COVID-19 Research Paper Volume 12, Issue 12 pp 11287—11295
Serum calcium as a biomarker of clinical severity and prognosis in patients with coronavirus disease 2019
- 1 Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China
- 2 Department of Intensive Care Unit, Lishui People's Hospital, Nanjing, Jiangsu Province, China
- 3 Department of Intensive Care Unit, Drum Tower Hospital, Nanjing University, Nanjing, Jiangsu Province, China
- 4 Department of Intensive Care Unit, Wuxi People's Hospital, Nanjing Medical University, Wuxi, Jiangsu Province, China
- 5 Department of Isolation Units, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Jiangsu Province, China
Received: April 6, 2020 Accepted: May 30, 2020 Published: June 25, 2020https://doi.org/10.18632/aging.103526
How to Cite
Copyright © 2020 Sun et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The aim of this study was to investigate the correlations between serum calcium and clinical outcomes in patients with coronavirus disease 2019 (COVID-19). In this retrospective study, serum calcium levels, hormone levels and clinical laboratory parameters on admission were recorded. The clinical outcome variables were also recorded. From February 10 to February 28, 2020, 241 patients were enrolled. Of these patients, 180 (74.7%) had hypocalcemia on admission. The median serum calcium levels were 2.12 (IQR, 2.04-2.20) mmol/L, median parathyroid hormone (PTH) levels were 55.27 (IQR, 42.73-73.15) pg/mL, and median 25-hydroxy-vitamin D (VD) levels were 10.20 (IQR, 8.20-12.65) ng/mL. The serum calcium levels were significantly positively correlated with VD levels (P =0.004) but negatively correlated with PTH levels (P =0.048). Patients with lower serum calcium levels (especially ≤2.0 mmol/L) had worse clinical parameters, higher incidences of organ injury and septic shock, and higher 28-day mortality. The areas under the receiver operating characteristic curves of multiple organ dysfunction syndrome, septic shock, and 28-day mortality were 0.923 (P <0.001), 0.905 (P =0.001), and 0.929 (P <0.001), respectively. In conclusion, serum calcium was associated with the clinical severity and prognosis of patients with COVID-19. Hypocalcemia may be associated with imbalanced VD and PTH levels.