youngsinatra
Member
I am currently at home, because I got tested positive for COVID thrice lately and I was curious if there is a connection between COVID-19 severity and calcium metabolism (PTH, vitamin D, serum calcium, phosphate) and it turns out that there is something!
"In a large group of SARS patients in North America, hypocalcemia was detected in 60% of patients at hospital admission and in 70% during hospitalization [6]. Moreover, data from patients with Ebolavirus infection in United States and European hospitals reported a similar incidence of hypocalcemia [7]."
- Hypocalcemia is highly prevalent and predicts hospitalization in patients with COVID-19
"Few mechanisms which explain the causes of hypocalcaemia in COVID-19 have been discussed, such as vitamin D deficiency, hypoalbuminemia, impaired intestinal absorption of calcium, hypoxic tissue damage with subsequent increase in calcium influx and impaired secretion of and response to parathyroid hormone (PTH) secondary to increased levels of inflammatory cytokines"
"To date, little is known about the effect of the novel coronavirus (SARS-CoV-2) on parathyroid glands. Elkattawy et al. reported a 46-year-old patient admitted with severe COVID-19 infection and had a prolonged hospital stay. His laboratory workup showed hyperphosphatemia and low parathyroid hormone level. All possible causes of hypoparathyroidism have been excluded. To the best of our knowledge, this is the first and the only report in the literature so far which stated that COVID-19 can be considered as a possible direct cause of hypoparathyroidism [2]. Because of the limited data which link between SARS-CoV-2 and parathyroid glands, going back to the studies which were conducted on the previous generation of coronavirus (SARS-CoV), the culprit of severe acute respiratory syndrome (SARS) epidemic in 2003, could improve our understanding of this topic. Tissue samples taken from patients died of SARS identified SARS-CoV RNA and antigenic materials in parathyroid gland acidophilic cells [3]. In addition, Increased expression levels of angiotensin converting enzyme 2 (ACE2) receptors were detected in acidophilic cells of parathyroid glands [4]. Therefore, SARS-CoV-2 might have the potential to directly invade the parathyroid glands by binding with acidophilic cells ACE2 receptors. This could explain the finding of hypoparathyroidism in the COVID-19 patient reported by Elkattawy et al."
- The effect of COVID-19 on parathyroid glands
There are also some papers that show that PTH secretion is impaired in COVID-19 and thus causing hypocalcemia. Maybe some more clues why vitamin D (and dietary calcium) may be so protective against COVID-19 severity.
"In a large group of SARS patients in North America, hypocalcemia was detected in 60% of patients at hospital admission and in 70% during hospitalization [6]. Moreover, data from patients with Ebolavirus infection in United States and European hospitals reported a similar incidence of hypocalcemia [7]."
- Hypocalcemia is highly prevalent and predicts hospitalization in patients with COVID-19
"Few mechanisms which explain the causes of hypocalcaemia in COVID-19 have been discussed, such as vitamin D deficiency, hypoalbuminemia, impaired intestinal absorption of calcium, hypoxic tissue damage with subsequent increase in calcium influx and impaired secretion of and response to parathyroid hormone (PTH) secondary to increased levels of inflammatory cytokines"
"To date, little is known about the effect of the novel coronavirus (SARS-CoV-2) on parathyroid glands. Elkattawy et al. reported a 46-year-old patient admitted with severe COVID-19 infection and had a prolonged hospital stay. His laboratory workup showed hyperphosphatemia and low parathyroid hormone level. All possible causes of hypoparathyroidism have been excluded. To the best of our knowledge, this is the first and the only report in the literature so far which stated that COVID-19 can be considered as a possible direct cause of hypoparathyroidism [2]. Because of the limited data which link between SARS-CoV-2 and parathyroid glands, going back to the studies which were conducted on the previous generation of coronavirus (SARS-CoV), the culprit of severe acute respiratory syndrome (SARS) epidemic in 2003, could improve our understanding of this topic. Tissue samples taken from patients died of SARS identified SARS-CoV RNA and antigenic materials in parathyroid gland acidophilic cells [3]. In addition, Increased expression levels of angiotensin converting enzyme 2 (ACE2) receptors were detected in acidophilic cells of parathyroid glands [4]. Therefore, SARS-CoV-2 might have the potential to directly invade the parathyroid glands by binding with acidophilic cells ACE2 receptors. This could explain the finding of hypoparathyroidism in the COVID-19 patient reported by Elkattawy et al."
- The effect of COVID-19 on parathyroid glands
There are also some papers that show that PTH secretion is impaired in COVID-19 and thus causing hypocalcemia. Maybe some more clues why vitamin D (and dietary calcium) may be so protective against COVID-19 severity.