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Cancarevic I, Nassar M, Foster A, Umar Z, Parikh A, Ahammed MR, Shaban L, Abosheaishaa H, Mergen D, Amin T, Ozkan BI, Sánchez Ruiz AM, Hosna A, ul Rasool MH, Ahmed N, Ayotunde F, Ashfaq S, Lopez R, Rizzo V. Electrolyte disturbances in patients hospitalized for COVID-19 infection: An observational study. Medicine (Baltimore) 2024; 103:e37749. [PMID: 38758907 PMCID: PMC11098206 DOI: 10.1097/md.0000000000037749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 03/07/2024] [Indexed: 05/19/2024] Open
Abstract
There are multiple mechanisms by which The Coronavirus-19 (COVID-19) infection can cause electrolyte abnormalities, which may not be the case for bacterial causes of pneumonia. This study aimed to assess the differences in electrolyte levels between patients suffering from COVID-19 and bacterial pneumonia. This is an original, retrospective study. Two cohorts of hospitalized patients were included, 1 suffering from COVID-19 and the other from bacterial pneumonia. Their day 1 and day 3 levels of sodium, potassium, magnesium, and phosphorus, as well as their outcomes, were extracted from the charts. Statistical analysis was subsequently performed. Mean admission levels of sodium, potassium, phosphorus, and magnesium were 135.64 ± 6.13, 4.38 ± 0.69, 3.53 ± 0.69, and 2.03 ± 0.51, respectively. The mean day 3 levels of these electrolytes were 138.3 ± 5.06, 4.18 ± 0.59, 3.578 ± 0.59, and 2.11 ± 0.64, respectively. Patients suffering from bacterial pneumonia were significantly older (N = 219, mean = 64.88 ± 15.99) than patients with COVID-19 pneumonia (N = 240, mean = 57.63 ± 17.87). Bacterial pneumonia group had significantly higher serum potassium (N = 211, mean = 4.51 ± 0.76), and magnesium (N = 115, mean = 2.12 ± 0.60) levels compared to COVID-19 group (N = 227, mean = 4.254 ± 0.60 for potassium and N = 118, mean = 1.933 ± 0.38 for magnesium). Only magnesium was significantly higher among day 3 electrolytes in the bacterial pneumonia group. No significant association between electrolyte levels and outcomes was seen. We found that COVID-19 patients had lower potassium and magnesium levels on admission, possibly due to the effect of COVID-19 on the renin-angiotensin-aldosterone system as well as patient characteristics and management. We did not find enough evidence to recommend using electrolyte levels as a determinator of prognosis, but more research is needed.
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Affiliation(s)
- Ivan Cancarevic
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Mahmoud Nassar
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, NY, USA
| | - Allison Foster
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Zaryab Umar
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Avish Parikh
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Md Ripon Ahammed
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Lilia Shaban
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Hazem Abosheaishaa
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Damla Mergen
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Toka Amin
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Bike Ilayda Ozkan
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | | | - Asma Hosna
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | | | - Nazaakat Ahmed
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Fatima Ayotunde
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Salman Ashfaq
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Ricardo Lopez
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
| | - Vincent Rizzo
- Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA
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May C, Or G, Gad S, Daniel Z, Hila H, Boris F, Pninit L, Hadar A, Galia B. Can Patients with Electrolyte Disturbances Be Safely and Effectively Treated in a Hospital-at-Home, Telemedicine-Controlled Environment? A Retrospective Analysis of 267 Patients. J Clin Med 2024; 13:1409. [PMID: 38592241 PMCID: PMC10932046 DOI: 10.3390/jcm13051409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/10/2024] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Morbidities indicated for hospital-at-home (HAH) treatment include infectious diseases and exacerbations of chronic conditions. Electrolyte disturbances are not included per se. However, their rate is high. We aimed to describe our experience via the monitoring and treatment of such patients. METHODS This was a retrospective analysis of patients in the setting of telemedicine-controlled HAH treatment. We collected data from the electronic medical records of patients who presented electrolyte disturbances. RESULTS For 14 months, we treated 267 patients in total in HAH settings, with a mean age of 72.2 + 16.4, 44.2% for males. In total, 261 (97.75%) patients were flagged with electrolyte disturbances, of whom 149 had true electrolyte disturbances. Furthermore, 67 cases (44.96%) had hyponatremia, 9 (6.04%) had hypernatremia after correction for hyperglycemia, 20 (13.42%) had hypokalemia and 27 (18.12%) had hyperkalemia after the exclusion of hemolytic samples. Ten (6.09%) patients had hypocalcemia and two (1.34%) had hypercalcemia corrected to albumin levels. Thirteen (8.72%) patients had hypomagnesemia and one (0.67%) had hypermagnesemia. Patients with electrolyte disturbances suffered from more chronic kidney disease (24.2% vs. 12.2%; p = 0.03) and malignancy (6.3% vs. 0.6%; p = 0.006), and were more often treated with diuretics (12.6% vs. 4.1%; p = 0.016). No patient died or suffered from clinically significant cardiac arrhythmias. CONCLUSIONS The extent of electrolyte disturbances amongst HAH treatment patients is high. The monitoring and treatment of such patients can be conducted safely in this setting.
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Affiliation(s)
- Cohn May
- 3rd Faculty of Medicine, Charles University, 11636 Prague, Czech Republic
| | - Gueron Or
- School of Medicine, University of Nicosia, Nicosia 2417, Cyprus;
| | - Segal Gad
- Chaim Sheba Medical Center, Education Authority, 2nd Sheba Road, Ramat-Gan 5262000, Israel
- Chaim Sheba Medical Center, Sheba-Beyond Virtual Hospital, 2nd Sheba Road, Ramat-Gan 5262000, Israel (F.B.); (B.G.)
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Zubli Daniel
- Chaim Sheba Medical Center, Sheba-Beyond Virtual Hospital, 2nd Sheba Road, Ramat-Gan 5262000, Israel (F.B.); (B.G.)
- Chaim Sheba Medical Center, The Infection Prevention & Control Unit, 2nd Sheba Road, Ramat-Gan 5262000, Israel
| | - Hakim Hila
- Chaim Sheba Medical Center, Sheba-Beyond Virtual Hospital, 2nd Sheba Road, Ramat-Gan 5262000, Israel (F.B.); (B.G.)
| | - Fizdel Boris
- Chaim Sheba Medical Center, Sheba-Beyond Virtual Hospital, 2nd Sheba Road, Ramat-Gan 5262000, Israel (F.B.); (B.G.)
| | - Liber Pninit
- Chaim Sheba Medical Center, Sheba-Beyond Virtual Hospital, 2nd Sheba Road, Ramat-Gan 5262000, Israel (F.B.); (B.G.)
| | - Amir Hadar
- Chaim Sheba Medical Center, Sheba-Beyond Virtual Hospital, 2nd Sheba Road, Ramat-Gan 5262000, Israel (F.B.); (B.G.)
| | - Barkai Galia
- Chaim Sheba Medical Center, Sheba-Beyond Virtual Hospital, 2nd Sheba Road, Ramat-Gan 5262000, Israel (F.B.); (B.G.)
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
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Mao S, Wu L, Shi W. Calcium, phosphorus, magnesium levels in frequent respiratory tract infections. Ann Med 2024; 55:2304661. [PMID: 38233369 PMCID: PMC10798295 DOI: 10.1080/07853890.2024.2304661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/16/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND It was well documented that calcium (Ca), phosphorus (P), and magnesium (Mg) participate in many physiological processes. We aimed to study the changing trend of serum levels of Ca, P, and Mg in frequent respiratory tract infections (FRTI) in children. METHODS A retrospective study was performed in our centre. A total of 213 FRTI cases and 33 controls were enrolled in our study. We analyzed the correlation between serum Ca/P/Mg levels and inflammatory indexes by using Spearman correlation analysis. Standard mean difference (SMD) was applied to test the differences of serum Ca/P/Mg levels between FRTI subgroups and controls. In terms of the findings of SMD between Ca/P/Mg status between FRTI subgroups and controls, receiver operating characteristics (ROC) curve analysis was further applied to test the association between serum Ca level and bronchitis, parainfluenza virus infection, influenza B virus infection and cytomegalovirus infection. RESULTS Serum Ca level was significantly associated with white blood cell (WBC), platelet (PLT) and procalcitonin (PCT) (p = 0.006; p < 10-4; p = 0.004). Serum P level was markedly associated with eryhtrocyte sedimentation rate (ESR) and PCT (p = 0.018; p < 10-4). Controls showed significantly lower serum Ca level than that among bronchitis (p = 0.001), parainfluenza virus infection (p = 0.027), influenza B virus infection (p = 0.017), cytomegalovirus infection (p = 0.029), and two pathogens infected (p = 0.020). ROC curve analysis showed that serum Ca level was significantly associated with bronchitis (p = 0.047) and influenza B virus infection (p = 0.049). CONCLUSIONS Serum levels of Ca and P may reflect the inflammatory status in children with FRTI. Alteration of serum Ca level may predict the risk of bronchitis and influenza B virus infection. Keeping the homeostasis of Ca, P, and Mg may be important for the prevention and treatment of FRTI.
