Physico-chemical characterization of acid base disorders in patients with COVID-19: A cohort study.

Autor:	de Souza SP; Department of Nephrology, Hospital São Rafael, Salvador, BA 41253190, Brazil.; Department of Nephrology, D'Or Institute for Research and Education (IDOR), Salvador, BA 41253190, Brazil.; Faculty of Medicine, Escola Bahiana de Medicina e Saúde Pública-EBMSP, Salvador, BA 40290000, Brazil. souzasp@gmail.com., Caldas JR; Department of Intensive Care, D'Or Institute for Research and Education (IDOR), Salvador, BA 41253190, Brazil., Lopes MB; Department of Nephrology, Hospital São Rafael, Salvador, BA 41253190, Brazil.; Department of Nephrology, D'Or Institute for Research and Education (IDOR), Salvador, BA 41253190, Brazil., Duarte Silveira MA; Department of Nephrology, Hospital São Rafael, Salvador, BA 41253190, Brazil.; Department of Nephrology, D'Or Institute for Research and Education (IDOR), Salvador, BA 41253190, Brazil., Coelho FO; Department of Nephrology, Hospital São Rafael, Salvador, BA 41253190, Brazil.; Department of Nephrology, D'Or Institute for Research and Education (IDOR), Salvador, BA 41253190, Brazil., Oliveira Queiroz I; Hospital São Rafael, D'Or Institute for Research and Education (IDOR), Salvador, BA 41253190, Brazil., Domingues Cury P; Hospital São Rafael, D'Or Institute for Research and Education (IDOR), Salvador, BA 41253190, Brazil., Passos RDH; Department of Intensive Care Unit, Hospital Israelita Albert Einstein, Sao Paulo, SP 05652900, Brazil.
Jazyk:	angličtina
Zdroj:	World journal of nephrology [World J Nephrol] 2024 Jun 25; Vol. 13 (2), pp. 92498.
DOI:	10.5527/wjn.v13.i2.92498
Abstrakt:	Background: Acid-base imbalance has been poorly described in patients with coronavirus disease 2019 (COVID-19). Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution that may have been overlooked using traditional acid-base analysis techniques. In a cohort of critically ill COVID-19 patients, we looked for an association between metabolic acidosis surrogates and worse clinical outcomes, such as mortality, renal dialysis, and length of hospital stay. Aim: To describe the acid-base disorders of critically ill COVID-19 patients using Stewart's approach, associating its variables with poor outcomes. Methods: This study pertained to a retrospective cohort comprised of adult patients who experienced an intensive care unit stay exceeding 4 days and who were diagnosed with severe acute respiratory syndrome coronavirus 2 infection through a positive polymerase chain reaction analysis of a nasal swab and typical pulmonary involvement observed in chest computed tomography scan. Laboratory and clinical data were obtained from electronic records. Categorical variables were compared using Fisher's exact test. Continuous data were presented as median and interquartile range. The Mann-Whitney U test was used for comparisons. Results: In total, 211 patients were analyzed. The mortality rate was 13.7%. Overall, 149 patients (70.6%) presented with alkalosis, 28 patients (13.3%) had acidosis, and the remaining 34 patients (16.2%) had a normal arterial pondus hydrogenii. Of those presenting with acidosis, most had a low apparent strong ion difference (SID) (20 patients, 9.5%). Within the group with alkalosis, 128 patients (61.0%) had respiratory origin. The non-survivors were older, had more comorbidities, and had higher Charlson's and simplified acute physiology score 3. We did not find severe acid-base imbalance in this population. The analyzed Stewart's variables (effective SID, apparent SID, and strong ion gap and the effect of albumin, lactate, phosphorus, and chloride) were not different between the groups. Conclusion: Alkalemia is prevalent in COVID-19 patients. Although we did not find an association between acid-base variables and mortality, the use of Stewart's methodology may provide insights into this severe disease. Competing Interests: Conflict-of-interest statement: All the authors declare that they have no conflicts of interest related to the manuscript. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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