Hypocalcemia is a common condition in liver cirrhosis and is associated with the severity
of SARS-CoV-2 infection. However, there is a lack of data demonstrating the prognostic
value of hypocalcemia in COVID-19 patients with cirrhosis. This study aimed to evaluate
the prognostic value of hypocalcemia for COVID-19 severity, mortality and its associations
with abnormal liver function parameters. We selected 451 COVID-19 patients in this
retrospective study and compared the laboratory findings of 52 COVID-19 patients with
cirrhosis to those of 399 COVID-19 patients without cirrhosis. Laboratory tests measuring
albumin-corrected total serum calcium were performed on admission, and the levels
were monitored during hospitalization. The total serum calcium levels were significantly
lower in cirrhosis cases (2.16 mmol/L) compared to those without cirrhosis (2.32 mmol/L).
Multivariate analysis showed that hypocalcemia in COVID-19 patients with cirrhosis
was a significant predictor of in-hospital mortality, with an OR of 4.871 (p < 0.05;
95% CI 1.566–15.146). ROC analysis showed the AUC value of total serum calcium was
0.818 (95% CI 0.683–0.953, p < 0.05), with a sensitivity of 88.3% and a specificity
of 75%. The total serum calcium levels showed a significant negative correlation with
the Child–Turcette–Pugh score (r = −0.400, p < 0.05). Hypocalcemia on admission was
a significant prognostic factor of disease progression in COVID-19 patients with cirrhosis.
