Hypermagnesemia is a Significant Marker of COVID-19 Severity

Various electrolyte abnormalities which include hyponatremia, hypokalemia and hypocalcemia were reported in severe COVID-19 patients. A retrospective cohort study of 193 patients with confirmed COVID-19 pneumonia and hospitalization was conducted to evaluate the outcomes of hypermagnesemia in the patients with COVID-19. The majority of participants were males (108, 56%). The patients were classified on the basis of their magnesium levels at the time of admission into hypermagnesemia (Mg++ level > 2.5 mg/dL) and normomagnesemia (Mg++ level < 2.5 mg/dL). The baseline Mg++ level of patients who met the inclusion criteria was 2.44 mg/dL. 

The results indicated that 54% of the patients had hypermagnesemia (> 2.5 mg/dL) with no evidence of magnesium supplementation or renal dysfunction and 46% had normomagnesemia (< 2.5 mg/dL). The median age of the hypermagnesemia and normomagnesemia patient groups was 54 years and 53 years respectively. 91% of hypermagnesemia patients exhibited dyspnea and 86% had a cough. Whereas 73% of normomagnesemia patients showed dyspnea and 69% had a cough. Also, hypermagnesemia patients had lower oxygen saturation on room air (80%) as compared to normomagnesemia patients (87%). Significantly more patients with hypermagnesemia received dexamethasone and supplemental oxygen. Furthermore, hypermagnesemia patients had significantly higher levels of CRP, ESR, D-dimer, ferritin and LDH. Additionally, hypermagnesemia patients had a higher probability of admission to ICU (48%) as compared to normomagnesemia patients (15%). Thirty-four of 35 hypermagnesemia patients required a ventilator. 

In conclusion, hypermagnesemia is a significant marker of disease severity and adverse outcome in SARs-CoV-2 infections. This study suggests that serum magnesium should be added to the panel of routine tests in the evaluation of SARS-CoV-2 infections but further studies are needed on the association of  hypermagnesemia with SARS-Cov-2 infections.

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Ref Link: Epubmed