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Hypercalcemia as a Biomarker of Poor Prognosis in Frail Elderly Patients with COVID-19
1Cédric Annweiler, MD, PhD, Department of Geriatric Medicine, Angers University Hospital, F-49933 Angers, France; E-mail: Cedric.Annweiler@chu-angers.fr; Phone: ++33 2 41 35 47 25; Fax: ++33 2 41 35 48 94.
Insights
Hypercalcemia, or high calcium levels, in frail elderly patients hospitalized with COVID-19 was linked to increased 3-month mortality. This finding highlights a potential risk factor in this vulnerable population.
Area of Science:
- Gerontology
- Infectious Diseases
- Endocrinology
Background:
- COVID-19 poses significant risks to elderly populations, particularly those who are frail.
- Electrolyte imbalances, such as hypercalcemia, may influence disease severity and outcomes.
Purpose of the Study:
- To investigate the association between early hypercalcemia and 3-month mortality in frail elderly patients hospitalized with COVID-19.
Main Methods:
- A cohort study assessed calcium and albumin levels at admission in geriatric patients with COVID-19.
- Hypercalcemia was defined as corrected calcium >2.5 mmol/L.
- Statistical analyses, including adjusted hazard ratios and survival analysis, were performed.
Main Results:
- 22.3% of participants had hypercalcemia; 0% had hypocalcemia.
- Hypercalcemia was significantly associated with increased 3-month mortality (adjusted HR=3.03, P=0.009).
- Patients with hypercalcemia had shorter survival times compared to those with normocalcemia (log-rank P=0.002).
Conclusions:
- Hypercalcemia at hospital admission is linked to poorer survival outcomes in frail elderly patients with COVID-19.
- Early identification and management of hypercalcemia may be crucial for improving survival in this patient group.
Abstract:
The objective of this cohort study was to determine whether hypercalcemia in early COVID-19 was associated with 3-month mortality in frail elderly patients. Circulating calcium and albumin concentrations at hospital admission and 3-month mortality were assessed in geriatric patients hospitalized for COVID-19 with normal-to-high calcium concentrations. Hypercalcemia was defined as corrected calcium >2.5mmol/L. Covariables were age, sex, functional abilities, malignancies, hypertension, cardiomyopathy, number of acute health issues, use antibiotics and respiratory treatments. In total, 94 participants (mean±SD 88.0±5.5years; 47.9% women; 22.3% hypercalcemia; 0% hypocalcemia) were included. Sixty-five participants who survived at 3months exhibited less often hypercalcemia at baseline than the others (13.9% versus 41.4%, P=0.003). Hypercalcemia was associated with 3-month mortality (fully-adjusted HR=3.03, P=0.009) with specificity=0.86 and sensitivity=0.41. Those with hypercalcemia had shorter survival time than those with normocalcemia (log-rank P=0.002). In conclusion, hypercalcemia was associated with poorer survival in hospitalized frail elderly COVID-19 patients.
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