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. 2022 Feb;54(2):405-410.
doi: 10.1007/s11255-021-02855-1. Epub 2021 Jun 11.

Acid base disorders in patients with COVID-19

Gaetano Alfano  1   2   3 , Francesco Fontana  4 , Giacomo Mori  4 , Francesco Giaroni  5 , Annachiara Ferrari  5 , Silvia Giovanella  5   6 , Giulia Ligabue  5 , Elisabetta Ascione  4 , Silvia Cazzato  5 , Marco Ballestri  4 , Margherita Di Gaetano  7 , Marianna Meschiari  7 , Marianna Menozzi  7 , Jovana Milic  6   7 , Bedini Andrea  7 , Erica Franceschini  7 , Gianluca Cuomo  7 , Riccardo Magistroni  5   4 , Cristina Mussini  7 , Gianni Cappelli  5   4 , Giovanni Guaraldi  7 ; Modena Covid-19 Working Group (MoCo19)
Collaborators, Affiliations

Acid base disorders in patients with COVID-19

Gaetano Alfano et al. Int Urol Nephrol. 2022 Feb.

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 (PO2, 70.2 ± 25.1 mmHg), oxygen saturation (SO2, 92%) and a mild reduction of PO2/FiO2 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.

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Conflict of interest statement

The authors declare no conflict of interests.

Figures

Fig. 1
Fig. 1
Distribution of acid–base disorders in patients with COVID-19
See this image and copyright information in PMC

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