Hasan Savran shows how you can use the Cosmos DB SDK to create ACID transactions:
What about Azure Cosmos DB? It’s a NoSQL database, probably you can’t do ACID Transactions right? WRONG! Azure Cosmos DB has been supporting ACID transaction for some time now. We were able to create ACID transactions by using stored procedures of Cosmos DB. Last year (2019) Cosmos DB team introduced ACID transactions to Cosmos DB SDK. Now, we can create transactions by using C# just like writing transactions by using SQLClient class for SQL Server!
To create an ACID transaction in Cosmos DB SDK, we need to use TransactionalBatch object. You need add all operations in transaction to TransactionalBatch object. All the operations attached to the TransactionalBatch object must share the same partition key. In the following example, I created three objects and attach them to TransactionalBatch object. To start the transaction, I ran the ExecuteAsync() function. This function runs the transaction and returns the responses for each operation.
I’d think you would need to set a strong consistency level as well.