The relevance of magnesium homeostasis in COVID-19

Abstract

Purpose In less than one and a half year, the COVID-19 pandemic has nearly brought to a collapse our health care and economic systems. The scientific research community has concentrated all possible efforts to understand the pathogenesis of this complex disease, and several groups have recently emphasized recommendations for nutritional support in COVID-19 patients. In this scoping review, we aim at encouraging a deeper appreciation of magnesium in clinical nutrition, in view of the vital role of magnesium and the numerous links between the pathophysiology of SARS-CoV-2 infection and magnesium-dependent functions. Methods By searching PubMed and Google Scholar from 1990 to date, we review existing evidence from experimental and clinical studies on the role of magnesium in chronic non-communicable diseases and infectious diseases, and we focus on recent reports of alterations of magnesium homeostasis in COVID-19 patients and their association with disease outcomes. Importantly, we conduct a census on ongoing clinical trials specifically dedicated to disclosing the role of magnesium in COVID-19. Results Despite many methodological limitations, existing data seem to corroborate an association between deranged magnesium homeostasis and COVID-19, and call for further and better studies to explore the prophylactic or therapeutic potential of magnesium supplementation. Conclusion We propose to reconsider the relevance of magnesium, frequently overlooked in clinical practice. Therefore, magnesemia should be monitored and, in case of imbalanced magnesium homeostasis, an appropriate nutritional regimen or supplementation might contribute to protect against SARS-CoV-2 infection, reduce severity of COVID-19 symptoms and facilitate the recovery after the acute phase.

Antioxidant/anti‐inflammatory effect of Mg2+ in coronavirus disease 2019 (COVID‐19)

“… 170 , 172 Some authors also consider platelet‐activating factor (PAF) as key in generating microthrombosis in COVID‐19. 12 , 173 PAF has a central role in inflammation due to stimulating the activation of NF‐κB. Furthermore, it has been shown that the reduction of extracellular Mg 2+ results in a rapid increase in active PAF, inducing the NF‐κB activation.…”

“… 5 , 6 , 7 In this sense, magnesium (Mg 2+ ) deficiency causes low‐grade chronic inflammation and OS. 8 , 9 , 10 It has led to the hypothesis that Mg 2+ supplementation might improve the severity of COVID‐19 disease, 11 , 12 including a possible intervention of Mg 2+ in SARS‐CoV‐2 infection by inhibiting the activity of proteases required for protein S cleavage. 12 Therefore, this narrative review focuses on the effect of Mg 2+ to prevent developing severe COVID‐19 from the perspective of Mg 2+ deficiency, which could contribute to an antioxidant/anti‐inflammatory development in COVID‐19 and post‐COVID‐19 manifestations.…”

Populations in Low-Magnesium Areas Were Associated with Higher Risk of Infection in COVID-19’s Early Transmission: A Nationwide Retrospective Cohort Study in the United States

“…First, as previous studies have dicated, the magnesium intake of almost half the population of the United States is un the daily required dose. Thus, more attention should be paid to the increased COVID infection risk among this segment of the population, especially when considering t Since the beginning of the COVID-19 pandemic, the important role of magnesium in the prevention and treatment of COVID-19 has been noted by researchers [3,18,19,22,39]. However, the risks posed by COVID-19 to the magnesium-deficient population require further study.…”

Higher Intake of Dietary Magnesium Is Inversely Associated With COVID-19 Severity and Symptoms in Hospitalized Patients: A Cross-Sectional Study

“…The innate immune system is the first line of defense in response to pathogens invasion, such as viral infections like COVID-19 ( 38 ). Finally, magnesium regulates the immune system in a variety of ways by orchestrating the activity of immune cells such as neutrophils and macrophages ( 39 ), activating T cells via MagT1 ( 40 ), and regulating vitamin D activity ( 41 ), hence improving the first line of defense in response to pathogens invasion and acting against viral infections like COVID-19 ( 38 ).…”