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Observational Study
. 2021 Mar;58(2):95-101.
doi: 10.1177/0004563220972539. Epub 2020 Nov 20.

Correlating arterial blood gas, acid-base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients

Morne C Bezuidenhout  1 , Owen J Wiese  1 , Desiree Moodley  2 , Elizna Maasdorp  2 , Mogamat R Davids  2 , Coenraad Fn Koegelenberg  2 , Usha Lalla  2 , Aye A Khine-Wamono  1 , Annalise E Zemlin  1 , Brian W Allwood  2
Affiliations
Observational Study

Correlating arterial blood gas, acid-base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients

Morne C Bezuidenhout et al. Ann Clin Biochem. 2021 Mar.

Erratum in

  • Correction to Bezuidenhout et al. (2021).
    [No authors listed] [No authors listed] Ann Clin Biochem. 2022 Mar;59(2):152. doi: 10.1177/00045632221077327. Ann Clin Biochem. 2022. PMID: 35189722 Free PMC article. No abstract available.

Abstract

Background: During the outbreak of coronavirus disease 2019 (COVID-19), many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas, acid-base and blood pressure patterns. The aim of the study is to assess the arterial blood gas and acid-base patterns, blood pressure findings and their association with the outcomes of COVID-19 patients admitted to an intensive care unit.

Methods: A single-centre retrospective, observational study in a dedicated COVID-19 intensive care unit in Cape Town, South Africa. Admission arterial blood gas, serum electrolytes, renal function and blood pressure readings performed on COVID-19 patients admitted between 26 March and 2 June 2020 were analysed and compared between survivors and non-survivors.

Results: A total of 56 intensive care unit patients had admission arterial blood gas performed at the time of intensive care unit admission. An alkalaemia (pH > 7.45) was observed in 36 (64.3%) patients. A higher arterial pH (median 7.48 [interquartile range: 7.45-7.51] versus 7.46 [interquartile range: 7.40-7.48], P = 0.049) and partial pressure of oxygen in arterial blood (median 7.9 kPa [interquartile range: 7.3-9.6] versus 6.5 kPa [interquartile range: 5.2-7.3], P = <0.001) were significantly associated with survival. Survivors also tended to have a higher systolic blood pressure (median: 144 mmHg [interquartile range: 134-152] versus 139 mmHg [interquartile range: 125-142], P = 0.078) and higher arterial HCO3 (median: 28.0 mmol/L [interquartile range: 25.7-28.8] versus 26.3 mmol/L [interquartile range: 24.3-27.9], P = 0.059).

Conclusions: The majority of the study population admitted to intensive care unit had an alkalaemia on arterial blood gas. A higher pH and lower partial pressure of oxygen in arterial blood on arterial blood gas analysis were significantly associated with survival.

Keywords: COVID-19; SARS-CoV-2; acid–base; blood gas; critical care.

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