Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Aug 23;11(9):2362.
doi: 10.3390/biomedicines11092362.

Calcium, Phosphorus and Magnesium Abnormalities Associated with COVID-19 Infection, and Beyond

Lucreția Anghel  1   2 , Corina Manole  1   2 , Aurel Nechita  1   3 , Alin Laurențiu Tatu  1   4   5 , Bogdan Ioan Ștefănescu  2   6 , Luiza Nechita  1   2 , Camelia Bușilă  1   3 , Pușica Zainea  7 , Liliana Baroiu  1   4 , Carmina Liana Mușat  2   8
Affiliations
Review

Calcium, Phosphorus and Magnesium Abnormalities Associated with COVID-19 Infection, and Beyond

Lucreția Anghel et al. Biomedicines. .

Abstract

The coronavirus disease (COVID-19) pandemic caused by the novel coronavirus SARS-CoV-2 has had a profound impact on global health, leading to a surge in research to better understand the pathophysiology of the disease. Among the various aspects under investigation, disruptions in mineral homeostasis have emerged as a critical area of interest. This review aims to provide an overview of the current evidence linking calcium, phosphorus and magnesium abnormalities with COVID-19 infection and explores the potential implications beyond the acute phase of the disease. Beyond the acute phase of COVID-19, evidence suggests a potential impact of these mineral abnormalities on long-term health outcomes. Persistent alterations in calcium, phosphorus and magnesium levels have been linked to increased cardiovascular risk, skeletal complications and metabolic disorders, warranting continuous monitoring and management in post-COVID-19 patients.

Keywords: COVID-19; hypocalcemia; hypomagnesemia; hypoparathyroidism; hypophosphatemia; parathyroid hormone; phosphocalcium; post-COVID complications.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic illustration of the vitamin D synthesis pathway and signaling mechanism. The primary variants of vitamin D found in the natural environment encompass vitamin D3 (cholecalciferol), which is biosynthesized in the epidermis of animals and humans upon exposure to sunlight, as well as acquired through dietary source (DBP = vitamin D-binding protein).
Figure 2
Figure 2
The maintenance of calcium–phosphate balance is controlled by the parathyroid glands, bone, kidneys and intestinal tract.
Figure 3
Figure 3
A schematic illustration of several factors that have been identified as FGF23 production inducers. Calcium (Ca++), phosphate (Pi), leptin, secreted Klotho (sKL), iron, and metabolic acidosis.
Figure 4
Figure 4
Flow diagram of published studies related to COVID-19-associated phosphocalcium metabolism disorders.
Figure 5
Figure 5
Relationship between serum phosphate levels and vitamin D, PTH and calcium.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cappellini F., Brivio R., Casati M. Low Levels of Total and Ionized Calcium in Blood of COVID-19 Patients. Clin. Chem. Lab. Med. 2020;58:e171–e173. doi: 10.1515/cclm-2020-0611. - DOI - PubMed
    1. Gattineni J. Inherited Disorders of Calcium and Phosphate Metabolism. Curr. Opin. Pediatr. 2014;26:215–222. doi: 10.1097/MOP.0000000000000064. - DOI - PMC - PubMed
    1. Underland L., Markowitz M. Calcium and Phosphate Hormones: Vitamin D, Parathyroid Hormone, and Fibroblast Growth Factor 23. Pediatr. Rev. 2020;41:3–11. doi: 10.1542/pir.2018-0065. - DOI - PubMed
    1. Wang R., He M. Hypophosphatemia at Admission Is Associated with Increased Mortality in COVID-19 Patients. Int. J. Gen. Med. 2021;14:5313–5322. doi: 10.2147/IJGM.S319717. - DOI - PMC - PubMed
    1. Di Filippo L., Allora A. Hypocalcemia in COVID-19 Is Associated with Low Vitamin D Levels and Impaired Compensatory PTH Response. Endocrine. 2021;74:219–225. doi: 10.1007/s12020-021-02882-z. - DOI - PMC - PubMed

LinkOut - more resources