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Uncompensated metabolic acidosis in Covid-19 patients- treat to prevent intubation

The COVID-19 pandemic has affected 245,373,039 people globally with a death toll bearing 4,979,421 deaths to date [1]. It can be a cause of life-threatening metabolic acidosis that merits discussion [2]. Approximately 79.7% COVID affected individuals suffer acid-base disproportion [2]. According to a study, 2.8% of this total percentage is attributed to metabolic acidosis with 100% mortality at the end of follow up [2]. Various risk factors predispose a patient with COVID-19 to metabolic acidosis. SARS-CoV-2 infection is associated with grievous dysregulated inflammation (cytokine storm) involving the lungs [3]. With the engagement of the lung parenchyma, hypoxemia ensues, which increases the risk of fatal metabolic acidosis. Not to forget the role of sepsis in hypoperfusion, eventually inflicting metabolic acidosis. SARS-CoV-2 can directly or via sepsis trigger acute kidney injury giving rise to secondary metabolic acidosis in infected patients. Affected patients are at risk of acute liver failure due to the direct involvement of the liver during active infection which is another cause. Furthermore, in patients with diabetes mellitus who suffer from COVID-19, the use of corticosteroids to treat the infection is a potent inducer of diabetic ketoacidosis that predisposes to metabolic acidosis.