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Conflicts over calcium and the treatment of COVID-19

Bernard Crespi1, Joe Alcock2

  • 1Department of Biological Sciences, Simon Fraser University, Burnaby, BC, Canada.

Evolution, Medicine, and Public Health
|March 18, 2021
PubMed

Insights

Calcium channel blockers may reduce COVID-19 mortality. Hypocalcemia, low serum calcium, is linked to severe COVID-19, potentially acting as a host defense mechanism against viruses, including SARS-CoV-2.

Area of Science:

  • Virology
  • Immunology
  • Pharmacology

Background:

  • Recent studies suggest calcium channel blockers (CCBs) like amlodipine and nifedipine may reduce COVID-19 mortality.
  • Hypocalcemia (low serum ionized calcium) is strongly associated with increased COVID-19 severity.
  • Similar associations between CCBs, hypocalcemia, and viral outcomes exist for other viruses.

Purpose of the Study:

  • To evaluate the role of CCBs and hypocalcemia in the context of virus-host evolutionary conflicts over calcium metabolism.
  • To explore hypocalcemia as a potential antiviral mechanism, considering it as pathology, viral manipulation, or host defense.

Main Methods:

  • Review and synthesis of existing evidence on CCBs, hypocalcemia, and viral infections, particularly COVID-19.
  • Evolutionary analysis of calcium metabolism in virus-host interactions.

Main Results:

  • Evidence supports the hypothesis that hypocalcemia functions as a host defense mechanism against viral infections.
  • CCBs may exert antiviral effects by interfering with calcium metabolism in infected cells, mirroring hypocalcemia's potential effects.

Conclusions:

  • Hypocalcemia may represent a host defense strategy with antiviral properties, potentially modulated by CCBs.
  • Further prospective clinical studies are needed to confirm the efficacy of CCBs and understand the role of hypocalcemia in treating COVID-19 and other viral diseases.

Keywords:
COVID-19SARS-CoV-2calciumconflicthypocalcemia

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