Severe hypocalcaemia in a COVID-19 female patient

Abstract

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.

Serum vitamin D concentration in children with pneumonia and acute respiratory infections, risk factors for its low level

“…In the group of children with pneumonia, 37 (53%) were boys and 33 (47%) were girls, while in the group with ARI, there were 40 (57%) boys and 30 (43%) girls. There were 30 The groups for this study are presented in Table 1. Since the vitamin D deficiency and insufficiency groups were small, they were included in the main group with a low vitamin D content for comparison with the control group with a normal vitamin D content.…”

Parathyroid glands and COVID-19; a neglected entity

“…For example, Puca et al reported a case of significant hypocalcemia following SARS-CoV-2 in a female case, due to the significant vitamin D deficiency. They concluded a possible association among vitamin D deficiency and the intensity of SARS-CoV-2 (6).…”

Premature Ovarian Failure Related to SARS-CoV-2 Infection

“…Although SARS-CoV-2 infection is primarily a respiratory disease, it affects various systems and organs throughout the body. Its effects on the respiratory, cardiac, neurological, hematopoietic, gastrointestinal, muscle-skeletal, cutan, ocular, and urological systems are now well known [2][3][4][5][6][7][8][9][10][11][12][13]. In addition to the typical cases, there have been a large number of reports on atypical forms or presentations of the disease and related complications [11,[14][15][16][17][18].…”

“…Its effects on the respiratory, cardiac, neurological, hematopoietic, gastrointestinal, muscle-skeletal, cutan, ocular, and urological systems are now well known [2][3][4][5][6][7][8][9][10][11][12][13]. In addition to the typical cases, there have been a large number of reports on atypical forms or presentations of the disease and related complications [11,[14][15][16][17][18]. However, there are only a limited number of publications on the effect of SARS-CoV-2 infection on the ovaries.…”