Hypocalcemia in COVID-19: A prognostic marker for severe disease

Background & Objective: Previous studies have addressed the electrolyte abnormalities such as hypocalcemia in COVID-19 patients. We aimed to compare the laboratory findings especially the electrolyte levels among COVID-19 patients and healthy controls and evaluate their prognostic values. Methods: This case-control study included 91 COVID-19 patients and 169 healthy individuals. Their laboratory parameters including electrolytes, albumin, liver enzymes, complete blood count, vitamin D, and parathyroid hormone (PTH) were compared. We also analyzed the association between these markers and the major outcomes including severity, mortality and hospitalization. Results: Among patients with COVID-19, 59.3 of the patients had hypocalcemia on admission while in control group only 32.5 had low calcium level (OR=3.02, 95 CI: 1.79-5.13, P<0.001). The rates of death and ICU admission were significantly higher among the patients in hypocalcemic group than those of eucalcemic group (85.7 vs 14.3 and 33.3 Vs 9.1, respectively). However, there was no significant difference in the mean PTH and vitamin D levels between the two groups. In terms of the severity of the infection, 74.1 of patients in hypocalcemic group had a severe infection while 24.3 of the patients in eucalcemic group were diagnosed with severe infection (OR=8.89, 95 CI: 3.38-23.37, P<0.001). Conclusion: Patients with COVID-19 may present with considerable laboratory abnormalities including hypocalcemia. The hypocalcemia would be also associated with worse major clinical outcome and higher mortality risk

Vitamin D deficiency and mode of delivery: a study in Tehran Women General Hospital

Background: Vitamin D deficiency is a widespread problem especially in the developing countries like Iran. The prevalence of vitamin D deficiency differs from moderate to severe among Iranian women, particularly among pregnant women, and it can cause some problems such as preeclampsia, gestational diabetes mellitus (GDM), premature labor and primary cesarean section. The aim of this study was to evaluate whether the mode of delivery is related to serum vitamin D levels or not; and if there is any difference in the percentage of cesarean section between vitamin D-deficient and vitamin D-insufficient women. Methods: This cross-sectional study was carried out between the April 2012 and April 2014 in a woman university hospital, Tehran, Iran. One hundred and eighty-six women aged between 17 and 52 years old (Mean age 28.46 and SD5.97) were surveyed in this study. The study group comprised of (N=186) consecutive cases attending Tehran Women General Hospital Clinic for normal vaginal delivery or cesarean section. Women who underwent cesarean section due to previous cesarean delivery were not recruited for the study. The participants were divided into two groups: women with vaginal delivery and women with cesarean section. Serum vitamin D concentration (25(OH) Vitamin D) was measured for each patient. Concentration of serum vitamin D was compared between these 2 groups. Results: One hundred and twenty-eight (68.8%) women had cesarean section and 58 (32.2%) had vaginal delivery. Median and inter-quartile range (IQR) of serum 25(OH) D were 13.64 and 12.47 ng/ml; respectively, among women with cesarean section, compared to 11.68 and 12.59 ng/ml in those with vaginal delivery. No statistically significant difference was detected in serum vitamin D between these 2 groups (P=0.72). In addition, no statistically significant difference was detected between women with vitamin D deficiency and women who were vitamin D insufficient (P=0.8). Conclusion: In this study, there was no association between serum vitamin D levels and delivery mode