Lower Blood pH as a High Predisposing Factor for a Fatal Outcome in Critically Ill COVID-19 Patients at Intensive Care Unit: a Multivariable Analysis

Abstract Background: Data of critically ill COVID-19 patients are being evaluated worldwide, not only to understand the various aspects of this disease and to refine treatment strategies but also to improve clinical decision-making. For the last aspect in particular, predictors of a lethal course of disease would be highly relevant.Methods:In this retrospective cohort study, we analyzed the first 59 adult critically ill Covid-19 patients treated in one of the intensive care units of the University Medical Center Regensburg, Germany. Using uni- and multivariable regression models, we extracted a set of parameters that allowed predictions of in-hospital mortality.Results:Blood pH value, mean arterial pressure, base excess, troponin, and procalcitonin were identified as highly significant predictors (p < 0.001) of in-hospital mortality. In the multivariable logistic regression analysis, the pH value and the mean arterial pressure turned out to be the most influential predictors and thus predisposing factors for a lethal course.Conclusions:We developed a formula that enables the easy calculation of the probability of a fatal outcome in COVID-19 intensive care patients. Currently a follow-up study with a larger group of patients is in progress to re-evaluate the established predictors.