Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
J Infect Public Health. 2020 Sep;13(9):1224-1228. doi: 10.1016/j.jiph.2020.05.029. Epub 2020 Jun 22.
The aim of this study was to investigate the performance and predictive value of hypocalcemia in severe COVID-19 patients.
We retrospectively investigated the clinical and laboratory characteristics of severe COVID-19 patients. 107 patients were divided into hypocalcemia group and normal serum calcium group. The clinical and laboratory data were compared between two groups. The discriminative power of hypocalcemia regarding poor outcome were evaluated by receiver operating curves (ROC) analyses.
Sixty seven patients (62.6%) had hypocalcemia. In hypocalcemia group, leukocytes, c-reactive protein (CRP), procalcitonin (PCT), Interleukin 6 (IL-6), and D-dimer levels was higher, while lymphocytes and albumin (ALB) levels was lower. No significant difference was identified in gender, age, signs and symptoms, comorbidities and other laboratory indicators. Serum calcium levels were negatively correlated with leukocytes, CRP, PCT, IL-6 and D-dimer, while positively correlated with lymphocytes and ALB. Patients with hypocalcemia more commonly presented poor outcome (47.8% (32/67) vs 25% (10/40), p=0.02). Median serum calcium levels were significantly lower in the patients with poor outcome (2.01(1.97-2.05) vs 2.10(2.03-2.20), p<0.001), and it could predict the prognosis with an area under the ROC curve (AUC) of 0.73(95% confidence interval (CI) 0.63-0.83, p<0.001).
Hypocalcemia commonly occurred in severe COVID-19 patients and it was associated with poor outcome.
本研究旨在探讨低钙血症在重症 COVID-19 患者中的表现和预测价值。
我们回顾性调查了重症 COVID-19 患者的临床和实验室特征。将 107 例患者分为低钙血症组和正常血清钙组。比较两组的临床和实验室数据。通过受试者工作特征曲线（ROC）分析评估低钙血症对不良结局的预测能力。
67 例（62.6%）患者存在低钙血症。在低钙血症组中，白细胞、C 反应蛋白（CRP）、降钙素原（PCT）、白细胞介素 6（IL-6）和 D-二聚体水平较高，而淋巴细胞和白蛋白（ALB）水平较低。两组间性别、年龄、体征和症状、合并症及其他实验室指标无显著差异。血清钙水平与白细胞、CRP、PCT、IL-6 和 D-二聚体呈负相关，与淋巴细胞和 ALB 呈正相关。低钙血症患者更常出现不良结局（47.8%（32/67）比 25%（10/40），p=0.02）。不良结局患者的血清钙水平中位数明显更低（2.01（1.97-2.05）比 2.10（2.03-2.20），p<0.001），ROC 曲线下面积（AUC）为 0.73（95%置信区间（CI）0.63-0.83，p<0.001），可预测预后。
低钙血症在重症 COVID-19 患者中较为常见，与不良结局相关。
