低钙血症与严重 COVID-19 相关：系统评价和荟萃分析。
Hypocalcemia is associated with severe COVID-19: A systematic review and meta-analysis.
机构信息
Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia.
Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia; Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
出版信息
Diabetes Metab Syndr. 2021 Jan-Feb;15(1):337-342. doi: 10.1016/j.dsx.2021.01.003. Epub 2021 Jan 18.
BACKGROUND AND AIMS
Hypocalcemia is commonly in critically ill patients and studies have shown that hypocalcemia is prevalent in patients with COVID-19. This meta-analysis aimed to evaluate the prognostic performance of hypocalcemia in patients with coronavirus disease 2019 (COVID-19).
METHODS
We performed a systematic literature search on PubMed, Scopus, and Embase with keywords "SARS-CoV-2″ OR″COVID-19″ OR ″2019-nCoV" AND "hypocalcemia" up until 10 December 2020. The key exposure was hypocalcemia, defined as serum calcium below study-defined cut-off points. The main outcome was poor outcome, which was a composite of mortality and severity. The effect estimate of the main outcome was reported as odds ratio (OR) and its 95% confidence interval (95% CI). We also generate sensitivity, specificity, positive and negative likelihood ratio (PLR & NLR), diagnostic odds ratio (DOR), and area under curve (AUC).
RESULTS
There are 2032 patients from 7 studies included in this systematic review and meta-analysis. The incidence of poor outcome in this study was 26%. Serum calcium was lower in patients with poor outcome (mean difference -0.173 mmol/L [-0.259, -0.087], p < 0.001; I: 31.3%). Hypocalcemia was associated with poor outcome (OR 3.19 [2.02, 5.06], p < 0.001; I: 32.86%); with sensitivity of 0.74 [0.53, 0.88], specificity of 0.54 [0.29, 0.77], PLR of 1.6 [1.1, 2.3], NLR of 0.49 [0.35, 0.66], DOR of 3 [2, 5], and AUC of 0.70 [0.66, 0.74]. In this pooled analysis, the post-test probability was 36% in patients with hypocalcemia and 15% in patients without hypocalcemia.
CONCLUSION
Hypocalcemia was associated with poor outcome in COVID-19 patients.
PROSPERO ID
CRD42020225506.
背景与目的
低钙血症在危重症患者中很常见，研究表明 COVID-19 患者中低钙血症很常见。本荟萃分析旨在评估低钙血症在 2019 年冠状病毒病（COVID-19）患者中的预后表现。
方法
我们使用关键词“SARS-CoV-2”或“COVID-19”或“2019-nCoV”和“低钙血症”在 PubMed、Scopus 和 Embase 上进行了系统的文献检索，检索时间截至 2020 年 12 月 10 日。关键暴露是低钙血症，定义为血清钙低于研究定义的截断值。主要结局是不良结局，是死亡率和严重程度的综合指标。主要结局的效应估计值以比值比（OR）及其 95%置信区间（95%CI）表示。我们还生成了敏感性、特异性、阳性和阴性似然比（PLR 和 NLR）、诊断比值比（DOR）和曲线下面积（AUC）。
结果
本系统评价和荟萃分析共纳入了来自 7 项研究的 2032 名患者。本研究中不良结局的发生率为 26%。不良结局患者的血清钙水平较低（平均差值-0.173mmol/L[-0.259，-0.087]，p<0.001；I：31.3%）。低钙血症与不良结局相关（OR 3.19[2.02，5.06]，p<0.001；I：32.86%）；敏感性为 0.74[0.53，0.88]，特异性为 0.54[0.29，0.77]，阳性似然比为 1.6[1.1，2.3]，阴性似然比为 0.49[0.35，0.66]，诊断比值比为 3[2，5]，AUC 为 0.70[0.66，0.74]。在这项汇总分析中，低钙血症患者的后验概率为 36%，无低钙血症患者的后验概率为 15%。
结论
低钙血症与 COVID-19 患者的不良结局相关。
PROSPERO 注册号：CRD42020225506。
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