Hallo,

hier die Antwort auf mein Schreiben, das von Andrea Giustina (zufällig derzeit auch ESE-Präsident!) an den zuständigen Dr. di Filippo weitergeleitet wurde:

Dear Dr. Sieger,

thank you for your precious suggestions! As you suggest, acid-base balance in covid-19 patients of our cohort had a central role influencing calcium metabolism and indirectly (or directly as recent studies suggest) kidney actions.

In our patients and in our studies we have evaluated calcium levels at admission in ED, everyone was without oxygen supplements or additional ventilation, and we have found a very high incidence of alkalosis, due mainly to hyperventilation (mean respiratory rate found in ed is about 25-30 rr bpm). However we have evaluated also ionized calcium levels corrected for a ph of 7.4 and found a very high incidence of hypocalcemia (so, without respiratory alkalosis influence).

Mechanical ventilation could induce worse respiratory alkalosis influencing ionized calcium levels, but we have found that also corrected ionized calcium levels were very low, probably due to the patients’ clinical worsening.

Hypoparathyroid patients are at high risk of severe hypocalcemia during covid19, due to viral calcium-dependent mechanisms of action, respiratory alkalosis, kidney influence and their calcium-vitamind delicate balance. We suggest to strictly monitor their calcium and vitamin d values at symptom onset, and optimize, when indicated, their replacement therapies. When hospitalized and when indicated we suggest to use also intravenous replacements since hypocalcemia negativly impact on cardiac and neurological outcomes and features tipically found in covid-19 patients. We suggest a daily monitoring of ionized and total calcium levels in all hospitalized covid19 patients, especially in critical patients.

I hope to have answered in part to your questions, and thanks for your suggestions in this important topic on covid19.
I am at you disposal for other clarifications.

Best regards,
dr Luigi di Filippo

Dott. Luigi di Filippo

Medico specializzando in Endocrinologia e Malattie del Metabolismo

U.O. Endocrinologia

IRCCS Ospedale San Raffaele

Durch den Dr.-Titel (den er mir „verliehen“ hat 😉 ) fühle ich mich natürlich geehrt und ich bin auch erfreut, dass der ESE-Präsident in Sachen Hypopara-Forschung vorn dabei ist. Inhaltlich ist das Schreiben aber weniger erfreulich. Über Unterstützung bei der Übersetzung würde ich mich freuen, damit der Text noch besser Hilfestellung im akuten Fall geben kann.

Viele Grüße
Frauke