期刊
JOURNAL OF MEDICAL VIROLOGY
卷 93, 期 3, 页码 1639-1651出版社
WILEY
DOI: 10.1002/jmv.26515
关键词
calcium; COVID-19; discriminative performance; phosphorus
类别
资金
- Novel Coronavirus Epidemic Prevention and Control Research Project of Shanxi Province [202003D31002/GZ, 202003D31005/GZ]
- Research Project of Shanxi Health Commission [6]
This study found that low serum calcium and phosphorus are more prevalent in severe or critical COVID-19 patients, with high specificity but suboptimal sensitivity. Combining calcium and phosphorus with lymphocyte count provides the best discriminatory performance for severe COVID-19 patients.
Background This study aimed to evaluate the clinical performance of low serum calcium and phosphorus in discriminative diagnosis of the severity of patients with coronavirus disease 2019 (COVID-19). We conducted a single-center hospital-based study and consecutively recruited 122 suspected and 104 confirmed patients with COVID-19 during January 24 to April 25, 2020. Clinical risk factors of COVID-19 were identified. The discriminative power of low calcium and phosphorus regarding the disease severity was evaluated. Low calcium and low phosphorus are more prevalent in severe or critical COVID-19 patients than moderate COVID-19 patients (odds ratio [OR], 15.07; 95% confidence interval [CI], 1.59-143.18 for calcium; OR, 6.90; 95% CI, 2.43-19.64 for phosphorus). The specificity in detecting the severe or critical patients among COVID-19 patients reached 98.5% (95% CI, 92.0%-99.7%) and 84.8% (95% CI, 74.3%-91.6%) by low calcium and low phosphorus, respectively, albeit with suboptimal sensitivity. Calcium and phosphorus combined with lymphocyte count could obtain the best discriminative performance for the severe COVID-19 patients (area under the curve [AUC] = 0.80), and combined with oxygenation index was promising (AUC = 0.71). Similar discriminative performances of low calcium and low phosphorus were found between suspected and confirmed COVID-19 patient. Low calcium and low phosphorus could indicate the severity of COVID-19 patients, and may be utilized as promising clinical biomarkers for discriminative diagnosis.
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