Pal Rimesh, Ram Sant, Zohmangaihi Deepy, Biswas Indranil, Suri Vikas, Yaddanapudi Laxmi N, Malhotra Pankaj, Soni Shiv L, Puri Goverdhan D, Bhalla Ashish, Bhadada Sanjay K
Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Front Med (Lausanne). 2021 Jan 7;7:590805. doi: 10.3389/fmed.2020.590805. eCollection 2020.
To compare serum total calcium and phosphate levels in patients with non-severe COVID-19 with age, sex, and serum 25-hydroxyvitamin D level matched healthy adult cohort. In this retrospective case-control study, medical records of patients (≥18 years) diagnosed as non-severe COVID-19 admitted at and discharged from our tertiary care institution during the period from April 10, 2020 and June 20, 2020 were retrieved. Baseline investigations, notably, serum calcium, phosphate, albumin, magnesium, 25-hydroxyvitamin D, and C-reactive protein (CRP), were performed at admission before any form of calcium or vitamin D supplementation were considered. The biochemical parameters were compared with age, sex, and 25-hydroxyvitamin D matched healthy adult controls (1:1 ratio) derived from the Chandigarh Urban Bone Epidemiological Study (CUBES). After exclusion, 72 patients with non-severe COVID-19 (63 mild and 9 moderate disease) and an equal number of healthy controls were included in the final analysis. Age, sex, serum 25-hydroxyvitamin D, and albumin levels were matched between the 2 groups. Hypovitaminosis D and hypocalcemia were seen in 97 and 67% of the patients, respectively. The patients had lower serum calcium ( value <0.001) and phosphate ( = 0.007) compared with the controls. There was no statistically significant correlation between serum calcium and CRP. Hypocalcemia is highly prevalent even in COVID-19 patients with non-severe disease probably implying that hypocalcemia is intrinsic to the disease. Prospective studies with larger number of patients are required to prove this hypothesis and unravel the underlying pathophysiological mechanisms.
比较非重症新型冠状病毒肺炎（COVID-19）患者与年龄、性别及血清25-羟基维生素D水平相匹配的健康成人队列的血清总钙和磷水平。在这项回顾性病例对照研究中，检索了2020年4月10日至2020年6月20日期间在我们的三级医疗机构收治并出院的被诊断为非重症COVID-19的患者（≥18岁）的病历。在考虑任何形式的钙或维生素D补充之前，入院时进行了基线检查，特别是血清钙、磷、白蛋白、镁、25-羟基维生素D和C反应蛋白（CRP）。将这些生化参数与来自昌迪加尔城市骨流行病学研究（CUBES）的年龄、性别及25-羟基维生素D相匹配的健康成人对照组（1:1比例）进行比较。排除后，最终分析纳入了72例非重症COVID-19患者（63例轻症和9例中症）以及同等数量的健康对照。两组之间年龄、性别、血清25-羟基维生素D和白蛋白水平相匹配。分别有97%和67%的患者存在维生素D缺乏症和低钙血症。与对照组相比，患者的血清钙（值<0.001）和磷（=0.007）较低。血清钙与CRP之间无统计学显著相关性。即使在非重症疾病的COVID-19患者中，低钙血症也非常普遍，这可能意味着低钙血症是该疾病所固有的。需要更多患者的前瞻性研究来证实这一假设并阐明潜在的病理生理机制。
