Hypocalcemia associated with adverse outcomes in patients hospitalized with COVID-19

Researchers have found in a new study that Hypocalcemia is associated with adverse outcomes in patients hospitalized with COVID-19.

The new study conducted by Alessandro Minasi and team found that serum calcium observed on admission was negatively associated with proinflammatory indicators of severe COVID-19 and can be used to better characterize risk stratification for poor in-hospital outcomes.

The findings of this study were published in Endocrine Journal.

Numerous biological activities are regulated by calcium ions, and they may potentially have an impact on viral replication. In patients with critical illnesses and infectious infections, including those with COVID-19, hypocalcemia has been often described. It is strongly correlated with mortality and a pro-inflammatory condition. The purpose of this study was to ascertain the prevalence of hypocalcemia upon admission in COVID-19 (Coronavirus disease 2019) hospitalized patients and to assess the relationship between hypocalcemia and COVID-19 in-hospital outcomes.

Review of 118 patients who were hospitalized for COVID-19 between March and May 2020. At admission, data on the patient's clinical features, inflammatory indicators, biochemical routine, and mineral metabolism parameters were gathered. Total serum calcium levels under 2.2 mmol/L were considered hypocalcemic. Tertiles of total serum calcium were used to stratify the population. The primary outcome was a composite of in-hospital mortality or ICU admission (ICU). In-hospital deaths, ICU admissions, and the requirement for non-invasive breathing were all considered secondary outcomes. Cox-regression analysis and logistic regression were used with survival curves to test associations.

The key findings of this study were:

1. Only 6.7% of patients had levels of 25-(OH)-vitamin D more than 30 ng/ml, resulting in a 76.6% incidence of hypocalcemia overall.

2. Total serum calcium was negatively correlated (p 0.05) with a number of inflammatory indicators and a worse COVID-19 hospital outcome.

3. When compared to other groups, those with lower tertiles of total calcium (2.02 mmol/L) had an increased risk of in-hospital mortality (HR 2.77; 1.28–6.03, p = 0.01).

Reference:

Minasi, A., Andreadi, A., Maiorino, A., Giudice, L., De Taddeo, S., D'Ippolito, I., de Guido, I., Laitano, R., Romano, M., Ruotolo, V., Magrini, A., Di Daniele, N., Rogliani, P., Bellia, A., & Lauro, D. (2022). Hypocalcemia is associated with adverse outcomes in patients hospitalized with COVID-19. Endocrine. https://doi.org/10.1007/s12020-022-03239-w