The Role of Acidosis in the Pathogenesis of Severe Forms of COVID-19

Abstract

COVID-19 has specific characteristics that distinguish this disease from many other infections. We suggest that the pathogenesis of severe forms of COVID-19 can be associated with acidosis. This review article discusses several mechanisms potentially linking the damaging effects of COVID-19 with acidosis and shows the existence of a vicious cycle between the development of hypoxia and acidosis in COVID-19 patients. At the early stages of the disease, inflammation, difficulty in gas exchange in the lungs and thrombosis collectively contribute to the onset of acidosis. In accordance with the Verigo-Bohr effect, a decrease in blood pH leads to a decrease in oxygen saturation, which contributes to the exacerbation of acidosis and results in a deterioration of the patient’s condition. A decrease in pH can also cause conformational changes in the S-protein of the virus and thus lead to a decrease in the affinity and avidity of protective antibodies. Hypoxia and acidosis lead to dysregulation of the immune system and multidirectional pro- and anti-inflammatory reactions, resulting in the development of a “cytokine storm”. In this review, we highlight the potential importance of supporting normal blood pH as an approach to COVID-19 therapy.

A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications

“…These obviously include breathlessness due to low O 2 directly, and thrombotic events such as acute myocardial infarction [180,181], stroke [181][182][183], etc due to the microclots. The lack of O 2 transport to tissues explains straightforwardly how a nominally respiratory disease also leads to the dysfunction of organs such as the kidney [184,185], PoTS ( postural tachycardia syndrome [186]), myalgia in skeletal muscle [187,188], neurological disorders [189], and lactic acidosis [190,191] (the mass of lactate is too low to have been detected in our own COVID untargeted metabolomics experiments [192]), and potentially the benefits of hyperbaric O 2 therapy [193]. It is also worth stressing that amyloid structures themselves tend to be cytotoxic, often via membrane disruption [194][195][196][197][198].…”

COVID-19-Associated Candidiasis: Possible Patho-Mechanism, Predisposing Factors, and Prevention Strategies

“…to manipulate and evade the host immune system [ 71 , 73 , 80 ]. COVID-19 patients with poor clinical outcomes or severe cases were found to have elevated levels of blood lactate [ 81 ] and increased levels of acid in blood and body tissues, i.e., acidosis [ 82 ]. When Candida spp.…”

Connections between Orthopedic Conditions and Oxidative Stress: Current Perspective and the Possible Relevance of Other Factors, Such as Metabolic Implications, Antibiotic Resistance, and COVID-19

“…It is known that diabetes triggers an exaggerated inflammatory syndrome, which suggests that in combination with an autoimmune disease, such as RA, the outcome could be fatal. The decrease in oxygen saturation leads to increased acidosis, which in turn might change the conformation of the virus’ S-protein and lower the antibody affinity and protection [ 68 , 69 ]. Prolonged studies across Europe have reported that populations aged 18 and younger were more likely to receive a diabetes diagnosis after more than 30 days post-infection, whereas in the general population it is a common complication to receive a type 1 diabetes diagnosis or an increase in diabetic ketoacidosis [ 32 ].…”