Horm Metab Res 2023; 55(01): 31-39
DOI: 10.1055/a-1899-8862
Original Article: Endocrine Care

Serum Calcium, Magnesium, and Phosphorus Levels in Patients with COVID-19: Relationships with Poor Outcome and Mortality

1   Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Spain
Pedro Iglesias
1   Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Spain
Agustín García
2   Department of Admission and Clinical Documentation, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
Ignacio Martín-Casasempere
3   Subdirección General de Farmacia y Productos Sanitarios, Consejería de Sanidad de la Comunidad de Madrid, Madrid, Spain
Francisco A. Bernabéu-Andréu
4   Department of Biochemistry, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
› Author Affiliations


In this retrospective study to assess the impact of serum corrected calcium (CorrCa), magnesium (Mg) and phosphorus (P) levels, all adult patients with laboratory-confirmed COVID-19 hospitalized during 2020 were included. Poor outcome was considered in patients who presented need for mechanical ventilation, intensive care unit (ICU) admission, or in-hospital mortality. We analyzed 2473 patients (956 females) aged (mean±SD) 63.4±15.9 years. During admission, 169 patients (6.8%) required mechanical ventilation, 205 (8.3%) were admitted to the ICU, and 270 (10.9%) died. Composite variable of poor outcome, defined as need for mechanical ventilation, ICU admission or death, was present in 434 (17.5%) patients. In univariate analysis, the need for mechanical ventilation was positively related to Mg levels (OR 8.37, 95% CI 3.62–19.33; p<0.001); ICU admission was related to CorrCa (OR 0.49, 95% CI 0.25–0.99; p=0.049) and Mg levels (OR 5.81, 95% CI 2.74–12.35; p<0.001); and in-hospital mortality was related to CorrCa (OR 1.73, 95% CI 1.14–2.64; p=0.011). The composite variable of poor outcome was only related to Mg (OR 2.68, 95% CI 1.54–4.68; p=0.001). However, in multivariate analysis only CorrCa was significantly related to the need for mechanical ventilation (OR 0.19, 95% CI 0.05–0.72; p=0.014) and ICU admission (OR 0.25; 95% CI 0.09–0.66; p=0.005), but not with in-hospital mortality or the composite variable. In conclusion, CorrCa can be used as a simple and reliable marker of poor outcome in patients with COVID-19, although not to predict the risk of in-hospital mortality.

Supplementary Material

Publication History

Received: 26 March 2022

Accepted after revision: 30 June 2022

Article published online:
23 August 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
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