ABSTRACT
Due to global spread of COVID-19, the search for new factors that could influence its clinical course becomes highly important. This review summarize the relevant publications on the association between immune system and the main regulators of mineral homeostasis including. In addition, we have highlighted the various aspects of phosphorus-calcium metabolism related to the acute respiratory diseases and in particular to COVID-19. The data about the calcium-phosphorus metabolism in SARS-CoV-2 infection is required to understand the possible clinical implications and to develop new therapeutic and preventive interventions.
Subject(s)
COVID-19 , Vitamin D Deficiency , Humans , Vitamin D Deficiency/drug therapy , Vitamin D/therapeutic use , Parathyroid Hormone , Calcium/metabolism , SARS-CoV-2 , Phosphorus/metabolism , MineralsABSTRACT
Increasingly, there is evidence of the association of mineral metabolism with COVID-19, in particular states such as hypocalcaemia, vitamin D deficiency, which may weigh up the course of a new coronavirus infection. Objective. Evaluate the basic parameters of mineral metabolism in patients with COVID-19 of different severity at admission to the hospital. Material and methods. A single-center study was carried out at the Endocrinology Research Centre, Moscow. Analysis of the mineral metabolism parameters, as well as clinical and instrumental assessment of the COVID-19 severity before specific immunotherapy was performed in 60 patients. Results. The frequency of hypocalcemia (according to the level of albumin-adjusted calcium) and vitamin D deficiency/insufficiency in the study group was 36.7 and 95%, respectively. Lower saturation (SpO2) was observed in the subgroup with a lower level of 25(OH)D (p=0.001) and calcium (p=0.002). Patients with severe COVID-19 pneumonia (computer tomography (CT) scan grade 3-4) compared with those with less changes (CT grade 1-2) had significantly lower total calcium and albumin (p<0.001 for both). Decreased vitamin D levels were associated with higher CRP values (OR 0.892, 95% CI 0.8-0.995) and lower SpO2 (OR 1.227, 95% CI 1.028-1.465). Conclusion. The severe course of COVID-19 is associated with significantly lower levels of 25(OH)D and calcium, which indicates the necessity for their timely correction. Further research is needed to determine the impact of impaired mineral metabolism on COVID-19 to develop the optimal therapeutic approach to patients with SARS-CoV-2. © 2020, Media Sphera Publishing Group. All rights reserved.