Hypocalcemia and hypoalbuminemia during COVID-19 infection: Opportunities for therapeutic intervention

Singh, Vijay; Khatua, Biswajit; El-Kurdi, Bara

doi:10.1016/j.jiph.2020.09.019

Cited by 5 publications

(4 citation statements)

References 10 publications

(14 reference statements)

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“… 30 Timely supplementation of calcium has been suggested in severe COVID-19 patients to prevent organ failure as an early diagnosis and treatment of hypocalcemia may alleviate organ injury. 31 …”

Section: Discussionmentioning

confidence: 99%

Association between Hypocalcemia and Outcome in COVID-19 Patients: A Retrospective Study

et al. 2022

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Background Calcium has been shown to play a vital role in the pathophysiology of severe acute respiratory syndrome-coronavirus-2 and middle east respiratory syndrome coronavirus diseases, but less is known about hypocalcemia in coronavirus disease 2019 (COVID-19) patients and its association with the disease severity and the final outcome. Therefore, this study was conducted with an aim to assess clinical features in COVID-19 patients having hypocalcemia and to observe its impact on COVID-19 disease severity and the final outcome. Methods In this retrospective study, consecutive COVID-19 patients of all age groups were enrolled. Demographical, clinical, and laboratory details were collected and analyzed. On the basis of albumin-corrected calcium levels, patients were classified into normocalcemic (n = 51) and hypocalcemic (n = 110) groups. Death was the primary outcome. Results The mean age of patients in the hypocalcemic group was significantly lower (p < 0.05). A significantly higher number of hypocalcemic patients had severe COVID-19 infection (92.73%; p < 0.01), had comorbidities (82.73%, p < 0.05), and required ventilator support (39.09%; p < 0.01) compared with normocalcemic patients. The mortality rate was significantly higher in the hypocalcemic patients (33.63%; p < 0.05). Hemoglobin (p < 0.01), hematocrit (p < 0.01), and red cell count (p < 0.01) were significantly lower with higher levels of absolute neutrophil count (ANC; p < 0.05) and neutrophil-to-lymphocyte ratio (NLR; p < 0.01) in the hypocalcemic patients.Albumin-corrected calcium levels had a significant positive correlation with hemoglobin levels, hematocrit, red cell count, total protein, albumin, and albumin-to-globulin ratio and a significant negative correlation with ANC and NLR. Conclusion The disease severity, ventilator requirement, and mortality were considerably higher in hypocalcemic COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Association between Hypocalcemia and Outcome in COVID-19 Patients: A Retrospective Study

et al. 2022

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“…Hospitalized patients with serum ionised calcium level below 4.80 mg/dl have increased risk of acute respiratory failure and had more requirement of mechanical ventilation [30]. Timely supplementation of calcium has been suggested in severe COVID-19 patients to prevent organ failure as an early diagnosis and treatment of hypocalcemia may alleviate organ injury [31].…”

Section: Discussionmentioning

confidence: 99%

The Association Between Hypocalcemia and Outcome in COVID-19 Patients: a Retrospective Study

Patidar

Mukhopadhayay

Subramanian

et al. 2021

Preprint

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Background: Calcium has been shown to have a vital role in the pathophysiology of SARS-CoV and MERS-CoV diseases but less is known about hypocalcemia in COVID-19 patients and its association with the disease severity and the final outcome. Therefore, this study was conducted with an aim to assess the clinical features in the COVID-19 patients having hypocalcemia and to observe its impact on COVID-19 disease severity and final outcome.Method: In this retrospective study, consecutive COVID-19 patients of all age groups were enrolled. Demographical, clinical and laboratory details were collected and analysed. On the basis of albumin-corrected calcium level patients were classified into normocalcemic (n=51) and hypocalcemic (n=110). Death was the primary outcome. Results: The mean age of hypocalcemic were significantly lower (p<0.05). A significantly higher number of normocalcemic patients had severe COVID-19 disease(92.73%, p<0.01), had comorbidities (82.73%, p<0.05) and required ventilator support(39.09%, p<0.01)compared to the hypocalcemic patients. The mortality rate was significantly higher (33.63%, p<0.05) in the hypocalcemic patients when compared with the normocalcemic patients (15.69%). Haemoglobin (p<0.01), hematocrit (p<0.01) and red cell count (p<0.01) were significantly lower with higher levels of absolute neutrophil count (<0.05) and neutrophil to lymphocyte ratio (p<0.01) in the hypocalcemic patients. Albumin-corrected calcium level had a significant positive correlation with haemoglobin level, haematocrit, red cell count, total protein, albumin and albumin to globulin ratio and a significant negative correlation with absolute neutrophil count and neutrophil to lymphocyte ratio.Conclusion: The disease severity, ventilator requirement and mortality were considerably higher in hypocalcemic COVID-19 patients.

