Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Biosci Rep. 2023 Mar 29;43(3). doi: 10.1042/BSR20222362.
Severe coronavirus disease 2019 (COVID-19) infection can lead to extensive lung infiltrate, a significant increase in the respiratory rate, and respiratory failure, which can affect the acid-base balance. No research in the Middle East has previously examined acid-base imbalance in COVID-19 patients. The present study aimed to describe the acid-base imbalance in hospitalized COVID-19 patients, determine its causes, and assess its impact on mortality in a Jordanian hospital. The study divided patients into 11 groups based on arterial blood gas data. Patients in normal group were defined as having a pH of 7.35-7.45, PaCO2 of 35-45 mmHg, and HCO3- of 21-27 mEq/L. Other patients were divided into 10 additional groups: mixed acidosis and alkalosis, respiratory and metabolic acidosis with or without compensation, and respiratory and metabolic alkalosis with or without compensation. This is the first study to categorize patients in this way. The results showed that acid-base imbalance was a significant risk factor for mortality (P<0.0001). Mixed acidosis nearly quadruples the risk of death when compared with those with normal levels (OR = 3.61, P=0.05). Furthermore, the risk of death was twice as high (OR = 2) for metabolic acidosis with respiratory compensation (P=0.002), respiratory alkalosis with metabolic compensation (P=0.002), or respiratory acidosis with no compensation (P=0.002). In conclusion, acid-base abnormalities, particularly mixed metabolic and respiratory acidosis, were associated with increased mortality in hospitalized COVID-19 patients. Clinicians should be aware of the significance of these abnormalities and address their underlying causes.
严重的 2019 年冠状病毒病（COVID-19）感染可导致广泛的肺部浸润、呼吸频率显著增加和呼吸衰竭，从而影响酸碱平衡。以前在中东没有研究检查过 COVID-19 患者的酸碱失衡。本研究旨在描述住院 COVID-19 患者的酸碱失衡，确定其原因，并评估其对约旦一家医院死亡率的影响。该研究根据动脉血气数据将患者分为 11 组。正常组的患者定义为 pH 值为 7.35-7.45、PaCO2 为 35-45mmHg 和 HCO3-为 21-27mEq/L。其他患者分为 10 个附加组：混合性酸中毒和碱中毒、有或无代偿的呼吸性和代谢性酸中毒以及有或无代偿的呼吸性和代谢性碱中毒。这是首次以这种方式对患者进行分类的研究。结果表明，酸碱失衡是死亡的显著危险因素（P<0.0001）。与正常水平相比，混合性酸中毒使死亡风险增加近四倍（OR=3.61，P=0.05）。此外，代谢性酸中毒伴有呼吸代偿（OR=2，P=0.002）、呼吸性碱中毒伴有代谢代偿（P=0.002）或呼吸性酸中毒无代偿（P=0.002）的死亡风险均增加一倍。总之，酸碱异常，特别是混合性代谢性和呼吸性酸中毒，与住院 COVID-19 患者的死亡率增加相关。临床医生应该意识到这些异常的重要性，并解决其根本原因。
