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. 2022 Jan 1;101(1):61-63.
doi: 10.1097/PHM.0000000000001907.

Immobilization-Related Hypercalcemia in a COVID-19 Patient With Prolonged Intensive Care Unit Stay

Jean-Baptiste Mesland  1 , Christine Collienne, Pierre-François Laterre, Philippe Hantson
Affiliations

Immobilization-Related Hypercalcemia in a COVID-19 Patient With Prolonged Intensive Care Unit Stay

Jean-Baptiste Mesland et al. Am J Phys Med Rehabil. .

Abstract

Immobilization-related hypercalcemia is an uncommon finding in patients admitted to intensive care unit. We report a case of severe hypercalcemia in a COVID-19 patient admitted to intensive care unit for hypoxemic respiratory failure. He developed an acute kidney injury requiring continuous renal replacement therapy with regional citrate anticoagulation. Citrate chelates ionized calcium and stop the coagulation cascade locally, preventing filter clotting. Calcium is then given intravenously to a specific target (normocalcemia). It is only when calcium infusion has been stopped that bone resorption and hypercalcemia were unmasked.

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Conflict of interest statement

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Figures

FIGURE 1
FIGURE 1
Calcium evolution during renal replacement therapy. CVVH, continuous veno-venous hemofiltration; IHD, intermittent hemodialysis.
See this image and copyright information in PMC

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