Low levels of total and ionized calcium in blood of COVID-19 patients

Cappellini, Fabrizio; Brivio, Rinaldo; Casati, Marco; Cavallero, Annalisa; Contro, Ernesto; Brambilla, Paolo

doi:10.1515/cclm-2020-0611

Cited by 90 publications

(98 citation statements)

References 7 publications

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“…In a previous study, lower calcium levels were reported in patients positive to SARS-CoV-2 RT-qPCR test as compared to negative patients, hypothesizing a direct influence of viral infection on calcium metabolism [ 4 ]. However, no comparative clinical data were reported and thus also in this case a possible influence of differences in disease severity on calcium levels could not be excluded.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, in patients positive for nasopharyngeal swabs SARS-CoV-2 real-time reverse-transcriptase polymerase chain reaction (RT-qPCR) test, lower total and ionized calcium levels as compared to those admitted in ED with same clinical signs and symptoms and negative to RT-qPCR test were reported [ 4 ]. However, no clinical, biochemical, and disease severity parameters were reported for these two groups making difficult an accurate comparison.…”

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confidence: 99%

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Hypocalcemia is a distinctive biochemical feature of hospitalized COVID-19 patients

et al. 2020

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Hypocalcemia is a distinctive biochemical feature of hospitalized COVID-19 patients

et al. 2020

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“…Calcium was reported as a key role in viral fusion for many enveloped viruses such as SARS-CoV, MERS-CoV and Ebola virus [21]. Low levels of serum total and ionized calcium were reported in COVID-19 patients [22]. Hypocalcemia had already shown to be common in patients with SARS and in patients with Ebola virus disease, and may occur also in COVID-19 [21].…”

Section: Discussionmentioning

confidence: 99%

Associations of blood essential and toxic metal(loid)s with both disease severity and mortality in patients with COVID-19: a retrospective study

Zeng

Yang

Yuan

et al. 2020

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Background The variations and dynamics of blood essential and toxic metal(loid)s in patients with COVID-19 still remains unclear.Methods A retrospective study was performed in a cohort of confirmed COVID-19 patients for their whole blood levels of essential and/or toxic metal(loid)s including magnesium, calcium, chromium, manganese, iron, copper, zinc, arsenic, cadmium, mercury, thallium and lead according to the disease severity and outcome.Results Compared to the non-severe COVID-19 patients, Whole blood calcium, chromium and copper were higher in the severe patients, while magnesium, manganese, iron, zinc, arsenic, thallium and lead were lower. These differences were further found to be consistently existed across the clinical course since the disease onset by longitudinal analysis. Moreover, among the severe patients, chromium and cadmium were higher in the deceased group compared to the recovered group, while arsenic were found to be lower. Whole blood iron, arsenic, and age and sex were determined to be independently factors associated with the disease severity, while chromium, cadmium and the co-morbidity of cardiovascular disease were determined to be independently factors associated with the mortality.Conclusions These results suggest variations of whole blood metal(loid)s as associated factors correlated with the disease severity and mortality for COVID-19.

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“…A report showed that 70% acutely ill patients had decreased levels of serum calcium which is associated with a poor prognosis (6). Previous studies of COVID -19 patients showed that severe/critical cases with electrolyte disturbance including calcium unbalance (7,8), hypokalemia in COVID-19 patients had been associated with ECG changes including long QT (9,10). But the role of abnormal calcium level in COVID-19 is unknown.…”

Section: Introductionmentioning

confidence: 99%

Low serum calcium: a new, important indicator of COVID-19 patients from mild/moderate to severe/critical

et al. 2020

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Background: Coronavirus disease 2019 (COVID-19) virus is still spreading, finding out the initial hits of viral infection is important to minimize the mild/moderate population, prevent disease aggravation and organs dysfunction. Objective: We investigated COVID-19 patients with different serum calcium levels. Design: We checked the serum calcium level of the patients based on days after symptom onset as well as the severity of COVID-19. We also checkeed multi-organ injuries and immune cytokines level in their blood. Results: Both mild/moderate and severe critical cases we observed showed low calcium level in the early stage of viral infection, while the severe/critical cases showed significant lower calcium level than mild/moderate cases in the early stage. We also found that low calcium level related to severe/critical multi-organ injuries especially in the mild/moderate population. Proinflammatory cytokine IL-6 also correlated to calcium change in both mild/moderate and severe/critical cases. Conclusions: Our finding indicates that calcium balance is a primal hit of COVID-19 and a biomarker of clinical severity at the beginning of symptom onset. Calcium is closely associated with virus-associated multiple organ injuryes and the increase of inflammatory cytokines. Our results provide a new, important indicator of COVID-19 patients from mild/moderate to severe/critical: serum calcium.

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Low levels of total and ionized calcium in blood of COVID-19 patients

Cited by 90 publications

References 7 publications

Hypocalcemia is a distinctive biochemical feature of hospitalized COVID-19 patients

Hypocalcemia is a distinctive biochemical feature of hospitalized COVID-19 patients

Associations of blood essential and toxic metal(loid)s with both disease severity and mortality in patients with COVID-19: a retrospective study

Low serum calcium: a new, important indicator of COVID-19 patients from mild/moderate to severe/critical

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