Serum Calcium and Magnesium Levels in Patients with Type 2 Diabetes and COVID-19 Infection Requiring Hospitalization—Correlations with Various Parameters

Round 1

Reviewer 1 Report

The study entitled “SERUM CALCIUM AND MAGNESIUM LEVELS IN PATIENTS WITH TYPE 2 DIABETES AND COVID 19 INFECTION REQUIRING HOSPITALIZATION – correlations with various parameters”describes the impact of SARS-CoV-2 infection on serum calcium and magnesium and their pathophysiological mechanisms. As calcium homeostasis is altered in viral infections and magnesium acts as an antagonist to calcium, both electrolytes playing essential roles in the human body, and this electrolyte can also be influenced by viral infection, with low magnesium levels facilitating viral infection, inflammatory response, or cytokine storm.

The study is executed and well-descriptive with in depth analysis of biomarkers associated with Covid-19 pathology. The only concern was smaller sample size and single center study; however, it is already acknowledged.

Author Response

Thank you very much for all your suggestions and good advice!

Author Response File: Author Response.pdf

Reviewer 2 Report

1. 1. Can you provide insights into the potential mechanisms underlying the lack of statistically significant influence of type 2 diabetes mellitus on serum calcium and magnesium levels upon hospitalization for SARS-CoV-2 infection, especially considering the known metabolic implications of diabetes on calcium and magnesium homeostasis?

 2. Can you discuss the clinical implications of these findings and their relevance for patient management?

3.      3.  The association between altered serum calcium levels and various clinical outcomes in COVID-19 patients, such as acute kidney injury, sepsis, and mortality, is discussed. How might these findings inform clinical management strategies and potential interventions targeting calcium homeostasis in COVID-19 patients?

4.       The study mentions the correlation between serum magnesium levels and various lipid and inflammatory markers in COVID-19 patients. Could you elaborate on the potential implications of these correlations for understanding the pathophysiology of COVID-19 and identifying prognostic factors?

 4. Considering the limitations of the study, such as the small sample size and single-center design, what are the implications for the generalizability of the findings, and how might future research address these limitations to provide more robust insights into the relationship between serum calcium, magnesium levels, and clinical outcomes in COVID-19 patients?

Overall The scientific significance of findings in this study appears limited, suggesting it may not contribute substantially to the existing literature in this field unless the study is repeated with more than 500 patients.

Author Response

Thank you very much for all your suggestions and good advice!

Author Response File: Author Response.pdf