosis; Kidney disease; Metabolic acidosis; SARS-CoV-2.