Hypocalcemia as a Risk of COVID-19 Mortality: What Level of Hypocalcemia? Direct Measurement or Corrected Calcium Value?

Yıl 2025, Cilt: 18 Sayı: 1, 71 - 79, 30.04.2025

Fuat Doğan Saliha Yıldız

https://doi.org/10.52976/vansaglik.1635549

Öz

Aim: The negative effects of vitamin D deficiency and hypocalcemia on the frequency and severity of COVID-19 are quite striking. To determine the presence of hypocalcemia in hospitalized COVID-19 patients, the relationship between severity and outcome, and whether albumin correction is necessary to predict this relationship.
Materials and methods: Hospitalized COVID-19 patients were grouped for lung involvement, need for intensive care, need for mechanical ventilation, long hospitalization (≥14 days), sepsis, and mortality. Blood calcium, albumin, 25OHvitamin D, parathyroid hormone, phosphorus, and magnesium values and albumin-corrected calcium data were evaluated retrospectively.
Results: The study included 129 hospitalized COVID-19 patients, 67 (51.9%) male and 62 (40%) female. Vitamin D was insufficient in 89.9% of the patients and no association was found with disease severity. Calcium levels were significantly lower in terms of need for intensive care, sepsis, mechanical ventilation and mortality (p: 0.00, 0.013, 0.021, 0.004, respectively). No association was found with corrected Ca (p>0.05 for all). A significant increase was found in the same cases when total Ca values were below 8 mg/dl (p: 0.00, 0.001, 0.005 and 0.001, respectively). In the logistic regression analysis, it was found that age, increase in CRP and decrease in Ca levels significantly increased the risk for mortality (p: 0.005, 0.001 and 0.013, respectively).
Conclusion: We found that total Ca values obtained by direct measurement below 8 mg/dl in COVID-19 patients are significantly more likely to require intensive care, require mechanical ventilation, sepsis and mortality, and in the analysis we determined that age, CRP and a decrease in direct measured total Ca values, together with advanced age and high CRP, are risk factors that increase mortality.

Anahtar Kelimeler

COVID-19 , calcium , corrected calcium , mortality

Etik Beyan

Van YYU Girişimsel Olmayan Araştırmalar Etik Kurulu Karar No:2021/10-08

COVID-19 Mortalite Riski Olarak Hipokalsemi: Ne Düzeyde Bir Hipokalsemi? Direkt Ölçüm mü, Düzeltilmiş Kalsiyum Değeri mi?

Öz

Amaç: D vitamini eksikliği ve hipokalseminin COVİD-19’daki sıklığı ve ciddiyeti üzerine olumsuz etkileri oldukça çarpıcıdır. Hospitalize COVİD-19 hastalarındaki hipokalsemi varlığını, şiddet sonuç ilişkisini ve bu ilişkiyi öngörmede albümin düzeltmesinin gerekli olup olmadığını belirlemek.
Materyal ve metod: Yatan COVİD-19 hastaları akciğer tutulumu, yoğun bakım ihtiyacı, mekanik ventilasyon ihtiyacı, uzun yatış (≥14gün), sepsis, mortalite için gruplandırıldı. Kan kalsiyum, albümin, 25OHvitamin D, parathormon, fosfor ve magnezyum değerleri ile albüminle düzeltilmiş kalsiyum verileri retrospektif değerlendirildi.
Bulgular: Çalışmaya 67 (51.9%) erkek ve 62 (40%) kadın hasta olmak üzere 129 hospitalize COVİD-19 hastası alındı. Hastaların 89.9%’unda D vitamini yetersizdi ve hastalık şiddeti ile bir ilişki saptanmadı. Kalsiyum düzeyleri; yoğun bakım ihtiyacı, sepsis, mekanik ventilasyon ve mortalitede anlamlı olarak düşük tespit edilmiştir (sırası ile p: 0.00, 0.013,0.021, 0.004 ). Düzeltilmiş Ca ile bir ilişki saptanmadı (hepsinde p>0.05). Total Ca değeri 8mg/dl altında yine aynı durumlarda anlamlı olarak artış tespit edildi (sırası ile p:0.00, 0.001, 0.005 ve 0.001). Logistik regresyon analizinde mortalite için yaş, CRP artışı ve Ca düzeylerinde düşmenin anlamlı risk artışı yaptığı saptandı (sırası ile p: 0.005, 0.001 ve 0.013).
Sonuç: COVİD-19 hastalarında direkt ölçüm ile elde edilen total Ca değerinin 8 mg/dl nin altında olmasını yoğun bakım ihtiyacı, mekanik ventilasyon ihtiyacı, sepsis ve mortalitede anlamlı olarak daha fazla bulduk ve yapılan analizde yaş, CRP ve direkt ölçüm total Ca değerinde düşmenin, ileri yaş ve CRP yüksekliği ile birlikte mortaliteyi artıran bir risk faktörü olduğunu belirledik.

Anahtar Kelimeler

COVİD-19 , kalsiyum , düzeltilmiş kalsiyum , mortalite

Kaynakça

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