MON-766 - Parathyroid and Calcium Dysfunction in Post-Acute COVID-19: A Retrospective Cohort Study

COVID-19 has been associated with endocrine and metabolic disturbances, including disruptions in calcium homeostasis. However, the long-term impact on parathyroid function remains poorly characterized. This study examined the long-term risk of hypoparathyroidism, calcium dysregulation, and metabolic imbalances in individuals following COVID-19 infection. This retrospective cohort study extracted data between 2020-2026 from the TriNetX Research USA Network with minimal date shift. The Research USA Network comprises data for over 97 million patients across 56 healthcare organizations. Study cohorts included adult patients (≥18 years of age) with a positive COVID-19 screening result (positive cohort) and propensity-matched controls (negative cohort) using age, gender, race, healthcare status, and comorbidities associated with adverse COVID-19 outcomes. Each cohort had 273,740 patients. We evaluated three new-onset outcomes post COVID-19 screening, including hypoparathyroidism (ICD-10: E20), calcium dysregulation (ICD-10: E20, E83.5), and metabolic imbalances (ICD-10: E20, E55, E83.5). Measures of association for outcomes were performed using risk, risk difference (RD), odds ratio (OR), risk ratio (RR), and respective 95% confidence intervals (CI) reported. We compared outcomes for two post-acute COVID-19 time intervals: six months to one year (6m–1y) and one to three years (1y-3y). The positive cohort's risk of hypoparathyroidism was not significant in the 6m-1y post-COVID interval (RR 1.19, CI 0.84-1.68; RD 0.004%), but was significant in the 1y-3y interval (RR 2.16, CI 1.69-2.76; RD 0.040%) compared to the control cohort. Compared to controls, the positive cohort had a significantly increased risk of calcium dysregulation for both the 6m-1y (RR 1.49, CI 1.38-1.60; RD 0.23%) and the 1y-3y (RR 2.77, CI 2.64-2.91; RD 1.55%) intervals. This same pattern was observed for the outcome of metabolic dysregulation, with higher risk in the COVID-19 positive cohort (6m-1y: [RR 1.54, CI 1.47-1.61; RD 0.90%]; 1y-3y: [RR 2.36, CI 2.30-2.43; RD 4.79%]). COVID-19 infection was associated with an increased risk of calcium dysregulation and metabolic imbalance beginning in the post-acute phase and persisting over time. Notably, hypoparathyroidism demonstrated a delayed onset, becoming significant only at 1y-3y, suggesting a time-dependent parathyroid dysfunction. This finding supports ongoing endocrine dysregulation and highlights a potential long-term consequence of COVID-19.

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