Low serum calcium predicts hospitalization in COVID-19 patients

Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV-2), presents primarily with fever, dry cough, and fatigue or myalgia.¹ Although most patients have a favorable prognosis, infection may not infrequently lead to a severe syndrome requiring hospitalization and assisted ventilation with high lethality.² Previous studies have reported that calcium played a central role in viral infections and replicative mechanisms of SARS-CoV, MERS-CoV, and Ebolavirus.³ In a large group of SARS patients in North America, hypocalcemia was detected in 60% of patients at hospital admission and in 70% during hospitalization.⁴ Moreover, data from patients with Ebolavirus infection in United States and European hospitals reported a similar incidence of hypocalcemia.⁵ Several studies investigated so far the clinical and laboratory characteristics of COVID-19 patients, including inflammatory and organ injury biomarkers.⁶

Filippo et al⁷ investigated the incidence of hypocalcemia in a large single center population of COVID-19 patients and evaluate its possible clinical implications.

A retrospective cohort study at IRCCS San Raffaele Hospital, a tertiary health-care hospital in Milan, Italy. Study included patients (aged ≥ 18 years) with COVID-19 admitted to our Emergency Department (ED). In this study, exclusion of COVID-19 patients transferred from other hospitals and patients initially hospitalized for other diseases.

In conclusion, since hypocalcemia is highly incident in COVID-19 patients and predicts the need for hospitalization authors suggest that ionized calcium should always be assessed at initial hospital evaluation in order to identify more severe patients.

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References:

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7. Filippo DL, Formenti AM, Rovere-Querini R, Carlucci M et al. Hypocalcemia is highly prevalent and predicts hospitalization in patients with COVID-19. Endocrine https://doi.org/10.1007/s12020-020-02383-5.