ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO026

Impact of Metabolic Acidosis on All-Cause Mortality in Patients With COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Kim, Yaerim, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Kwon, Soie, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Lee, Jeonghwan, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Seoul, Korea (the Republic of)
  • Paek, Jin hyuk, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Park, Woo Yeong, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Jin, Kyubok, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Han, Seungyeup, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Seoul, Korea (the Republic of)
Background

Low total CO2 (tCO2) levels are significantly associated with all-cause mortality. Lots of factors are related to the poor prognosis of COVID-19, it was a lack of data to evaluate the impact of tCO2. We evaluated the impact of metabolic acidosis on all-cause mortality in patients with COVID-19.

Methods

We retrospectively reviewed the data from two independent hospitals that care for admitted patients with COVID-19 between February 2020 and September 2021. We excluded subjects with underlying end-stage kidney disease, no data of tCO2 value, and age under 18 years old. The primary outcome was in-hospital mortality. We evaluate the impact of tCO2 as a continuous variable on mortality using the Cox-proportional hazard model. In addition, we tried to find the relative value of tCO2 to increase the risk of mortality using a generalized additive model. We also evaluated the impact of such a value of tCO2 and 22mEq/L of tCO2 on mortality.

Results

A total of 4,423 patients were included, and the mean age was 54.7±18.3 years old. Mean tCO2 was 26.2±3.6 mEq/L, and there were 792 (17.9%) with tCO2 <22 mEq/L. Increased in 1 mEq/L of tCO2 significantly decreased risk for all-cause mortality after adjustment with age, sex, history of hypertension, diabetes, and laboratory results such as serum white blood count, hemoglobin, platelet, calcium, phosphate, albumin, and eGFR (adjusted HR 0.95, 95% CI 0.91, 0.99). We found that the level of 24 mEq/L of tCO2 as a cut-off value to increase risk of mortality. In the Cox-proportional hazard model, the risk of all-cause mortality was significantly increased by around 1.6 times in subjects with lower tCO2 irrespective of the cut-off value of 22 or 24 mEq/L.

Conclusion

Decreased tCO2 significantly increased the risk of all-cause mortality in patients with COVID-19. Monitoring of tCO2 could be a good indicator to predict prognosis, and it needs to be considered to encourage in patients with a specific condition.