Hypermagnesemia and hyperphosphatemia are highly prevalent in patients with COVID-19 and increase the risk of death

Malinowska, Justyna; Małecka‐Giełdowska, Milena; Bańkowska, Diana; Borecka, Kinga; Ciepiela, Olga

doi:10.1016/j.ijid.2022.06.057

Cited by 8 publications

(11 citation statements)

References 49 publications

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“…However, a recent study by Malinowska et al stated that hyperphosphatemia could also contribute to the development of severe COVID-19. Their findings also indicated no significant association between hypophosphatemia and severity of COVID-19, but this finding should be considered cautiously regarding the small number of subjects (6% of the total population) [43]. Pal et al indicated that COVID-19 patients had lower serum phosphate levels than the healthy population [25].…”

Section: Discussionmentioning

confidence: 92%

Hypophosphatemia in Coronavirus Disease 2019 (COVID-19), Complications, and Considerations: A Systematic Review

Fakhrolmobasheri

Vakhshoori

Heidarpour

et al. 2022

BioMed Research International

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Coronavirus disease 2019 (COVID-19) has various manifestations on different body organs, including the lungs, heart, kidneys, and central nervous system. However, the frequency of electrolyte abnormalities, especially hypophosphatemia, is still debated in this pandemic. Our main aim in this review is to evaluate the frequency and complications of hypophosphatemia in COVID-19-infected individuals. A systematic literature review was performed in Web of Science, Scopus, PubMed, EMBASE, and Cochrane electronic databases with the combination of different keywords till October 2021. We recruited all relevant published records (including cross-sectional and case-control studies as well as editorials and brief reports) assessing hypophosphatemia among patients with COVID-19 infection. After assessing all 928 recruited records and discarding duplicates, 4 records met the inclusion criteria. Three articles were further included during a manual search of the literature. Overall, the included studies reported 1757 subjects (males: 51.3%), with the mean age ranging from 37.2 ± 13.6 years to 65.9 ± 13.9 years. Hypophosphatemia prevalence has been reported from 7.6% to 19.5%. Patients with the severe status of COVID-19 had a higher prevalence of low serum phosphate levels than those with moderate infection. This review indicates that hypophosphatemia might be categorized as a complication in clinical settings during the COVID-19 pandemic, requiring a high clinical suspicion to implement appropriate diagnostic and therapeutic interventions to prevent life-threatening outcomes. However, it needs to be more elucidated by further studies whether hypophosphatemia in severe COVID-19 is directly related to COVID-19 or is just a complication of severe illness.

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Section: Discussionmentioning

confidence: 92%

Hypophosphatemia in Coronavirus Disease 2019 (COVID-19), Complications, and Considerations: A Systematic Review

Fakhrolmobasheri

Vakhshoori

Heidarpour

et al. 2022

BioMed Research International

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“…[13][14][15][16] The results of the studies in this field are heterogeneous. [15][16][17] While some authors suggest that magnesium deficiency is associated with low-grade chronic inflammation and may exacerbate the course of COVID-19, 16 others state that hypermagnesemia among hospitalized COVID-19 patients is associated with an increased rate of mortality. 15 Although the exact mechanism of the relationship between dysmagnesemia and COVID-19 outcome and possible mortality is unclear, it is the hypothesis that hypermagnesemia potentially represents increased cell turnover and higher severity of illness, which is frequently associated with more severe forms of diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, some researchers have suggested that alternation in serum magnesium levels in COVID‐19 patients may be associated with the development of severe disease in COVID‐19 patients and poor outcomes 13–16 . The results of the studies in this field are heterogeneous 15–17 .…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17] While some authors suggest that magnesium deficiency is associated with low-grade chronic inflammation and may exacerbate the course of COVID-19, 16 others state that hypermagnesemia among hospitalized COVID-19 patients is associated with an increased rate of mortality. 15 Although the exact mechanism of the relationship between dysmagnesemia and COVID-19 outcome and possible mortality is unclear, it is the hypothesis that hypermagnesemia potentially represents increased cell turnover and higher severity of illness, which is frequently associated with more severe forms of diseases. 14 A possible explanation for the high incidence of hypermagnesemia and poor outcomes in COVID-19 patients can be related to the common risk factor, including advanced age, diabetes, obesity, hypertension, arrhythmias, thrombosis, and cardiovascular events, between magnesium dysregulation and co-morbidities that related with mortalities.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19][20] Another explanation can be related to the alternation of the level of cytokine, including higher levels of IL-6, IL-4, and IL-10. 21 It is hypothesized that the transcellular shift of magnesium from the intracellular to extracellular space in response to stress hormones is associated with vasopressor use [14][15][16][17][18] Although Lippi et al reported the result of electrolyte imbalances in patients with severe COVID-19 in a meta-analysis. 22 The result of this meta-analysis demonstrated serum sodium level was significantly lower in patients with severe COVID-19, the result of our study is not congruent with existing literature.…”

