Abstract Background: Coronavirus disease 2019 (COVID-19) virus is still spreading, finding out the initial hits of viral infection is important to minimize the mild/moderate population, prevent disease aggravation and organs dysfunction. Objective: We investigated COVID-19 patients with different serum calcium levels. Design: We checked the serum calcium level of the patients based on days after symptom onset as well as the severity of COVID-19. We also checked multiorgan injuries and immune cytokines level in their blood. Results: Both mild/moderate and severe critical cases we observed showed low calcium level in the early stage of viral infection, while the severe/critical cases showed significant lower calcium level than mild/moderate cases in the early stage. We also found that low calcium level related to severe/critical multiorgan injuries especially in the mild/moderate population. Proinflammatory cytokine IL-6 also correlated to calcium change in both mild/moderate and severe/critical cases. Conclusions: Our finding indicates that calcium balance is a primal hit of COVID-19 and a biomarker of clinical severity at the beginning of symptom onset. Calcium is closely associated with virus-associated multiple organ injuries and the increase in inflammatory cytokines. Our results provide a new, important indicator of COVID-19 patients from mild/moderate to severe/critical: serum calcium.
【저자키워드】 COVID-19, pro-inflammatory cytokine, serum calcium, Multi-organ injury, 【초록키워드】 viral infection, Coronavirus disease 2019, Biomarker, IL-6, cytokine, virus, immune, severity of COVID-19, Inflammatory cytokines, disease, early stage, calcium, Blood, Clinical severity, COVID-19 patient, dysfunction, symptom onset, Critical case, organ injury, multiorgan injury, organ, Prevent, initial, the patient, investigated, indicate, correlated, increase in, checked, calcium balance, 【제목키워드】 serum, COVID-19 patient,