Prevalence and predictive value of hypocalcemia in severe COVID-19 patients
Prevalence and predictive value of hypocalcemia in severe COVID-19 patients
复制标题
重症 COVID-19 患者低钙血症的患病率和预测价值
DOI：
10.1016/j.jiph.2020.05.029
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发表时间：
2020-09-01
影响因子：
6.7
通讯作者：
Tian, Dean
中科院分区：
文献类型：
--
作者：
Liu, Jingmei;Han, Ping;Tian, Dean
背景：本研究旨在探讨低钙血症在重症COVID-19患者中的表现及其预测价值。方法：回顾性分析重症COVID-19患者的临床和实验室特征。将107例患者分为低钙组和正常血钙组。比较两组患者的临床及实验室资料。通过受试者工作曲线（ROC）分析评估低钙对不良预后的判别能力。结果：低钙患者67例（62.6%）。低钙血症组白细胞、c反应蛋白（CRP）、降钙素原（PCT）、白细胞介素6 （IL-6）、d -二聚体水平升高，淋巴细胞和白蛋白（ALB）水平降低。在性别、年龄、体征和症状、合并症和其他实验室指标方面没有发现显著差异。血清钙水平与白细胞、CRP、PCT、IL-6、d -二聚体呈负相关，与淋巴细胞、ALB呈正相关。低钙血症患者预后较差(47.8% （32/67)vs 25% (10/40), p = 0.02）。中位血钙水平在预后较差的患者中显著降低(2.01(1.97-2.05)vs 2.10(2.03-2.20), p < 0.001)，其预测预后的ROC曲线下面积（AUC）为0.73（95%可信区间（CI） 0.63-0.83, p < 0.001）。结论：低钙血症在重症COVID-19患者中常见，且与预后不良相关。(C) 2020作者。由爱思唯尔有限公司代表沙特国王本阿卜杜勒阿齐兹健康科学大学出版。
Background: The aim of this study was to investigate the performance and predictive value of hypocalcemia in severe COVID-19 patients.Methods: We retrospectively investigated the clinical and laboratory characteristics of severe COVID-19 patients. 107 patients were divided into hypocalcemia group and normal serum calcium group. The clinical and laboratory data were compared between two groups. The discriminative power of hypocalcemia regarding poor outcome were evaluated by receiver operating curves (ROC) analyses.Results: Sixty seven patients (62.6%) had hypocalcemia. In hypocalcemia group, leukocytes, c-reactive protein (CRP), procalcitonin (PCT), Interleukin 6 (IL-6), and D-dimer levels was higher, while lymphocytes and albumin (ALB) levels was lower. No significant difference was identified in gender, age, signs and symptoms, comorbidities and other laboratory indicators. Serum calcium levels were negatively correlated with leukocytes, CRP, PCT, IL-6 and D-dimer, while positively correlated with lymphocytes and ALB. Patients with hypocalcemia more commonly presented poor outcome (47.8% (32/67) vs 25% (10/40), p = 0.02). Median serum calcium levels were significantly lower in the patients with poor outcome (2.01(1.97-2.05) vs 2.10(2.03-2.20), p < 0.001), and it could predict the prognosis with an area under the ROC curve (AUC) of 0.73(95% confidence interval (CI) 0.63-0.83, p < 0.001).Conclusions: Hypocalcemia commonly occurred in severe COVID-19 patients and it was associated with poor outcome. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences.