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新冠病毒肺炎患者血清钙水平与疾病严重程度及预后的相关性

Correlation of Serum Calcium with Severity and Outcomes in Patients of COVID-19 Pneumonia.

作者信息

Fatima Jalees, Shukla Vaibhav, Siddiqi Zeba, Kumar Devendra, Mateen Saboor, Gupta Akhilesh Bandhu

机构信息

Department of Medicine, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India.

Maharishi Markendeshwar College of Medical Science and Research, Ambala, Haryana, India.

出版信息

J Family Med Prim Care. 2024 Apr;13(4):1421-1427. doi: 10.4103/jfmpc.jfmpc_1595_23. Epub 2024 Apr 22.

Abstract

BACKGROUND

Calcium is an essential electrolyte with critical physiological functions. Recently, it has been implicated in the pathogenesis and outcomes of COVID-19. This retrospective study was conducted to estimate serum ionic calcium and its correlation with clinical severity, inflammatory markers, and in-hospital outcomes in moderate to severe COVID-19 patients.

METHODS

We retrospectively analyzed data from 377 COVID-19 patients, aged between 23 and 79 years, with a mean age of 54.17±11.53 years. Severity of the disease was determined using ICMR criteria. Parameters including age, gender, inflammatory markers, calcium levels, and clinical outcomes were assessed.

RESULTS

The study showed a prevalence of moderate and severe COVID-19 in 58.1% and 41.9% patients, respectively. Severity was significantly associated with younger age, higher mean inflammatory markers, notably IL-6, procalcitonin, D-Dimer, and lower ionic and total calcium levels, as well as vitamin D levels. Mortality and referral rate were significantly higher in the severe group. Hypocalcemia was prevalent in 39% of the patients and was significantly associated with disease severity, ARDS, and mortality. On multivariate assessment, only age and ionic calcium were significantly associated with COVID-19 severity.

CONCLUSION

Lower serum ionic calcium levels are associated with increased severity and poor outcomes, including higher mortality in COVID-19 patients, underscoring the potential role of calcium as a diagnostic and prognostic marker in COVID-19 pneumonia and may be an important factor in various other forms of pneumonia.

摘要

背景

钙是一种具有关键生理功能的必需电解质。最近,它被认为与新型冠状病毒肺炎(COVID-19)的发病机制和预后有关。本回顾性研究旨在评估中度至重度COVID-19患者的血清离子钙水平及其与临床严重程度、炎症标志物和住院结局的相关性。

方法

我们回顾性分析了377例COVID-19患者的数据,这些患者年龄在23至79岁之间,平均年龄为54.17±11.53岁。使用印度医学研究理事会(ICMR)标准确定疾病的严重程度。评估了包括年龄、性别、炎症标志物、钙水平和临床结局等参数。

结果

研究显示,中度和重度COVID-19的患病率分别为58.1%和41.9%。疾病严重程度与较年轻的年龄、较高的平均炎症标志物水平显著相关,尤其是白细胞介素-6(IL-6)、降钙素原、D-二聚体,以及较低的离子钙和总钙水平,还有维生素D水平。严重组的死亡率和转诊率显著更高。39%的患者存在低钙血症,且低钙血症与疾病严重程度、急性呼吸窘迫综合征(ARDS)和死亡率显著相关。多因素评估显示,只有年龄和离子钙与COVID-19的严重程度显著相关。

结论

较低的血清离子钙水平与COVID-19患者病情加重和不良结局相关,包括较高的死亡率,这突出了钙作为COVID-19肺炎诊断和预后标志物的潜在作用,并且可能是其他各种形式肺炎的一个重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a35/11141953/3d4a892bf387/JFMPC-13-1421-g001.jpg

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