Serum Calcium and Vitamin D levels: Correlation with severity of COVID-19 in hospitalized patients in Royal Hospital, Oman

Abstract

Introduction There have been studies revealing hypocalcemia in severe covid-19 and low vitamin D levels that warranted further studies. Objective Our study investigates the correlation between calcium levels at presentation as a primary endpoint, and pre-existing calcium levels as a secondary endpoint, to severity of disease presentation and progression. Method Observational cohort study in adults admitted with COVID-19 from March till September 2020. Multiple clinical scales, laboratory parameters, were used to correlate corrected calcium and vitamin D associations with risk factors and outcomes. Results Around 445 patients were included in the study. Hypocalcemic patients had more abnormal laboratory parameters and longer hospitalization duration. Hypocalcemia was in 60-75% of all age groups (p-value 0.053), for which 77.97% were ICU admissions (p-value 0.001) and 67.02% were diabetic (p-value 0.347). There were non-significant correlations between Vitamin D and almost all the parameters except for chronic respiratory diseases with P value of 0.024. Conclusion It can be concluded that hypocalcemia is a significant and reliable marker of disease severity and progression regardless of underlying comorbidities. Meanwhile, Vitamin D levels fail to reflect correlation with severity of COVID-19 infections.

Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1

“…A recent study reported that serum calcium and vitamin D levels in COVID-19 patients were lower than in healthy individuals [43]. Osman et al showed that hypocalcemic COVID-19 patients had longer hospitalization duration and higher severity of the disease, yet they could not find a link between vitamin D status and COVID-19 [44]. Our results showed that the Ca 2+ level of cases was relatively increased on the 7th and day after treatment, yet it was not statistically significant It is known that vitamin D acts as a regulator of many cytokines in many cell types of the immune system and in many diseases [11,[19][20][21].…”

Vitamin D and COVID-19: An Overview of Recent Evidence

“…Others have found associations between vitamin D sufficiency and reduced incidence of COVID-19, but not in outcomes after infection [ 155 , 158 ]. However, some studies have reported contrary, negative results [ 143 , 144 , 147 ]. Overall, the evidence supports the importance of the relationship between vitamin D and COVID-19, a relationship that requires continued investigation by means of large-scale, nationally representative studies.…”

Endocrine Follow-up During Post-Acute COVID-19: Practical Recommendations Based on Available Clinical Evidence

“…Hypocalcemia was seen in 68.8% of the patients. Patients with hypocalcemia needed a significantly longer duration of hospitalization and required more high-dependency unit (HDU)/ICU admissions than those without hypocalcemia ( 61 ). Nevertheless, a high frequency of asymptomatic hypocalcemia (and hypophosphatemia) has also been reported in non-severe COVID-19 patients, the clinical relevance of which remains uncertain ( 62 ).…”