Association Between Respiratory Alkalosis and the Prognosis of COVID-19 Patients.

Chenfang Wu,Guobao Wu,Yanjun Zhong,Quan Zhang,Guyi Wang,Shangjie Wu,Siye Zhang,Jianlei Lv,Bo Yu

doi:10.3389/fmed.2021.564635

Abstract

Aim: The aim of the study was to describe the clinical characteristics of patients with or without respiratory alkalosis, and analyze the relationship of respiratory alkalosis and the outcome of adult coronavirus disease 2019 (COVID-19) patients.Methods: Clinical and laboratory data of adult COVID-19 patients in a single center in China, were retrospectively collected and analyzed. The Kaplan-Meier (KM) curve and cox regression were adopted to analyze the association between respiratory alkalosis and prognosis of COVID-19 patients.Results: Of 230 adult COVID-19 patients, 66 patients (28.7%) had respiratory alkalosis on admission. Of 66 patients, the median age was 53 years old (range, 21–84 years), and 43 (65.2%) were female. Compared with those without respiratory alkalosis, patients with respiratory alkalosis were significantly older (P = 0.002), had a higher proportion of female (P = 0.004), and showed higher ratios of underlying diseases including hypertension (P = 0.023) and cardiovascular disease (P = 0.028). Moreover, they demonstrated higher proportion of severe events (P = 0.001). Patients with respiratory alkalosis had a higher possibility of developing severe events compared with those without respiratory alkalosis (Log Rank P = 0.001). After adjusting for gender, age, and comorbidities, patients with respiratory alkalosis still showed significantly elevated risks of developing to severe cases (HR 2.445, 95% CI 1.307–4.571, P = 0.005) using cox regression analyses.Conclusions: Respiratory alkalosis as a common acid—base disorder in COVID-19 patients, was associated with a higher risk of developing severe event.

Highlights

Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China, at December 2019 [1,2,3,4,5], has spread widely and rapidly around the world [6, 7]
We sought to present the clinical characteristics of COVID-19 patients with or without respiratory alkalosis, and analyze the association between respiratory alkalosis and the outcomes of COVID19 patients
After adjusting for gender, age and common comorbidities, patients with respiratory alkalosis still showed significantly elevated risks of developing to severe cases than those without respiratory alkalosis (HR 2.445, 95% confidence interval (95% CI) 1.307–4.571, P = 0.005) (Table 3)

Summary

Introduction

Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China, at December 2019 [1,2,3,4,5], has spread widely and rapidly around the world [6, 7]. Respiratory alkalosis as the most common acid—base imbalance in clinical practice, is generally induced by a process involving hyperventilation, which include hypoxemic causes, pulmonary diseases and central diseases. Some COVID-19 patients showed hypoxemia and dyspnea, but the incidence of respiratory acid-base disorders and their relations with the prognosis of COVID19 remained unknown. To address this question, we sought to present the clinical characteristics of COVID-19 patients with or without respiratory alkalosis, and analyze the association between respiratory alkalosis and the outcomes of COVID19 patients

Objectives

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Conclusion