{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:10:18Z","timestamp":1760238618087,"version":"build-2065373602"},"reference-count":17,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Institute of Intensive Care Medicine, University Hospital of Zurich","award":["DA1209\/4-3","DA1209\/7-1","310030 208100"],"award-info":[{"award-number":["DA1209\/4-3","DA1209\/7-1","310030 208100"]}]},{"name":"the DFG","award":["DA1209\/4-3","DA1209\/7-1","310030 208100"],"award-info":[{"award-number":["DA1209\/4-3","DA1209\/7-1","310030 208100"]}]},{"name":"Schweizerischer Nationalfonds","award":["DA1209\/4-3","DA1209\/7-1","310030 208100"],"award-info":[{"award-number":["DA1209\/4-3","DA1209\/7-1","310030 208100"]}]},{"name":"the Deutsches Zentrum Lungenforschung (DZL)","award":["DA1209\/4-3","DA1209\/7-1","310030 208100"],"award-info":[{"award-number":["DA1209\/4-3","DA1209\/7-1","310030 208100"]}]},{"name":"Terumo","award":["DA1209\/4-3","DA1209\/7-1","310030 208100"],"award-info":[{"award-number":["DA1209\/4-3","DA1209\/7-1","310030 208100"]}]},{"name":"Octapharma","award":["DA1209\/4-3","DA1209\/7-1","310030 208100"],"award-info":[{"award-number":["DA1209\/4-3","DA1209\/7-1","310030 208100"]}]},{"name":"Cytosorbents","award":["DA1209\/4-3","DA1209\/7-1","310030 208100"],"award-info":[{"award-number":["DA1209\/4-3","DA1209\/7-1","310030 208100"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Renal tubular acidosis (RTA) is an extremely rare cause of metabolic acidosis (10 in 100,000). RTA has been linked neither to pregnancy nor to severe coronavirus disease 2019 (COVID-19). The purpose of this study was to analyze the prevalence and clinical course of normal anion gap metabolic acidosis in critically ill pregnant COVID-19 patients and to compare them to an age-matched nonpregnant female patient cohort. Methods: Secondary analysis was conducted on a prospective observational cohort of critically ill patients suffering from COVID-19 consecutively admitted to a tertiary intensive care unit (ICU) between February 2020 and April 2021. Results: A total of 321 COVID-19 patients required admission to the ICU; 95 (30%) were female, and 18 (19%) were of childbearing age. Seven of eight (88%) pregnant women (all in the last trimester) required advanced respiratory support due to COVID-19. The estimated glomerular filtration rate was 135 (123\u2013158) mL\/min\/m2 body surface area, and six pregnant women (86%) were diagnosed with a normal, respiratory compensated, anion gap metabolic acidosis (pHmin 7.3 (7.18\u20137.31), HCO3\u2212min 14.8 (12.8\u201318.6) mmol\/L, and paCO2 3.4 (3.3\u20134.5) kPa). Three (43%) acidotic pregnant women fulfilled diagnostic criteria for RTA. All women recovered spontaneously within less 7 days. Conclusions: Metabolic acidosis seems to be very common (85%) in pregnant critically ill COVID-19 patients, and the prevalence of RTA might be higher than normal. It remains to be demonstrated if this observation is an indirect epiphenomenon or due to a direct viral effect on the tubular epithelium.<\/jats:p>","DOI":"10.3390\/jcm11154273","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T12:53:45Z","timestamp":1658494425000},"page":"4273","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Renal Tubular Acidosis in Pregnant Critically Ill COVID-19 Patients: A Secondary Analysis of a Prospective Cohort"],"prefix":"10.3390","volume":"11","author":[{"given":"Simona","family":"Humbel","sequence":"first","affiliation":[{"name":"Institute of Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro David","family":"Wendel-Garcia","sequence":"additional","affiliation":[{"name":"Institute of Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Unseld","sequence":"additional","affiliation":[{"name":"Institute of Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5718-8003","authenticated-orcid":false,"given":"Fabienne","family":"Noll","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reto Andreas","family":"Schuepbach","sequence":"additional","affiliation":[{"name":"Institute of Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph Camille","family":"Ganter","sequence":"additional","affiliation":[{"name":"Institute of Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harald","family":"Seeger","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8231-0461","authenticated-orcid":false,"given":"Sascha","family":"David","sequence":"additional","affiliation":[{"name":"Institute of Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8694-1271","authenticated-orcid":false,"given":"Rea","family":"Andermatt","sequence":"additional","affiliation":[{"name":"Institute of Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102745","DOI":"10.1016\/j.amsu.2021.102745","article-title":"Coronavirus disease 2019 (COVID-19): Multisystem review of pathophysiology","volume":"69","author":"Mir","year":"2021","journal-title":"Ann. 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