Sanghani Hiren, Bansal Sumit, Parmar Vijaysinh, Shah Rima
Department of Biochemistry, Shantabaa Medical College and General Hospital, Amreli, IND.
Anesthesiology, Max Super Speciality Hospital, Patparganj, New Delhi, IND.
Cureus. 2022 Jul 10;14(7):e26715. doi: 10.7759/cureus.26715. eCollection 2022 Jul.
Background The high prevalence of pneumonia and renal involvement in coronavirus disease 2019 (COVID-19) leads to frequent acid-base abnormalities in serious patients and affects prognosis. In this study, we aimed to assess the arterial blood gas (ABG) and acid-base patterns in COVID-19 patients admitted to a tertiary care hospital. Methodology A retrospective observational study was conducted in a designated COVID-19 hospital involving 267 reverse transcription-polymerasechain reaction-positive COVID-19 patients. Demographic and laboratory data including ABG data within the first day after admission and in patients with multiple ABG analyses, only the first measurement was collected and analyzed statistically, including its association with comorbidities. Results The most common age group of the patients was 51-60 years (30.8%), with a male predominance (male:female = 2.7:1). The most common comorbidities were hypertension, diabetes mellitus, and chronic obstructive pulmonary disease found in 147 (55%) COVID-19 patients. Alkalosis and acidosis were observed in 145 (54.3%) and 50 (18.7%) patients, respectively. The most common ABG abnormality observed was primary respiratory alkalosis with secondary metabolic acidosis in 67 (25.1%) patients, followed by primary respiratory alkalosis with secondary metabolic alkalosis in 54 (20.2%) patients. Statistically significant negative correlation was found with PaCO and pH (r = -0.530, p < 0.0001), statistically significant positive correlation was found between pH and base (r = 0.533, p < 0.0001), pH and TCO (r = 0.260, p < 0.0001), and pH and HCO (r = 0.354, p < 0.0001). Conclusions Acid-base abnormalities are commonly encountered in COVID-19 patients. Respiratory alkalosis as a part of a single or mixed pattern on ABG was the most common pattern found in critically ill COVID-19 patients. ABG on admission in moderate-to-severe COVID-19 patients can help in the early correction of metabolic abnormalities leading to improved patient outcomes.
2019冠状病毒病（COVID-19）中肺炎和肾脏受累的高发生率导致重症患者频繁出现酸碱异常，并影响预后。在本研究中，我们旨在评估一家三级医院收治的COVID-19患者的动脉血气（ABG）和酸碱模式。
在一家指定的COVID-19医院进行了一项回顾性观察研究，纳入267例逆转录-聚合酶链反应阳性的COVID-19患者。收集人口统计学和实验室数据，包括入院后第一天的ABG数据，对于进行多次ABG分析的患者，仅收集并统计分析首次测量数据，包括其与合并症的关联。
患者最常见的年龄组为51 - 60岁（30.8%），男性占优势（男:女 = 2.7:1）。147例（55%）COVID-19患者中最常见的合并症为高血压、糖尿病和慢性阻塞性肺疾病。分别有145例（54.3%）和50例（18.7%）患者观察到碱中毒和酸中毒。观察到的最常见ABG异常是67例（25.1%）患者出现原发性呼吸性碱中毒伴继发性代谢性酸中毒，其次是54例（20.2%）患者出现原发性呼吸性碱中毒伴继发性代谢性碱中毒。发现PaCO₂与pH呈显著负相关（r = -0.530，p < 0.0001），pH与碱（r = 0.533，p < 0.0001）、pH与总二氧化碳（TCO₂）（r = 0.260，p < 0.0001）以及pH与碳酸氢根（HCO₃⁻）（r = 0.354，p < 0.0001）之间呈显著正相关。
COVID-19患者中常见酸碱异常。ABG显示呼吸性碱中毒作为单一或混合模式的一部分是重症COVID-19患者中最常见的模式。中重度COVID-19患者入院时的ABG有助于早期纠正代谢异常，从而改善患者预后。
