Department of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland; Doctoral School at Medical University of Warsaw, Warsaw, Poland.
Department of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland; Central Laboratory, Central Teaching Hospital of University Clinical Center of Medical University of Warsaw, Warsaw, Poland.
Int J Infect Dis. 2022 Sep;122:543-549. doi: 10.1016/j.ijid.2022.06.057. Epub 2022 Jul 5.
Nonrespiratory manifestations of COVID-19 include endocrine disorders, among which are calcium-magnesium-phosphate homeostasis abnormalities, which seem to influence the disease severity and patient outcome. The aim of this study was to evaluate the prevalence and impact of calcium-magnesium-phosphate and vitamin D3 disorders on survival in patients hospitalized for COVID-19 depending on the severity of the disease and kidney function.
The study was conducted between April 2020 and May 2021 at Central Clinical Hospital in Warsaw, Poland. A total of 146 patients who had tested concentration of at least one of the studied elements, estimated glomerular filtration ratio, creatinine levels, and blood saturation, and were diagnosed with COVID-19 disease were included in the analysis.
We found that hypermagnesemia was common and associated with a 1.5-fold increased risk of death in the whole cohort. Hyperphosphatemia also increased the risk of death, exactly 2.4-fold. Furthermore, we found a statistically significant association between increased mortality in the whole cohort and hypovitaminosis D3 (P <0.05). Serum creatinine concentration and estimated glomerular filtration ratio significantly correlated with serum magnesium and phosphate levels.
Hypermagnesemia, hyperphosphatemia, and hypovitaminosis D but not hypocalcemia influence the mortality of patients with COVID-19. These parameters should be monitored routinely in this group of patients, especially in those with decreased kidney function.
COVID-19 的非呼吸表现包括内分泌紊乱，其中包括钙镁磷稳态异常，这些异常似乎会影响疾病的严重程度和患者的预后。本研究的目的是评估 COVID-19 住院患者中钙镁磷和维生素 D3 紊乱对生存率的影响，同时考虑疾病严重程度和肾功能。
本研究于 2020 年 4 月至 2021 年 5 月在波兰华沙中央临床医院进行。共纳入了 146 名至少检测了一种研究元素、估计肾小球滤过率、肌酐水平和血液饱和度，并被诊断为 COVID-19 疾病的患者。
我们发现高镁血症很常见，并且与整个队列的死亡风险增加 1.5 倍有关。高磷酸盐血症也会增加死亡风险，正好增加 2.4 倍。此外，我们还发现整个队列中死亡率增加与维生素 D3 缺乏之间存在统计学显著关联（P<0.05）。血清肌酐浓度和估计肾小球滤过率与血清镁和磷水平显著相关。
高镁血症、高磷酸盐血症和维生素 D3 缺乏症而不是低钙血症会影响 COVID-19 患者的死亡率。这些参数应在该组患者中常规监测，特别是在肾功能下降的患者中。
