التفاصيل البيبلوغرافية
| العنوان: |
Retrospective case–control study to evaluate hypocalcaemia as a distinguishing feature of COVID-19 compared with other infective pneumonias and its association with disease severity |
| المؤلفون: |
Mehta, Meera, Ghani, Hakim, Chua, Felix, Draper, Adrian, Calmonson, Sam, Prabhakar, Meghna, Shah, Rijul, Navarra, Alessio, Vaghela, Tejal, Barlow, Andrew, Vancheeswaran, Rama |
| المصدر: |
BMJ Open ; volume 11, issue 12, page e053810 ; ISSN 2044-6055 2044-6055 |
| بيانات النشر: |
BMJ |
| سنة النشر: |
2021 |
| الوصف: |
Objectives To investigate whether calcium derangement was a specific feature of COVID-19 that distinguishes it from other infective pneumonias, and its association with disease severity. Design A retrospective observational case–control study looking at serum calcium on adult patients with COVID-19, and community-acquired pneumonia (CAP) or viral pneumonia (VP). Setting A district general hospital on the outskirts of London, UK. Participants 506 patients with COVID-19, 95 patients with CAP and 152 patients with VP. Outcome measures Baseline characteristics including hypocalcaemia in patients with COVID-19, CAP and VP were detailed. For patients with COVID-19, the impact of an abnormally low calcium level on the maximum level of hospital care, as a surrogate of COVID-19 severity, was evaluated. The primary outcome of maximal level of care was based on the WHO Clinical Progression Scale for COVID-19. Results Hypocalcaemia was a specific and common clinical finding in patients with COVID-19 that distinguished it from other respiratory infections. Calcium levels were significantly lower in those with severe disease. Ordinal regression of risk estimates for categorised care levels showed that baseline hypocalcaemia was incrementally associated with OR of 2.33 (95% CI 1.5 to 3.61) for higher level of care, superior to other variables that have previously been shown to predict worse COVID-19 outcome. Serial calcium levels showed improvement by days 7–9 of admission, only in survivors of COVID-19. Conclusion Hypocalcaemia is specific to COVID-19 and may help distinguish it from other infective pneumonias. Hypocalcaemia may independently predict severe disease and warrants detailed prognostic investigation. The fact that decreased serum calcium is observed at the time of clinical presentation in COVID-19, but not other infective pneumonias, suggests that its early derangement is pathophysiological and may influence the deleterious evolution of this disease. Trial registration number 20/HRA/2344. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1136/bmjopen-2021-053810 |
| الإتاحة: |
https://doi.org/10.1136/bmjopen-2021-053810Test |
| حقوق: |
http://creativecommons.org/licenses/by-nc/4.0Test/ |
| رقم الانضمام: |
edsbas.EC4D6A37 |
| قاعدة البيانات: |
BASE |
