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Hypocalcemia is associated with COVID-19 patients and is linked to poor prognosis, Fibroblast growth factor 23 (FGF23) and Sclerostin inhibit vitamin D activation and are linked to hypocalcemia.
Levels of FGF23 and Sclerostin in COVID-19 patients will be detected and correlated to calcium levels.
COVID 19 is a current worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 "SARS-CoV-2". Hypovitaminosis D and hypocalcaemia have been reported to be associated with COVID 19 infection, they are considered good biomarkers of clinical severity of COVID 19. Poor prognosis related to hypocalcemia is increased in elderly patients.
Fibroblast growth factor 23 and sclerostin are secreted from the bone, they decrease active vitamin D levels. Their levels and their relation to calcium levels in COVID-19 patients will be detected.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mild to moderate COVID 19 patients | According to COVID 19 treatment guidelines of National Institutes of Health (NIH): Mild illness that show symptoms like fever, cough, nausea, vomiting, sore throat, loss of taste & smell but don't show dyspnea or abnormal chest imaging. Moderate illness that show clinical or radiological lower respiratory disease with SpO2 > 94% on room air. |
| |
| Severe to critical COVID 19 patients | According to COVID 19 treatment guidelines of National Institutes of Health (NIH): Severe illness that show SpO2 < 94% on room air, (PaO2/FiO2) <300 mm Hg & lung infiltration > 50% with respiratory rate > 30 breath/min. Critical illness that show respiratory failure, septic shock or multiorgan failure. |
| |
| Normal male subjects (Control) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Calcium | Diagnostic Test | Free calcium serum levels |
|
| Measure | Description | Time Frame |
|---|---|---|
| Changes in serum calcium levels | Expected lower serum calcium levels in COVID 19 patients compared to control | 6 months |
| changes in FGF23 levels | Expected higher FGF23 levels in COVID 19 patients compared to control | 6 months |
| changes in sclerostin levels | Expected higher sclerostin levels in COVID 19 patients compared to control | 6 months |
| Changes in parathyroid hormone levels | Expected lower levels in COVID 19 patients compared to control | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Relation between FGF 23 and calcium levels | A negative relation is expected | 6 months |
| Relation between sclerostin and calcium levels | A negative relation is expected |
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Inclusion Criteria:
Exclusion Criteria:
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(Group A): Mild to moderate COVID 19 patients. (Group B): Severe to critical COVID 19 patients. (Group C): Normal male subjects (Control)
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| Name | Affiliation | Role |
|---|---|---|
| Asmaa Abdelmageed Muhammed, Lecturer | Aswan University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Aswan University hospital | Aswān | 81511 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32150360 | Background | Cascella M, Rajnik M, Aleem A, Dulebohn SC, Di Napoli R. Features, Evaluation, and Treatment of Coronavirus (COVID-19). 2023 Aug 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK554776/ | |
| 33252122 | Background | Zhou X, Chen D, Wang L, Zhao Y, Wei L, Chen Z, Yang B. Low serum calcium: a new, important indicator of COVID-19 patients from mild/moderate to severe/critical. Biosci Rep. 2020 Nov 30;40(12):BSR20202690. doi: 10.1042/BSR20202690. Online ahead of print. |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| D006996 | Hypocalcemia |
| C537525 | Sclerosteosis |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D020013 | Calcium Signaling |
| ID | Term |
|---|---|
| D015290 | Second Messenger Systems |
| D015398 | Signal Transduction |
| D001669 | Biochemical Phenomena |
| D055598 | Chemical Phenomena |
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| Fibroblast growth factor 23 | Diagnostic Test | Serum level |
|
| Sclerostin | Diagnostic Test | Serum level |
|
| parathyroid hormone | Diagnostic Test | serum level |
|
| 6 months |
| 33512007 | Background | Demir M, Demir F, Aygun H. Vitamin D deficiency is associated with COVID-19 positivity and severity of the disease. J Med Virol. 2021 May;93(5):2992-2999. doi: 10.1002/jmv.26832. Epub 2021 Feb 9. |
| 33846867 | Background | di Filippo L, Doga M, Frara S, Giustina A. Hypocalcemia in COVID-19: Prevalence, clinical significance and therapeutic implications. Rev Endocr Metab Disord. 2022 Apr;23(2):299-308. doi: 10.1007/s11154-021-09655-z. Epub 2021 Apr 13. |
| 24688605 | Background | Lewiecki EM. Role of sclerostin in bone and cartilage and its potential as a therapeutic target in bone diseases. Ther Adv Musculoskelet Dis. 2014 Apr;6(2):48-57. doi: 10.1177/1759720X13510479. |
| 22421513 | Background | Quarles LD. Role of FGF23 in vitamin D and phosphate metabolism: implications in chronic kidney disease. Exp Cell Res. 2012 May 15;318(9):1040-8. doi: 10.1016/j.yexcr.2012.02.027. Epub 2012 Mar 7. |
| D014777 |
| Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002128 | Calcium Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D014883 | Water-Electrolyte Imbalance |
| D017136 |
| Ion Transport |
| D001692 | Biological Transport |
| D008660 | Metabolism |
| D002468 | Cell Physiological Phenomena |