ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1504326
Hypocalcemia is associated with adverse outcomes in patients with diabetes and COVID-19
Provisionally accepted
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Background: Patients with diabetes and COVID-19 have a worse prognosis. The aim of this study was to investigate the prevalence of hypocalcemia in patients with diabetes and COVID-19, and assess the relationship between serum calcium levels and prognosis in these patients.Methods: A retrospective analysis was conducted on 919 patients with diabetes admitted for COVID-19 from February 2022 to May 2022. The population was categorized into three groups according to serum calcium levels. The primary outcome was the risk of developing severe COVID-19, and the secondary outcomes included the risk of requiring advanced respiratory support (including high-flow oxygen, non-invasive ventilation, and invasive ventilation). Logistic regression analysis was used to evaluate the association between hypocalcemia and the prognosis of COVID-19 patients with diabetes.Result: Among the 919 patients with diabetes, the median age was 70 (56-81) years, and 498 (54.2%) were male. The prevalence of hypocalcemia in COVID-19 patients with diabetes was 78.8%. The serum calcium level was negatively correlated with inflammatory markers (hsCRP, ESR, PCT, IFN). The serum calcium level was positively correlated with albumin, CD4+ T cell counts, and CD8+ T cell counts. In Multivariate analysis, after adjustment for age and gender, the higher risk of severe illness was observed in patients with a serum calcium level <1.94 mmol/L (OR 2.86, 95%CI [1.78-4.59], P<0.001).Admission serum calcium level is associated with the prognosis of COVID-19 patients with diabetes. Hypocalcemia increases the risk of progression to severe COVID-19 in patients with diabetes.
Keywords: COVID-19, Hypocalcemia, diabetes, Serum calcium, outcome. (Min.5-Max. 8
Received: 30 Sep 2024; Accepted: 12 Jun 2025.
Copyright: © 2025 Xu, Zhu, Yang, Liu, Wu, Qu, Wang and zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaolong zhao, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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