Section: Discussionmentioning

confidence: 99%

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Electrolyte abnormalities in hospitalized COVID‐19 patients at tertiary referral centers in Tehran: Hypermagnesemia as a marker of fatality: A retrospective cross‐sectional study

Mardani

Hakamifard

Sarhangipour

et al. 2023

Health Science Reports

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Background and Aims: To evaluate biochemical abnormalities and their association with the outcome of hospitalized coronavirus disease 2019 (COVID-19) patients at a tertiary referral center in Iran. Methods: This retrospective study was conducted on COVID-19 patients who were admitted at tertiary referral centers in Tehran, Iran, from March 2021 to 2022. Demographic and biochemical laboratory data of the patients including blood sodium, potassium, calcium, and magnesium were collected from patient treatment sheets of severe COVID-19 patients admitted to a different ward of the hospital. A logistic regression model was fitted to identify the associated parameters with mortality.Results: Four hundred and ninety-nine patients with COVID-19, including 287 males (57.5%), who had a mean age of 58.95 ± 16.60 years, were enrolled.Thirty-eight patients (7.62%) died during hospitalization. The factors we found to be independently associated with an increased risk of in-hospital death were having comorbidity (mortality of 94.7%, vs. 61% among those without comorbidity;

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Prevalence and predictors of magnesium imbalance among critically ill diarrheal children and their outcome in a developing country

Mamun,

Sarmin,

Alam

et al. 2023

PLoS ONE

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Despite having essential roles in maintaining human body physiology, magnesium has gained little attention. We sought to evaluate the prevalence and predictors of magnesium imbalance in diarrheal children admitted to an intensive care unit. This retrospective data analysis was conducted among children admitted between January 2019 and December 2019. Eligible children were categorized by serum magnesium levels that were extracted from the hospital database. Among 557 participants, 29 (5.2%) had hypomagnesemia, 344 (61.8%) had normomagnesemia and 184 (33.0%) had hypermagnesemia. By multivariable multinomial logistic regression, we have identified older children (adjusted multinomial odds ratio, mOR 1.01, 95% CI: 1.004–1.018, p = 0.002) as a predictor of hypomagnesemia. Conversely, younger children (adjusted mOR 0.99, 95% CI: 0.982–0.998, p = 0.02), shorter duration of fever (adjusted mOR 0.92, 95% CI: 0.857–0.996, p = 0.04), convulsion (adjusted mOR 1.55, 95% CI: 1.005–2.380, p = 0.047), dehydration (adjusted mOR 3.27, 95% CI: 2.100–5.087, p<0.001), pneumonia (adjusted mOR 2.65, 95% CI: 1.660–4.240, p<0.001) and acute kidney injury (adjusted mOR 2.70, 95% CI: 1.735–4.200, p<0.001) as the independent predictors of hypermagnesemia. The mortality was higher among children with hypermagnesemia (adjusted mOR 2.31, 95% CI: 1.26–4.25, p = 0.007). Prompt identification and management of the magnesium imbalance among critically ill diarrheal children might have survival benefits, especially in resource-limited settings.

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Hypermagnesemia and hyperphosphatemia are highly prevalent in patients with COVID-19 and increase the risk of death

Cited by 8 publications

References 49 publications

Hypophosphatemia in Coronavirus Disease 2019 (COVID-19), Complications, and Considerations: A Systematic Review

Hypophosphatemia in Coronavirus Disease 2019 (COVID-19), Complications, and Considerations: A Systematic Review

Electrolyte abnormalities in hospitalized COVID‐19 patients at tertiary referral centers in Tehran: Hypermagnesemia as a marker of fatality: A retrospective cross‐sectional study

Prevalence and predictors of magnesium imbalance among critically ill diarrheal children and their outcome in a developing country

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