PDF icon PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · J Lab Physicians 2023; 15(02): 187-193
DOI: 10.1055/s-0042-1757415
Original Article

Association between Hypocalcemia and Outcome in COVID-19 Patients: A Retrospective Study

Bhagwan Singh Patidar
1   Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Tapasyapreeti Mukhopadhyay 
1   Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Arulselvi Subramanian 
1   Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Richa Aggarwal
2   Department of Anaesthesia, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Kapil Dev Soni
2   Department of Anaesthesia, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Neeraj Nischal
3   Department of Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Debasis Sahoo
2   Department of Anaesthesia, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Surbhi Surbhi
2   Department of Anaesthesia, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Naveet Wig
3   Department of Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Ravindra Mohan Pandey
4   Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
,
Rajesh Malhotra
5   Department of Orthopedics, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Anjan Trikha
1   Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
› Institutsangaben
Funding None.
› Weitere Informationen
Auch verfügbar aufeRef
  Lizenzen und Reprints
Preview

Abstract

Background Calcium has been shown to play a vital role in the pathophysiology of severe acute respiratory syndrome-coronavirus-2 and middle east respiratory syndrome coronavirus diseases, but less is known about hypocalcemia in coronavirus disease 2019 (COVID-19) patients and its association with the disease severity and the final outcome. Therefore, this study was conducted with an aim to assess clinical features in COVID-19 patients having hypocalcemia and to observe its impact on COVID-19 disease severity and the final outcome.

Methods In this retrospective study, consecutive COVID-19 patients of all age groups were enrolled. Demographical, clinical, and laboratory details were collected and analyzed. On the basis of albumin-corrected calcium levels, patients were classified into normocalcemic (n = 51) and hypocalcemic (n = 110) groups. Death was the primary outcome.

Results The mean age of patients in the hypocalcemic group was significantly lower (p < 0.05). A significantly higher number of hypocalcemic patients had severe COVID-19 infection (92.73%; p < 0.01), had comorbidities (82.73%, p < 0.05), and required ventilator support (39.09%; p < 0.01) compared with normocalcemic patients. The mortality rate was significantly higher in the hypocalcemic patients (33.63%; p < 0.05). Hemoglobin (p < 0.01), hematocrit (p < 0.01), and red cell count (p < 0.01) were significantly lower with higher levels of absolute neutrophil count (ANC; p < 0.05) and neutrophil-to-lymphocyte ratio (NLR; p < 0.01) in the hypocalcemic patients.

Albumin-corrected calcium levels had a significant positive correlation with hemoglobin levels, hematocrit, red cell count, total protein, albumin, and albumin-to-globulin ratio and a significant negative correlation with ANC and NLR.

Conclusion The disease severity, ventilator requirement, and mortality were considerably higher in hypocalcemic COVID-19 patients.

Keywords

calcium - coronavirus - mortality - neutrophil-to-lymphocyte ratio - pandemic

Authors' Contributions

B.S.P. wrote the manuscript; B.S.P., T.M., and A.S. did data analysis; B.S.P., T.M., R.A., K.S., N.N., D.S., and Surbhi helped in data collection, clinical correlation, and interpretation; R.M.P. helped in statistical studies and interpretation; N.W., R.M., and A.T. helped in editing/review of the manuscript. A.S. is guarantee for the study.


Ethical Approval

The study was conducted after obtaining the approval from the Institutional Ethics Committee.




Publikationsverlauf

Artikel online veröffentlicht:
20. Oktober 2022

© 2022. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India