High Prevalence of Hypocalcemia in Non-severe COVID-19 Patients: A Retrospective Case-Control Study
Pal et al.
, High Prevalence of Hypocalcemia in Non-severe COVID-19 Patients: A Retrospective Case-Control Study
, Frontiers in Medicine, doi:10.3389/fmed.2020.590805
Retrospective 72 non-severe COVID-19 patients in India, showing very high levels of vitamin D deficiency (70 of 72 patients).
Pal et al., 7 Jan 2021, peer-reviewed, 11 authors.
Abstract: BRIEF RESEARCH REPORT
published: 07 January 2021
High Prevalence of Hypocalcemia in
Non-severe COVID-19 Patients: A
Retrospective Case-Control Study
Rimesh Pal 1 , Sant Ram 2*, Deepy Zohmangaihi 2 , Indranil Biswas 3 , Vikas Suri 4 ,
Laxmi N. Yaddanapudi 3 , Pankaj Malhotra 4 , Shiv L. Soni 3 , Goverdhan D. Puri 3 ,
Ashish Bhalla 4 and Sanjay K. Bhadada 1*
Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 2 Department
of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 3 Department of
Anesthesiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 4 Department of Internal
Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
University of Bari Aldo Moro, Italy
University of Siena, Italy
Sudhaker D. Rao,
Henry Ford Hospital, United States
Sanjay K. Bhadada
This article was submitted to
Infectious Diseases - Surveillance,
Prevention and Treatment,
a section of the journal
Frontiers in Medicine
Received: 03 August 2020
Accepted: 09 December 2020
Published: 07 January 2021
Pal R, Ram S, Zohmangaihi D,
Biswas I, Suri V, Yaddanapudi LN,
Malhotra P, Soni SL, Puri GD, Bhalla A
and Bhadada SK (2021) High
Prevalence of Hypocalcemia in
Non-severe COVID-19 Patients: A
Retrospective Case-Control Study.
Front. Med. 7:590805.
Frontiers in Medicine | www.frontiersin.org
Purpose: To compare serum total calcium and phosphate levels in patients with
non-severe COVID-19 with age, sex, and serum 25-hydroxyvitamin D level matched
healthy adult cohort.
Methods: In this retrospective case-control study, medical records of patients (≥18
years) diagnosed as non-severe COVID-19 admitted at and discharged from our
tertiary care institution during the period from April 10, 2020 and June 20, 2020
were retrieved. Baseline investigations, notably, serum calcium, phosphate, albumin,
magnesium, 25-hydroxyvitamin D, and C-reactive protein (CRP), were performed at
admission before any form of calcium or vitamin D supplementation were considered.
The biochemical parameters were compared with age, sex, and 25-hydroxyvitamin D
matched healthy adult controls (1:1 ratio) derived from the Chandigarh Urban Bone
Epidemiological Study (CUBES).
Results: After exclusion, 72 patients with non-severe COVID-19 (63 mild and 9
moderate disease) and an equal number of healthy controls were included in the final
analysis. Age, sex, serum 25-hydroxyvitamin D, and albumin levels were matched
between the 2 groups. Hypovitaminosis D and hypocalcemia were seen in 97 and 67%
of the patients, respectively. The patients had lower serum calcium (P value <0.001) and
phosphate (P = 0.007) compared with the controls. There was no statistically significant
correlation between serum calcium and CRP.
Conclusions: Hypocalcemia is highly prevalent even in COVID-19 patients with
non-severe disease probably implying that hypocalcemia is intrinsic to the disease.
Prospective studies with larger number of patients are required to prove this hypothesis
and unravel the underlying pathophysiological mechanisms.
Keywords: COVID-19, calcium, hypocalcemia, hypovitaminosis D, vitamin D
January 2021 | Volume 7 | Article..
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