Longitudinal Monitoring of Lactate in Hospitalized and Ambulatory COVID-19 Patients

Am J Trop Med Hyg. 2021 Jan 11;104(3):1041-1044. doi: 10.4269/ajtmh.20-1282.


Hypoxemia is readily detectable by assessing SpO2 levels, and these are important in optimizing COVID-19 patient management. Hyperlactatemia is a marker of tissue hypoxia, particularly in patients with increased oxygen requirement and microvascular obstruction. We monitored peripheral venous lactate concentrations in hospitalized patients with moderate to severe COVID-19 (n = 18) and in mild ambulatory COVID-19 patients in home quarantine (n = 16). Whole blood lactate decreased significantly during the clinical course and recovery in hospitalized patients (P = 0.008). The blood lactate levels were significantly higher in hospitalized patients than ambulatory patients (day 1: hospitalized versus ambulatory patients P = 0.002; day 28: hospitalized versus ambulatory patients P = < 0.0001). Elevated lactate levels may be helpful in risk stratification, and serial monitoring of lactate may prove useful in the care of hospitalized COVID-19 patients.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care Facilities / statistics & numerical data*
  • Biomarkers / blood
  • COVID-19 / epidemiology
  • COVID-19 / physiopathology*
  • Comorbidity
  • Female
  • Germany / epidemiology
  • Hospitalization / statistics & numerical data*
  • Humans
  • Hypoxia / blood
  • Lactic Acid / blood*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Oxygen Saturation
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult


  • Biomarkers
  • Lactic Acid