Affiliation:
1. University of Rome Tor Vergata Department of Medicine of the systems: Universita degli Studi di Roma Tor Vergata Dipartimento di Medicina dei Sistemi
2. University of Rome Tor Vergata Department of Experimental Medicine and Surgery: Universita degli Studi di Roma Tor Vergata Dipartimento di Medicina Sperimentale
3. University of Rome Tor Vergata Department of Biomedicine and Prevention: Universita degli Studi di Roma Tor Vergata Dipartimento di Biomedicina e Prevenzione
Abstract
Abstract
Purpose
Calcium ions are involved in the regulation of several cellular processes and may also influence viral replication. Hypocalcemia has been frequently reported during infectious diseases and in critically ill patients, significantly related with the pro-inflammatory state and mortality. The aim of this study is to investigate the prevalence of hypocalcemia at admission in patients hospitalized for COVID-19 (Coronavirus disease 2019) and to evaluate association of hypocalcemia with in-hospital COVID-19 outcomes.
Methods
Retrospective analysis on 118 consecutive patients, hospitalized for COVID-19 between March and May 2020. Clinical characteristics, inflammation markers, biochemical routine and mineral metabolism parameters at admission were collected. Hypocalcemia was defined as total serum calcium < 2.2 mmol/L. Population was stratified by tertiles of total serum calcium. Primary outcome was the composite of in-hospital death or admission to intensive care unit (ICU). Secondary outcomes included in-hospital death, admission to ICU and need for non-invasive ventilation as separate events. Associations were tested by logistic regression and Cox-regression analysis with survival curves.
Results
Overall prevalence of hypocalcemia was 76.6%, with just 6.7% of patients reporting levels of 25-(OH)-vitamin D > 30 ng/ml. Total serum calcium was inversely related with selected inflammatory biomarkers (p < 0.05) and poorer outcome of COVID-19 during hospitalization. Lower tertile of total calcium (≤ 2.02 mmol/L) had increased risk of in-hospital mortality (HR 2.77; 1.28–6.03, p = 0.01) compared with other groups.
Conclusion
Total serum calcium detected on admission is inversely related with proinflammatory biomarkers of severe COVID-19 and may be useful to better define risk stratification for adverse in-hospital outcome.
Publisher
Research Square Platform LLC