• A Pagano, G Porta, G Bosso, E Allegorico, C Serra, V Mercurio, G Sansone, S Orefice, and F G Numis.
• Emergency Department, Santa Maria delle Grazie Hospital, ASL Napoli 2 Nord, Via Domitiana località La Schiana Pozzuoli, Naples, Italy. Electronic address: antoniopag82@gmail.com.it.
• Am J Emerg Med. 2023 Apr 1; 66: 737573-75.

Background And ObjectivesElevated blood lactate levels are associated with poor outcome in several critical conditions. Patients with SARS-CoV-2 rarely develop hyperlactatemia. The purpose of this study is to evaluate the trend of lactatemia in patients affected by mild/moderate SARS-Co V-2-ARDS and if it affected prognosis.MethodsWe analyzed blood lactate levels in thirty-eight patients with severe SARS-CoV-2 infection admitted to COVID Care Unit of Santa Maria delle Grazie Hospital, Pozzuoli.ResultsTwenty patients survived and were discharged at home and 18 patients died. Despite severe hypoxia that affected all patients enrolled, T0 lactate was within normal values. All survivors showed a significant increase in lactate concentration the day prior to clinical improvement. In not-survivors levels of lactate did not increase significantly.ConclusionIn our study, patients who survive SARS CoV-2 ARDS have a fleeting increase in lactate, which precedes clinical improvement by one day.Copyright © 2023 Elsevier Inc. All rights reserved.

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