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Low Calcium associated with severe COVID-19 – several studies

Low Calcium increases Risk of COVID-19 death by 7X - Aug 2021

The effect of low serum calcium level on the severity and mortality of Covid patients: A systematic review and meta-analysis
Immunity, Inflammation and Disease 2021;1-10. DOI: 10.1002/iid3.528

Effat Alemzadeh1 © | Esmat Alemzadeh2,3 © | Masood Ziaee1 © | Ali Abedi4 © | Hamid Salehiniya5 ©
1Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
2Department of Medical Biotechnology, Faculty of Medicine, Birjand University of Medical Science, Birjand, Iran 3Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
4Zahedan University of Medical Sciences, Zahedan, Iran
5Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
Correspondence: Hamid Salehiniya, Birjand University of Medical Sciences, Ghafari Street, Birjand, South Khorasan 9717853577, Iran.
Email: alesaleh70 at yahoo.com

Introduction: Imbalances of various electrolytes, including calcium, are associated with the prognosis of Covid disease. This study investigated the relationship between serum calcium and clinical outcomes in patients with COVID-19.

Method: This study is a systematic review and meta-analysis by searching PubMed, Scopus, web of sciences until August 2021 using the keywords COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID, coronavirus disease, SARS-COV-infection. 2, SARS-COV-2, COVID19, calcium, calcium isotopes, calcium radioisotopes, hypercalcemia, and hypocalcemia were performed. Heterogeneity of studies was investigated using I2 index, data were analyzed using meta-analysis (random effects model) with Comprehensive Meta-Analysis Software software.

Results: Finally, 25 articles were included in the study. Clinical data from 12 articles showed that 59% (95% confidence interval [CI]: 0.49-0.68) of people with COVID-19 have hypocalcemia. The results of meta-analysis showed that hypocalcemia was significantly associated with severity of the disease (p = .002),

  • mortality in patients with COVID-19 (odds ratio [OR] = 6.99, 95% CI: 2.71-17.99), number of hospitalization days (p < .001) and
  • admission to the intensive care unit (OR = 5.09, 95% CI: 2.14-12.10).

The results also showed that there is a direct relationship between low serum calcium levels with increasing D-dimer levels (p = .02) and decreasing lymphocyte counts (p = .007).

Conclusion: Based on the results of meta-analysis in people with lower calcium, mortality and complications are higher, therefore, serum calcium is a prognostic factor in determining the severity of the disease. Consequently, it is suggested that serum calcium levels should be considered in initial assessments.

Possible reason clipped from PDF

According to some studies, cytokines can impair the expression of calcium receptor and thus cause an imbalance in serum calcium levels.37 Numerous studies have shown that inflammatory markers, including cytokines, are higher in the serum of COVID‐19 patients than in healthy individuals.38 39

  • 37 Klein GL. The role of calcium in inflammation‐associated bone resorption. Biomolecules. 2018;8(3):69‐70.
  • 38 Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID‐19: consider cytokine storm syndromes and immunosuppression. The lancet. 2020;395(10229):1033‐1034.
  • 39. Yang Z, Liu J, Zhou Y, Zhao X, Zhao Q, Liu J. The effect of corticosteroid treatment on patients with coronavirus infection: a systematic review and meta‐analysis. J Infect. 2020; 81(1):e13‐e20
Perhaps COVID ==> Low Calcium

It appears that COVID ==> Cytokine Strom ==> Low Calcium
Note: Increased vitamin D typicall increases Calcium

Hypocalcemia in COVID-19: Prevalence, clinical significance and therapeutic implications - April 2021

Review Rev Endocr Metab Disord . 2021 Apr 13. doi: 10.1007/s11154-021-09655-z
Luigi di Filippo 1, Mauro Doga 2, Stefano Frara 2, Andrea Giustina 2

Table of contents

COVID-19 extra-pulmonary features include several endocrine manifestations and these are becoming strongly clinically relevant in patients affected influencing disease severity and outcomes. At the beginning of COVID-19 pandemic no population data on calcium levels in patients affected were available and in April 2020 a first case of severe acute hypocalcemia in an Italian patient with SARS-CoV-2 infection was reported. Subsequently, several studies reported hypocalcemia as a highly prevalent biochemical abnormality in COVID-19 patients with a marked negative influence on disease severity, biochemical inflammation and thrombotic markers, and mortality. Also a high prevalence of vertebral fractures with worse respiratory impairment in patients affected and a widespread vitamin D deficiency have been frequently observed, suggesting an emerging "Osteo-Metabolic Phenotype" in COVID-19. To date, several potential pathophysiological factors have been hypothesized to play a role in determining hypocalcemia in COVID-19 including calcium dependent viral mechanisms of action, high prevalence of hypovitaminosis D in general population, chronic and acute malnutrition during critical illness and high levels of unbound and unsaturated fatty acids in inflammatory responses. Since hypocalcemia is a frequent biochemical finding in hospitalized COVID-19 patients possibly predicting worse outcomes and leading to acute cardiovascular and neurological complications if severe, it is reasonable to assess, monitor and, if indicated, replace calcium at first patient hospital evaluation and during hospitalization.


Calcium and Vitamin D category

Calcium often causes major health problems

Cytokine Storms in VitaminDWiki

CYTOKINE in VitaminDWiki 12 titles as of Aug 2021

Calcium hazards and bioavailability

Calcium often causes major health problems

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Created by admin. Last Modification: Monday September 20, 2021 21:37:42 GMT-0000 by oregional. (Version 18)

Attached files

ID Name Comment Uploaded Size Downloads
16239 Ca COVID mortality.jpg admin 19 Sep, 2021 51.86 Kb 397
16238 Low Ca COVID death.pdf admin 19 Sep, 2021 991.15 Kb 201
15438 Hypo ToC.jpg admin 14 Apr, 2021 32.87 Kb 462
15437 Hypocalcemia in COVID-19.pdf admin 14 Apr, 2021 696.52 Kb 296