the impact of late secondary hyperparathyroidism on mortality in covid-19 patients: a longitudinal study

Background: adverse effects of high parathormone hormone (pth) in critical illness have been described in some studies. objective: the relationship between high pth levels with mortality in hospitalized patients with covid-19 was evaluated in the present study.methods: a total of 123 patients were included in the study. the patients were evaluated in phase 1 (on admission) and phase 2 (days 4-6 of hospitalization). the patients were categorized into four groups based on the pth status in both phases: normal pth1/normal pth2 (group 1), high pth1/normal pth2 (group 2), high pth1/high pth2 (group 3), and normal pth1/high pth2 (group 4). the multiple logistic regression analysis was performed to examine the independent association of late hyperparathyroidism with mortality. after excluding ineligible participants, 115 patients in phase 1 and 96 patients in phase 2 (days 4-6 of hospitalization) were evaluated.findings: the level of phase 2 pth in non-survivors was significantly higher than in survivors (57.5 ±40.9 pg/ml vs. 27.6 ±16.2 pg/ml, p=0.001). the mortality rate was significantly higher in high-pth groups in phase 2 compared to normal-pth groups in this phase (50% and 42.9% in groups 3 and 4 vs. 6.6% and 18.2% in pth groups 1 and 2, respectively, p=0.007). late hyperparathyroidism was associated with 11.4 times higher mortality risk (95% ci: 2.3-56.1, p=0.003).conclusion: late hyperparathyroidism remained a significant predictor of mortality after adjusting for the main pth secretion modulators and disease severity. late hyperparathyroidism is an independent and strong risk factor for mortality in covid-19. further studies are necessary to clarify the mechanisms involved.