Assessment of Prevalence and Prognostic Value of Acid-Base and Electrolyte Imbalances in ICU-Admitted Severe COVID-19 Patients

Abstract

Background: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, is a global health crisis with diverse clinical manifestations. One of the common complications of COVID-19 is the disturbance of the acid-base and electrolyte balance, which can significantly impact disease severity and mortality risk. Objectives: This study aimed to investigate the prevalence and prognostic value of these disturbances among COVID-19 patients admitted to the intensive care unit (ICU). Methods: This retrospective study included 250 patients with severe COVID-19 admitted to the ICU. Patients were classified into different groups based on their pH, potassium (K), and sodium (Na) levels. Patient demographic, clinical, and laboratory data were collected upon admission. Results: The majority of the patients (50.4%) exhibited alkalosis (high pH), likely due to respiratory compensation through the excretion of carbon dioxide. Additionally, 74.8% of the patients had mild hypokalemia (low K). There was a significant association between hypokalemia and mortality (P < 0.05). The most frequent combination of disturbances observed was respiratory alkalosis with hypokalemia accompanied by hyponatremia (low Na). Furthermore, pH and Na levels showed a significant correlation with the need for mechanical ventilation (P < 0.05). Conclusions: The assessment of acid-base and electrolyte balance is crucial for predicting disease progression and outcomes in COVID-19 patients. The high prevalence of alkalosis, hypokalemia, and hyponatremia in this study underscores the importance of careful monitoring and management of these imbalances in the ICU setting to optimize patient care.