基于COX回归模型分析2 651例COVID-19患者低血钙与不良预后的关系

向和东; 刘川; 柯景彬; 谭虎; 张丽敏; 丁小涵; 李平; 高旭滨; 杨杰; 黄岚

doi:10.16016/j.1000-5404.202011151

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基于COX回归模型分析2 651例COVID-19患者低血钙与不良预后的关系

临床医学 | 更新时间：2026-01-09

- 基于COX回归模型分析2 651例COVID-19患者低血钙与不良预后的关系
- Correlation of hypocalcemia with poor prognosis of COVID-19 based on COX regression model: an analysis of 2 651 patients
- 第三军医大学学报 2021年43卷第8期页码：722-729
- 作者机构：
  
  400037 重庆，陆军军医大学(第三军医大学)第二附属医院心血管内科，全军心血管病研究所
- 作者简介：
  
  [黄岚，E-mail：huanglan260@126.com HUANG Lan, E-mail: huanglan260@126.com
- 基金信息：
- DOI：10.16016/j.1000-5404.202011151
  中图分类号： R511;R563.107;R591.1
- 收稿：2020-11-17，
  
  修回：2021-02-08，
  
  纸质出版：2021-04-30
- 稿件说明：
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向和东, 刘川, 柯景彬, 等. 基于COX回归模型分析2 651例COVID-19患者低血钙与不良预后的关系[J]. 第三军医大学学报, 2021,43(8):722-729.

Hedong XIANG, Chuan LIU, Jingbin KE, et al. Correlation of hypocalcemia with poor prognosis of COVID-19 based on COX regression model: an analysis of 2 651 patients[J]. Journal of Third Military Medical University, 2021, 43(8): 722-729.
向和东, 刘川, 柯景彬, 等. 基于COX回归模型分析2 651例COVID-19患者低血钙与不良预后的关系[J]. 第三军医大学学报, 2021,43(8):722-729. DOI： 10.16016/j.1000-5404.202011151.

Hedong XIANG, Chuan LIU, Jingbin KE, et al. Correlation of hypocalcemia with poor prognosis of COVID-19 based on COX regression model: an analysis of 2 651 patients[J]. Journal of Third Military Medical University, 2021, 43(8): 722-729. DOI： 10.16016/j.1000-5404.202011151.

摘要

目的

探讨低血钙与COVID-19患者预后不良的关系。

方法

回顾性分析2020年2月4日至4月11日在武汉火神山医院就诊的2 651例COVID-19患者资料，对比分析低血钙组患者(

=773)与正常血钙组患者(

=1 878)的人口学基本特征、实验室检查、治疗、并发症和预后结果，采用Cox回归模型分析低血钙是否为COVID-19患者预后不良的独立危险因素。

结果

与正常血钙组比较，低血钙组患者机械通气使用率、体外膜肺氧合使用率和重症监护室入住率显著升高(

0.05)，脓毒血症、休克、急性呼吸窘迫综合征、呼吸衰竭、低蛋白血症、急性心肌损伤、急性肾脏损伤、凝血障碍发生率和死亡率也显著增加(

0.05)，住院时间显著延长(

0.001)；轻型及普通型、重型、危重型COVID-19患者中血钙水平分别为2.17 (2.11，2.24)、2.13 (2.04，2.21)、2.03 (1.89，2.18) mmol/L，不同类型间患者血钙差异有统计学意义(

0.05)，并且随着COVID-19的临床类型加重血钙值越低(

0.05)，死亡患者血钙值显著低于非死亡患者[1.97 (1.87

2.03)

2.17 (2.09

2.23) mmol/L，

0.001

]

；多元Cox回归模型分析显示，血钙

2.11 mmol/L是COVID-19患者预后不良的独立危险因素(

=5.695，95%

：2.363~13.725，

0.001)。

结论

低血钙是影响COVID-19患者预后不良的独立危险因素，纠正低血钙可能是改善COVID-19患者预后的重要策略。

Abstract

Objective

To investigate whether hypocalcemia is associated with poor prognosis in COVID-19 patients.

Methods

A retrospective analysis was performed on 2 651 COVID-19 patients admitted to Wuhan Huoshenshan Hospital from February 4

2020 to April 11

2020. They were divided into low and normal calcium groups according to their serum calcium level lower than 2.11 mmol/L or not. Their basic demographic characteristics

results of laboratory tests

treatment

complications and outcomes were analyzed and compared between the 2 groups. COX regression model was used to analyze whether low calcium is an independent risk factors for poor outcomes in COVID-19 patients.

Results

The low calcium group had significantly higher ratios of mechanical ventilation

extracorporeal membrane oxygenation (ECMO) and ICU occupancy (

0.05); obviously higher incidences of sepsis

shock

hypoproteinemia

respiratory failure

coagulation disorders

acute kidney injury

acute myocardial injury

acute respiratory distress syndrome (ARDS)

and even mortality (

0.05); and remarkably longer length of hospital stay (

0.001) when compared with the normal calcium group. The blood calcium level of mild and common

severe

and critical COVID-19 patients was 2.17 (2.11

2.24)

2.13 (2.04

2.21)

and 2.03 (1.89

2.18) mmol/L

respectively

and significant differences were seen among the patients (

0.05). The calcium level was in a decreasing trend with the severity of COVID-19 (

0.05). The calcium level was statistically lower in the dead patients than those survival [1.97 (1.87

2.03)

2.17 (2.09

2.23)

0.001

]

. Multivariate Cox regression analysis indicated that serum calcium concentration

2.11 mmol/L was an independent risk factor for poor prognosis of COVID-19 (

=5.695

95%

: 2.363~13.725

0.001).

Conclusion

Low blood calcium level is an independent risk factor for poor prognosis in COVID-19 patients. Correction for hypocalcemia may be an important strategy to improve the prognosis of COVID-19 patients.

关键词

Keywords

references

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