Zemlin, Annalise E;
Sigwadhi, Lovemore N;
Wiese, Owen J;
Jalavu, Thumeka P;
Chapanduka, Zivanai C;
Allwood, Brian W;
Tamuzi, Jacques L;
... Nyasulu, Peter S; + view all
(2023)
The association between acid–base status and clinical outcome in critically ill COVID-19 patients admitted to intensive care unit with an emphasis on high anion gap metabolic acidosis.
Annals of Clinical Biochemistry
, 60
(2)
pp. 86-91.
10.1177/00045632221134687.
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Abstract
Objective: The aim of this study was to identify arterial blood gas (ABG) abnormalities, with a focus on a high anion gap (AG) metabolic acidosis and evaluate outcomes in coronavirus disease 2019 (COVID-19) patients admitted to the ICU. Methods: A retrospective, observational study was conducted in a tertiary hospital in Cape Town during the first and second COVID-19 waves. Age, gender, sodium (Na), potassium (K), chloride (Cl), bicarbonate (HCO<inf>3</inf>std), pH, partial pressure of carbon dioxide (pCO<inf>2</inf>), creatinine, estimated glomerular filtration rate (eGFR), lactate levels and ABG results were obtained. The Pearson χ2 test or Fisher exact test and the Wilcoxon rank-sum test were used to compare mortality and survival. To identify factors associated with non-survival, a multivariable model was developed. Results: This study included 465 patients, 226 (48%) of whom were female. The sample population’s median (IQR) age was 54.2 (46.1–61.3) years, and 63% of the patients died. ABG analyses found that 283 (61%) of the 465 patients had alkalosis (pH ≥ 7.45), 65 (14%) had acidosis (pH ≤ 7.35) and 117 (25%) had normal pH (7.35–7.45). In the group with alkalosis, 199 (70.3%) had a metabolic alkalosis and in the group with acidosis, 42 (64%) had a metabolic acidosis with an increased AG of more than 17. Non-survivors were older than survivors (56.4 years versus 50.3 years, p <.001). Conclusion: Most of the COVID-19 patients admitted to the ICU had an alkalosis, and those with acidosis had a much worse prognosis. Higher AG metabolic acidosis was not associated with patients’ characteristics.
| Type: | Article |
|---|---|
| Title: | The association between acid–base status and clinical outcome in critically ill COVID-19 patients admitted to intensive care unit with an emphasis on high anion gap metabolic acidosis |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/00045632221134687 |
| Publisher version: | https://doi.org/10.1177/00045632221134687 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | acid-base, ALL-CAUSE MORTALITY, arterial blood gas, COVID-19, intensive care unit, Life Sciences & Biomedicine, Medical Laboratory Technology, SARS-CoV-2, Science & Technology |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10210153 |
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