Arterial Blood Gas Analysis of Critically Ill Corona Virus Disease 2019 Patients

Abstract

Background/Aims: The aim of present study was to find out profile and sequential pattern of Arterial Blood Gas (ABG) in critically ill Corona Virus Disease 2019 (COVID-19) patients. Study Design: Observational prospective study. Methodology: A total of 80 Reverse Transcription Polymerase Chain Reaction (RT PCR) positive cases; that needed ICU admission for their life-threatening conditions were included in this study done at teaching hospital of Gujarat, India. Non consenting patients and patients who could not be followed up as per protocol were excluded. Data of Arterial Blood Gas (ABG), performed on admission, day 5 and day 10 were taken for the analysis. Patients were followed up till they remained in ICU. Results: Of 80 patients, 3 patients had normal, 24 patients (30%) had primary disorder on ABG while 53 patients (66.25%) had mixed disorders. The most common ABG abnormality observed was respiratory alkalosis with metabolic acidosis in 16 patients (20%) while respiratory alkalosis with metabolic alkalosis in 15 patients (18.75%). There was difference in ABG pattern observed among survivors and non-survivors (P=.04); of which conspicuous was presence of “respiratory acidosis with metabolic acidosis” in 5 non-survivors (15.63%), which was not seen in survivors. Of 80 patients admitted in COVID ICU; 2 improved after day 1; 6 after day 5; 40 after day 10, making total of 48 patients surviving COVID critical condition. Of 32 non-survivors, 14 died within twenty-four hours of admission, 14 within first 5 days and 04 after 10 days of ICU stay. Conclusion: ABG done on admission and serially in severe COVID-19 patients gives useful information on underlying pathophysiology. Mixed ABG pattern was more common than single disorder which can be sign of multi-organ involvement.  Respiratory acidosis with metabolic acidosis was observed significantly higher in non-survivors. Respiratory alkalosis as a part of single or mixed pattern on ABG was the most common pattern found in critically ill COVID patients.