Severe hypocalcaemia in a COVID-19 female patient
Edmond Puca1, Entela Puca2, Pellumb Pipero1
1Service of Infection Diseases, University Hospital Center, Tirane, Albania.
Insights
This case report highlights a COVID-19 patient with severe hypocalcemia, emphasizing the importance of monitoring calcium and vitamin D levels in patients with coronavirus disease. These deficiencies may correlate with COVID-19 severity.
Area of Science:
- * Internal Medicine
- * Infectious Diseases
- * Critical Care Medicine
Background:
- * Comorbidities are recognized risk factors for severe outcomes in patients with coronavirus disease (COVID-19).
- * The precise mechanisms underlying COVID-19 pathogenesis, particularly concerning metabolic derangements, remain incompletely understood.
- * Standard laboratory findings in COVID-19 are often nonspecific, though lymphopenia and elevated inflammatory markers are common.
Purpose of the Study:
- * To report a case of COVID-19 presenting with severe hypocalcemia.
- * To underscore the potential significance of calcium and vitamin D levels in COVID-19 patients.
- * To explore the possible correlation between vitamin D deficiency and COVID-19 disease severity.
Main Methods:
- * A case report detailing an 81-year-old female diagnosed with COVID-19.
- * Clinical presentation included fatigue, myalgia, fever, cough, and lymphopenia.
- * Laboratory investigations revealed severe hypocalcemia, hypoalbuminemia, and vitamin D deficiency; diagnostic imaging included a chest CT scan.
Main Results:
- * The patient presented with severe hypocalcemia (serum corrected calcium: 5.7 mg/dL) and low vitamin D levels (4.5 ng/mL), despite normal parathyroid hormone levels.
- * COVID-19 was confirmed via RT-PCR, with chest CT showing peripheral ground-glass opacities.
- * Treatment involved antiviral therapy, antibiotics, anticoagulation, high-dose calcium and vitamin D3 supplementation, and oxygen therapy.
Conclusions:
- * This case suggests a potential link between COVID-19 infection and severe hypocalcemia.
- * Monitoring vitamin D and calcium levels is crucial in COVID-19 management, as deficiencies may influence disease severity.
- * Further research is warranted to elucidate the relationship between calcium/vitamin D metabolism and COVID-19 pathogenesis.
Summary:
Comorbidities are a risk factor for patients with COVID-19 and the mechanisms of disease remain unclear. The aim of this paper is to present a case report of an COVID-19 patient with severe hypocalcaemia. This is a report of an 81-year-old female, suffered from myalgia and fatigue for more than 3-4 weeks. Fever and cough appear 2 days before she presented to the emergency room. On physical examination, she was febrile with a temperature of 38.8°C, accompanied by cough, sore throat, headache, fatigue, and muscle ache. Her past medical history was remarkable with no chronic disease. She had lymphopenia. Laboratory test revealed moderate liver dysfunction, hypoalbuminemia, and severe hypocalcaemia (serum corrected calcium level: 5.7 mg/dL). Parathyroid hormone (PTH) was 107.9 pg/mL (range: 15-65) and 25(OH)2D levels was 4.5 ng/mL (range: 25-80). Chest CT scan detected peripheral ground-glass opacity. Throat swab for coronavirus by RT-PCR assay tested positive for the virus. She was treated with lopinavir/ritonavir, third generation cephalosporin, anticoagulant, daily high-dose calcium acetate, vitamin D3, fresh frozen plasma and oxygen therapy. She was discharged after two negative throat swab tests for coronavirus by conventional RT-PCR.
Learning Points:
Comorbidities are a risk factor for patients with COVID-19. Laboratory findings are unspecific in COVID-19 patients; laboratory abnormalities include lymphopenia, elevated of LDH, CPK and the inflammatory markers, such as C reactive protein, ferritinemia and the erythrocyte sedimentation rate. In addition to inflammatory markers, in COVID-19 patients it is crucial to check the level of vitamin D and calcium. There may be a correlation between vitamin D deficiency and the severity of COVID-19 disease.
Related Concept Videos
01:21Skeleton and Calcium Homeostasis
01:17Antiepileptic Drugs: Calcium Channel Blockers
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
01:29Acute Kidney Injury III: Clinical Manifestations
01:30Acute Respiratory Failure-III
01:27Pulmonary Embolism III: Nursing Management
01:24Chronic Kidney Disease II: Clinical Manifestations