Hypocalcaemia and covid-19

Hypocalcaemia and covid-19

Publication date: 13-05-2021

Updated on: 14-02-2023

Topic: Covid-19

Estimated reading time: 1 min

Endocrinologists at the San Raffaele Research Hospital have been investigating low calcium levels in COVID-19 patients by evaluating possible clinical implications

A low level of calcium in COVID-19 patients’ blood is a predictive factor in the disease evolution regardless other pathologies. It can help to identify in advance those who are more likely to develop more serious illnesses.

These are the results of the study published in the Endocrine journal, which had been selected among the most prestigious Springer Nature 2020 Highlights. The study was conducted by Dr. Luigi Di Filippo, endocrinologist at the Vita-Salute San Raffaele University (UniSR), and coordinated by Prof. Andrea Giustina, Head of the Endocrinology Department at the San Raffaele Research Hospital, Vice-Rector and Professor of Endocrinology and Metabolic Diseases at UniSR, President of the European Society of Endocrinology.

The study

The study analysed 531 COVID-19 patients, which were admitted to the emergency room of the San Raffaele Research Hospital in March-April 2021 and were tested for serum calcium levels during initial evaluation.

Endocrinologists excluded patients with comorbidities and concomitant therapies influencing calcium metabolism, for example chronic kidney disease, diuretic treatments and osteoporosis.

“The idea of this retrospective analysis was born after a particular case of COVID-19 patient with severe hypocalcaemia. The aim of our study was to investigate the incidence of hypocalcaemia, if we can consider it as a sporadic or as a constant event in the population with aggressive COVID-19 forms,” explains Prof. Andrea Giustina.

Results: connection between calcium levels and covid-19

Hypocalcaemia was found in 80% of patients affected by the most aggressive COVID-19 forms, what led to hospitalization. These patients had significantly lower ionized calcium levels compared to non-hospitalized ones.

69% of hypercalcaemic patients were males with average age of 59.

Therefore, the study demonstrates that there is a strong connection between a very high incidence of hypocalcaemia and COVID-19 patients in critical condition.

Role of calcium and vitamin D

“According to the research outcomes, ionized calcium level tests, together with clinical and biochemical parameters, played a crucial role in identifying patients in severe conditions during initial medical evaluation.

Moreover, hypocalcaemia has a negative impact on cardiovascular and neurological manifestations, since it can be lethal in severe or acute form. It’s important to keep monitoring calcium levels in hospitalized COVID-19 patients and provide them with adequate calcium supplement when necessary,” explains Dr. Luigi Di Filippo, first author of the study.

Data registered in this study also interestingly related to another Italian population’s health problem: lack of vitamin D. It is also called hypovitaminosis D. Vitamin D is a nutrient that has beneficial effects on immune system.

Vitamin D plays essential role in calcium absorption, as underlined by Prof. Giustina and published in the British Medical Journal:

“In conclusion, based on the previous considerations, it could be hypothesized that low vitamin D could be partly linked to low serum calcium levels in the Italian population.”

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