Hypocalcemia in Covid-۱۹: A Prognostic Marker for Severe Disease

Background & Objective:  Previous studies have addressed the electrolyte abnormalitiessuch as hypocalcemiain COVID-۱۹ patients. We aimed to compare the laboratory findings especially the electrolyte levels amongCOVID-۱۹ patients and healthy controls and evaluate their prognostic values. Materials and Methods: This case-control study included ۹۱ COVID-۱۹ patients and ۱۶۹ healthy individuals. Their laboratory parameters including electrolytes, albumin, liver enzymes, complete blood count, vitamin D, and parathyroid hormone (PTH) were compared. We also analyzed the association between these markers and the major outcomes including severity, mortality and hospitalization. Results: Among patients with COVID-۱۹, ۵۹.۳% of the patients had hypocalcemia on admission while in control group only ۳۲.۵% had low calcium level (OR=۳.۰۲, ۹۵% CI: ۱.۷۹-۵.۱۳, p <۰.۰۰۱). The rates of death and ICU admission were significantly higher among the patients in hypocalcemic group than those of eucalcemic group (۸۵.۷% vs ۱۴.۳% and ۳۳.۳% Vs ۹.۱%, respectively). However, there was no significant difference in the mean PTH and vitamin D levels between the two groups. In terms of the severity of the infection, ۷۴.۱% of patients in hypocalcemic group had a severe infection while ۲۴.۳% of the patients in eucalcemic group were diagnosed with severe infection (OR=۸.۸۹, ۹۵% CI: ۳.۳۸-۲۳.۳۷, p <۰.۰۰۱). Conclusion: Patients with COVID-۱۹ had considerable laboratory abnormalities including hypocalcemia. The hypocalcemia was also associated with worse major clinical outcomes and higher mortality risk.

Keywords:

Albumin , COVID-۱۹ , Clinical severity , Electrolyte -imbalances , Hypocalcemia , Parathyroid hormone , Prognosis , Vitamin D