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“…Singh et al, en relación con el artículo de Liu et al, reforzaron el papel de la hipocalcemia, la hipoalbuminemia y la tormenta de citocinas en la severidad de la insuficiencia respiratoria por COVID-19, de manera que la suplementación precoz de calcio y albúmina, con el objetivo de mantener sus niveles normales, pudiera prevenir la progresión a la infección grave y que si esta acción se lleva a cabo fuera de este período no tendría ningún valor. 24 Torres et al reportaron la alta frecuencia de hipocalcemia en los pacientes hospitalizados con COVID-19 (63 %) y que permite la predicción de un peor pronóstico si ella se constata en las primeras 72 horas del ingreso. 25 Además, el grupo con hipocalcemia requirió alto soporte de oxígeno durante la hospitalización (49%) al compararlo con el grupo normocalcémico (32 %) y tuvieron más ingresos en UCI (42% vs 26%; p=0,005), sin que hubiera diferencias en la mortalidad entre los grupos.…”

Section: Discussionunclassified

Valor predictivo de la hipocalcemia en el diagnóstico de la insuficiencia respiratoria aguda en COVID-19 en un hospital de segundo nivel de atención

Santana-Téllez¹,

García²,

Águila-Grández³

2021

spmi

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Objetivo. Demostrar la validez de la hipocalcemia para predecir la gravedad de la insuficiencia respiratoria en pacientes con COVID-19. Materiales y métodos. Estudio tipo cohorte prospectivo, en 267 pacientes hospitalizados en la Unidad de Cuidados Intermedios del Hospital II EsSalud Pucallpa, entre enero y junio de 2021. Se extrajeron datos demográficos, clínicos y laboratoriales de las historias clínicas individuales. Se utilizó análisis multivariado para identificar las variables asociadas a la insuficiencia respiratoria aguda. Resultados. De los 267 pacientes, el 61 % tuvo hipocalcemia al ingreso. En este grupo predominaron la tos seca, fatiga y dolor torácico; la fiebre y la disnea en la totalidad de los pacientes. La principal comorbilidad fue la obesidad.Tanto la frecuencia respiratoria  30 rpm como la SaO2  93 % fueron más frecuentes en este grupo. Hubo relación inversa entre la hipocalcemia y la elevación de ciertos parámetros considerados marcadores inflamatorios; además de una mayor tasa de PaFiO2 anormal. Se constató una buena concordancia entre la hipocalcemia y los resultados de la PaFiO2 (índice Kappa de Cohen = 0,63). Conclusiones. La hipocalcemia puede considerarse un factor predictor de insuficiencia respiratoria grave en pacientes con COVID-19.

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Hypocalcemia and hypoalbuminemia during COVID-19 infection: Opportunities for therapeutic intervention

Cited by 5 publications

References 10 publications

Association between Hypocalcemia and Outcome in COVID-19 Patients: A Retrospective Study

Association between Hypocalcemia and Outcome in COVID-19 Patients: A Retrospective Study

The Association Between Hypocalcemia and Outcome in COVID-19 Patients: a Retrospective Study

Valor predictivo de la hipocalcemia en el diagnóstico de la insuficiencia respiratoria aguda en COVID-19 en un hospital de segundo nivel de atención

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Hypocalcemia and hypoalbuminemia during COVID-19 infection: Opportunities for therapeutic intervention

Cited by 5 publications

References 10 publications

Association between Hypocalcemia and Outcome in COVID-19 Patients: A Retrospective Study

Association between Hypocalcemia and Outcome in COVID-19 Patients: A Retrospective Study

The Association Between Hypocalcemia and Outcome in COVID-19&nbsp;Patients: a Retrospective Study

Valor predictivo de la hipocalcemia en el diagnóstico de la insuficiencia respiratoria aguda en COVID-19 en un hospital de segundo nivel de atención

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The Association Between Hypocalcemia and Outcome in COVID-19 Patients: a Retrospective Study