Diagnostic value of serum total calcium level in the prognosis of severe COVID-19 patients

doi:10.3969/j.issn.1673-8640.2020.10.010

Abstract

Abstract:

Objective To investigate the role of serum calcium level in the prognosis of severe corona virus disease 2019（COVID-19） patients. Methods The data（sex,age,past medical history,complications,outcomes and so on）,C-reactive protein（CRP）,procalcitonin（PCT）,serum glucose,serum calcium and acute physiology and chronic health evaluation scoring system Ⅱ（APACHE Ⅱ） within 24 h of intensive care unit（ICU） admission and 28 d mortality of 69 patients with severe COVID-19 were collected and analyzed retrospectively. According to serum calcium levels,the patients were classified into normal group（serum calcium 2.11-2.52 mmol/L） and hypocalcemia group（serum calcium < 2.11 mmol/L）. According to 28 d prognosis,the patients were classified into survival group and death group. Spearman correlation analysis was used for correlation analysis. Receiver operating characteristic（ROC） curve was used to evaluate the diagnostic value of serum calcium level for prognosis. Kaplan-Meier survival analysis was used to compare accumulative survival rate. Results The incidence of hypocalcemia in patients with severe COVID-19 was 57.97%. The prevalence of chronic kidney disease,age,CRP,serum glucose,APACHEⅡ and the proportions of the complications of acute respiratory distress syndrome（ARDS）,shock and hypoalbuminemia in hypocalcemia group were higher than those in normal group（P<0.05）. However,there was no statistical significance in sex and PCT between the 2 groups（P>0.05）. Spearman correlation analysis showed that there was a negative correlation between serum calcium level and CRP,serum glucose and APACHEⅡ（r values were -0.48,-0.41 and -0.65,respectively,P<0.05）,but there was no correlation with PCT（r=-0.18,P>0.05）. ROC curve analysis showed that the area under curve（AUC） of serum calcium for predicting the prognosis of severe COVID-19 was 0.777. The 28 d accumulative survival rate of hypocalcemia group was lower than that of normal group through Kaplan-Meier survival analysis（P=0.019）.Conclusions The prognosis of severe COVID-19 patients with hypocalcemia is poor. Serum calcium may be used as a predictor for prognosis in patients with severe COVID-19.

Key words: Serum calcium, Corona virus disease 2019, Severe acute respiratory syndrome coronavirus 2, Hypocalcemia

CLC Number:

R446.1

WANG Jianru, BAI Huan, ZHANG Chi. Diagnostic value of serum total calcium level in the prognosis of severe COVID-19 patients[J]. Laboratory Medicine, 2020, 35(10): 1008-1012.

Figures/Tables 5

References 19

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组别	例数	ARDS	休克	急性心脏损伤	AKI	肝脏损伤	低蛋白血症	酸碱异常
正常血钙组	29	7	4	5	2	3	1	2
低钙血症组	40	29	15	12	9	11	10	5
χ²值		15.76	4.74	1.47	2.00	3.06	4.33	0.13
P值		<0.01	0.03	0.23	0.16	0.08	0.04	0.72

组别	例数	ARDS	休克	急性心脏损伤	AKI	肝脏损伤	低蛋白血症	酸碱异常
正常血钙组	29	7	4	5	2	3	1	2
低钙血症组	40	29	15	12	9	11	10	5
χ²值		15.76	4.74	1.47	2.00	3.06	4.33	0.13
P值		<0.01	0.03	0.23	0.16	0.08	0.04	0.72

组别	例数	血钙/（mmol/L）	APACHEⅡ评分/分
存活组	56	2.11 ±0.17	9.84 ±2.72
死亡组	13	1.94 ±0.16	21.46 ±5.21
t值		3.239	-7.49
P值		<0.01	<0.01

组别	例数	血钙/（mmol/L）	APACHEⅡ评分/分
存活组	56	2.11 ±0.17	9.84 ±2.72
死亡组	13	1.94 ±0.16	21.46 ±5.21
t值		3.239	-7.49
P值		<0.01	<0.01