Serum calcium as a biomarker of clinical severity and prognosis in patients with coronavirus disease 2019
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- 25 June 2020
- journal article
- research article
- Published by Impact Journals, LLC in Aging
- Vol. 12 (12), 11287-11295
- https://doi.org/10.18632/aging.103526
Abstract
The aim of this study was to investigate the correlations between serum calcium and clinical outcomes in patients with coronavirus disease 2019 ( COVID-19). In this retrospective study, serum calcium levels, hormone levels and clinical laboratory parameters on admission were recorded. The clinical outcome variables were also recorded. From February 10 to February 28, 2020, 241 patients were enrolled. Of these patients, 180 (74.7%) had hypocalcemia on admission. The median serum calcium levels were 2.12 (IQR, 2.04-2.20) mmol/L, median parathyroid hormone (PTH) levels were 55.27 (IQR, 42.73-73.15) pg/mL, and median 25-hydroxyvitamin D (VD) levels were 10.20 (IQR, 8.20-12.65) ng/mL. The serum calcium levels were significantly positively correlated with VD levels (P = 0.004) but negatively correlated with PTH levels (P = 0.048). Patients with lower serum calcium levels (especially <= 2.0 mmol/L) had worse clinical parameters, higher incidences of organ injury and septic shock, and higher 28-day mortality. The areas under the receiver operating characteristic curves of multiple organ dysfunction syndrome, septic shock, and 28-day mortality were 0.923 (P < 0.001), 0.905 (P = 0.001), and 0.929 (P < 0.001), respectively. In conclusion, serum calcium was associated with the clinical severity and prognosis of patients with COVID-19. Hypocalcemia may be associated with imbalanced VD and PTH levels.Keywords
This publication has 17 references indexed in Scilit:
- A Novel Coronavirus from Patients with Pneumonia in China, 2019The New England Journal of Medicine, 2020
- Importance of vitamin D in acute and critically ill children with subgroup analyses of sepsis and respiratory tract infections: a systematic review and meta-analysisBMJ Open, 2019
- Serum calcium as an indicator of persistent organ failure in acute pancreatitisThe American Journal of Emergency Medicine, 2017
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016Critical Care Medicine, 2017
- ACG Clinical Guideline: Evaluation of Abnormal Liver ChemistriesThe American Journal of Gastroenterology, 2017
- Risk factors and prognosis of hypoalbuminemia in surgical septic patientsPeerJ, 2015
- Acute Respiratory Distress SyndromeJAMA, 2012
- ForewordKidney International Supplements, 2012
- Hypocalcemia in the Critically Ill patientJournal of Intensive Care Medicine, 2011
- Hypocalcemia in Patients with Acute Pancreatitis: A Putative Role for Systemic Endotoxin ExposurePancreas, 2003