Serum Magnesium Levels in Hospitalized Patients with SARS-CoV-2

Background: Early studies have reported various electrolyte abnormalities at admission in patients with severe coronavirus disease (COVID-19). 64 out of 112 patients admitted to our institution presented with hypermagnesemia at presentation. It is believed this may be important in the evaluation of severe SARS-CoV-2 infections. This study evaluated the outcomes of hypermagnesemia in patients with COVID-19. Methods: A retrospective chart review of patients admitted to the hospital with confirmed SARS-CoV-2 infection. A review of the medical literature regarding hypermagnesemia, magnesium levels in critical care illness and electrolyte abnormalities in COVID-19 patients was performed. Differences in demographic and clinical characteristics of patients with hypermagnesemia and normomagnesemia were evaluated using descriptive statistics. Other known variables of disease severity were analyzed. Results: 64 patients (57%) were identified with hypermagnesemia (≥ 2.5mg/dl). 30 of those patients were admitted to the ICU (47% p < 0.001). 21 patients required ventilator support (33% p < 0.0001). With age adjusted logistic regression analysis hypermagnesemia was associated with mortality (p = 0.037). Conclusion: Potential pathogenetic mechanisms were explored and discussed for hypermagnesemia and its relation to severe SARS-CoV-2. This study demonstrates that hypermagnesemia is a significant marker of disease severity and adverse outcome in SARS-CoV-2 infections. We recommend serum magnesium be added to the panel of tests routinely ordered in evaluation of severe SARS-CoV-2 infections. Funding Statement: The author(s) received no financial support for the research, authorship, and/or publication of this article. Declaration of Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Ethics Approval Statement: The Institutional Review Board of Kern Medical approved this study as minimal risk research.