Endocrine Abstracts

Introduction

Although most patients with COVID-19 have mild symptoms, some develop severe manifestations of the disease, leading to hospitalization and death. Previous studies reported that calcium played a central role in viral infections and replicative mechanisms of SARS-CoV. Hypocalcemia is a common finding among these patients. The aim of this study was to investigate the prevalence of hypocalcemia in a population of COVID-19 patients and to evaluate its clinical implications.

Material and Methods

Was performed a retrospective study that included adult COVID-19 patients admitted to the emergency department (ED) from March 15 to September 15, 2020, with ionized calcium (IC) measured in blood gas analysis. Demographic and clinical data were collected. Hypocalcemia was defined as calcium level below 1.18 mmol/l. Patients with comorbidities and on therapies influencing calcium metabolism were excluded. Assessed outcomes included hospitalization, length of stay and death. Statistical analysis was conducted with SPSS 3.5.0; the effect of IC on the outcomes was determined using generalized linear models; significance level considered was α = 0.05.

Results

We included 179 patients (50.3% male; median age = 69 years); 138 patients required hospitalization. Hypocalcemia was present in 78.8% (n = 141) of the patients admitted to ER, and in 71.7% (n = 99) of the hospitalized patients. Assessing the relation between the IC value at admission in the ED and hospitalization, it was found that there is a statistically significant association between hypocalcemia and requirement of hospitalization, especially for patients with less than 60 years of age (P = 0.033). Among the hospitalized patients, the IC value wasn’t related with the length of stay (P = 0.24). Of the 138 hospitalized patients, 28.2% (n = 39) died. The IC value wasn’t related with death (P = 0.29).

Conclusion

Hypocalcemia was present in a significant number of patients in this population. Hypocalcemia on admission is significantly related with hospitalization need. This finding may have relevance in clinical practice, as the presence of hypocalcemia in an arterial blood gas analysis at admission in the ED may alert to the need of hospitalization, especially among patients below 60 years-old.