Parathyroids: Pandemic update

Abstract

Parathyroid glands-related issues (also involving calcium-phosphorus metabolism) amid pandemic are represented by: complicated recovery after COVID-19 infection in cases with severe vitamin D (VD) deficiency or uncorrected hypocalcemia (hCa); the cases with primary hyperparathyroidism-related hypercalcemia who are postponed for parathyroid adenoma removal might be complicated with arrhythmia if the patient becomes COVID-19 positive; lockdown restrictions limited the physical activity, a situation which might aggravate sarcopenia and bone mineral density loss; subjects with renal hyperparathyroidism who do not have controlled values of serum calcium are at higher risk of severe COVID-19 infection due to a wide area of chronic renal failure-associated complications, including Ca, VD and PTH disturbances. This is an update concerning parathyroid glands in relationship to two-year pandemic experience. The mini-review of literature is based on PubMed navigation using a combination of key words like “parathyroid glands”, “parathyroid”, “parathormone”, “vitamin D”, “calcium” and “COVID-19” or “coronavirus” or “pandemic”. During the first months of COVID-19 pandemic there was a massive reduction of parathyroidectomies volume which was elective for severe forms associating life threatening values of serum calcium. The number of parathyroidectomies increased during the second year of pandemic Hypocalcemia remains a poor prognostic factor in severe COVID-19 infections while underling mechanisms are complex and might not be exclusively related to vitamin D deficiency which is a topic still on trends. Direct hypoparathyroidism is a new entity amid coronavirus-induced puzzle. E-health is mandatory to follow calcium correcting medication and associated life style intervention in cases with anomalies of calcium/PTH/VD levels.