Severe hyperphosphatasemia and severe acute respiratory syndrome coronavirus 2 infection in children

Abstract

It is now known that SARS-CoV-2 infection because of coronavirus is highly contagious and caused varying degrees of illness throughout the world. Hepatic dysfunction and the slight elevation of liver enzymes have been reported in cases of COVID-19 infection. Transient hyperphosphatasemia is a benign condition characterized by the elevation of serum alkaline phosphatase and the return to normal levels within weeks or months of first observation. We reported the first infant case of severe hyperphosphatasemia because of SARS-CoV-2 infection, in a 9-month-old child admitted to the Pediatric Covid-19 Unit of Amiens University Hospital. Given the hepatic tropism and COVID-19-related hyperinflammatory reactions, our case suggests that, an isolated severe hyperphosphatasemia in children with SARS-CoV-2 infection should increase the possibility of transient hyperphosphatasemia, even if is also demonstrated a classic natural history of the transient hyperphosphatasemia during viral infection, especially in SARS-CoV-2 infection.

Hypermagnesemia and hyperphosphatemia are highly prevalent in patients with COVID-19 and increase the risk of death

“…As important as phosphate is for energy metabolism, its high concentrations are life-threatening, irrespective of kidney function, which was also indicated by our OR analysis in which above normal phosphate levels were associated with an increased, exactly 2.4-fold, chance of death ( Broman et al , 2018 ). Viral infection may also be a cause of transient hyperphosphatemia, but we cannot comment on this because included only measurements made upon admission ( Tchidjou et al , 2020 ).…”

“…Furthermore, we found a statistically significant difference in the incidence of hyperphosphatemia between severe and nonsevere COVID-19 groups, 12% versus 34.2% ( P = 0.004 ). There are no scientific data on the incidence of hyperphosphatemia in the course of COVID-19, but there are reports of cases in which the infection is the cause of this abnormality ( Elkattawy et al , 2020 ;Tchidjou et al , 2020 ). As important as phosphate is for energy metabolism, its high concentrations are life-threatening, irrespective of kidney function, which was also indicated by our OR analysis in which above normal phosphate levels were associated with an increased, exactly 2.4-fold, chance of death ( Broman et al , 2018 ).…”

Benign transient hyperphosphatasemia in infants and children: a retrospective database study

“…They detected antibodies for multiple enteroviruses [20]. Respiratory syncytial virus, Epstein-Barr virus, human bocavirus, rotavirus, HIV, and recently also the coronavirus -severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -were also found to be associated with benign transient hyperphosphatasemia [7,[24][25][26][27][28][29]. However, the co-occurrence of benign transient hyperphosphatasemia and infections might be incidental.…”

Transient hyperphosphatasemia in a toddler with COVID-19 infection: A case report and literature review

“…Given the reports of TH associated with other viral infections, we concluded that our patient developed TH related to COVID-19 infection. Recently, two cases of TH associated with COVID-19 infection in children have been reported[ 16 , 17 ]. All 3 cases, including ours, were aged under 3 years, in accordance with the preponderance (82%) of TH in patients aged < 36 mo in a previous report[ 4 ].…”

“…Endocrinopathies associated with COVID-19 infection in children, such as thyroid diseases (subacute thyroiditis, hypothyroidism, hyperthyroidism), adrenal insufficiency, diabetes mellitus, vitamin D deficiency and hypopituitarism, had been previously reported[ 14 , 15 ]. TH observed with COVID-19 infection in toddlers is a new discovery that was recently described in two cases[ 16 , 17 ]. Here, we report a case of a 2-year-old boy who developed TH associated with COVID-19 infection.…”