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Hypocalcemia in Covid-19: A Prognostic Marker for Severe Disease Publisher



Raesi A1 ; Dezaki ES2 ; Moosapour H3 ; Saeidifard F4, 5 ; Habibi Z1 ; Rahmani F6 ; Kheiri S7 ; Taheri E8
Authors
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Authors Affiliations
  1. 1. Department of Internal Medicine, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
  2. 2. Department of Parasitology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
  3. 3. Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Medicine, Northwell Health-Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell, New York, United States
  5. 5. Division of Preventive Cardiology, Department of Cardiovascular Disease, Mayo Clinic, Rochester, United States
  6. 6. Department of Infectious Disease, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
  7. 7. Department of Epidemiology and Biostatistics, School of Health, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
  8. 8. Molecular Pathology and Cytogenetic Ward, Pathology Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Source: Iranian Journal of Pathology Published:2021


Abstract

Background & Objective: Previous studies have addressed the electrolyte abnormalities such as hypocalcemia in COVID-19 patients. We aimed to compare the laboratory findings especially the electrolyte levels among COVID-19 patients and healthy controls and evaluate their prognostic values. Methods: This case-control study included 91 COVID-19 patients and 169 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-19, 59.3% of the patients had hypocalcemia on admission while in control group only 32.5% had low calcium level (OR=3.02, 95% CI: 1.79-5.13, P<0.001). The rates of death and ICU admission were significantly higher among the patients in hypocalcemic group than those of eucalcemic group (85.7% vs 14.3% and 33.3% Vs 9.1%, 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, 74.1% of patients in hypocalcemic group had a severe infection while 24.3% of the patients in eucalcemic group were diagnosed with severe infection (OR=8.89, 95% CI: 3.38-23.37, P<0.001). Conclusion: Patients with COVID-19 may present with considerable laboratory abnormalities including hypocalcemia. The hypocalcemia would be also associated with worse major clinical outcome and higher mortality risk. © 2021, Iranian Society of Pathology. All rights reserved.
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