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Affiliation(s)
- Song Mao
- Department of Pediatrics, Shanghai Sixth People’s Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liangxia Wu
- Department of Pediatrics, Shanghai Sixth People’s Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjing Shi
- Department of Pediatrics, Shanghai Sixth People’s Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Biagetti B, Sánchez-Montalvá A, Puig-Perez A, Campos-Varela I, Pilia MF, Anderssen-Nordahl E, González-Sans D, Miarons M, Simó R. Hyponatremia after COVID-19 is frequent in the first year and increases re-admissions. Sci Rep 2024; 14:595. [PMID: 38182711 PMCID: PMC10770325 DOI: 10.1038/s41598-023-50970-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024] Open
Abstract
Hyponatremia on admission has been related to worse outcomes in patients with COVID-19 infection. However, little is known about the frequency and the associated risk factors of hyponatremia after COVID-19 discharge. We performed an observational 24-month follow-up study of patients admitted during the first COVID-19 wave. Kaplan-Meier curves and Cox proportional hazard models were used to assess the main variables in predicting hyponatremia on follow-up (HYPO-FU). A total of 161 out of 683 (24.4%) developed HYPO-FU. The group with HYPO-FU comprised of more men [(62.3%) vs. (49.2%); p < 0.01], older [65.6 ± 18.2 vs. 60.3 ± 17.0; p < 0.01] and more frequently re-admitted [(16.2%) vs. (3.8%); p < 0.01). The rate of HYPO-FU was higher in the first year 23.6 per 100 individuals per year. After Cox regression analysis, the independent risk factors of HYPO-FU were diabetes [OR 2.12, IC 95% (1.48-3.04)], hypertension [OR 2.18, IC 95% (1.53-3.12)], heart failure [OR 3.34, IC 95% (1.72-6.48)] and invasive ventilation support requirement [OR: 2.38, IC 95% (1.63-3.50)]. To conclude, HYPO-FU was frequent in the first year after COVID-19 infection, and the risk was higher in older men with comorbidities, increasing rehospitalisation. Further studies aimed at evaluating the beneficial effects of correcting hyponatremia in these patients are warranted.
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Affiliation(s)
- Betina Biagetti
- Endocrinology Department, Diabetes and Metabolism Research Unit, Vall d'Hebron University Hospital and Vall d'Hebron Research Institute (VHIR), Universidad Autónoma de Barcelona, Barcelona, Spain.
| | - Adrián Sánchez-Montalvá
- Infectious Diseases Department, Vall d'Hebrón University Hospital, Global Health Program from the Catalan Health Institute (PROSICS), Universitat Autònoma de Barcelona, Barcelona, Spain
- Mycobacterial Infection Study Group from the Spanish Society of Clinical Microbiology and Infectious Diseases (GEIM-SEIMC), Barcelona, Spain
- Infectious Diseases Netword Biomedical Research Center (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Albert Puig-Perez
- Endocrinology Department, Diabetes and Metabolism Research Unit, Vall d'Hebron University Hospital and Vall d'Hebron Research Institute (VHIR), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Isabel Campos-Varela
- Liver Unit, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut of Research (VHIR), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - María Florencia Pilia
- Pneumology Department, Vall d'Hebron University Hospital, Department of Medicine, Autonomous University of Barcelona (UAB), Barcelona, Spain
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Emilie Anderssen-Nordahl
- Department of Clinical Pharmacology, Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Didac González-Sans
- Systemic Autoimmune Diseases Unit, Internal Medicine Department, Hospital Universitario Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Marta Miarons
- Pharmacy Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Rafael Simó
- Endocrinology Department, Diabetes and Metabolism Research Unit, Vall d'Hebron University Hospital and Vall d'Hebron Research Institute (VHIR), Universidad Autónoma de Barcelona, Barcelona, Spain.
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Melikechi N, Adler HG, Safi A, Landis JE, Pourkamali-Anaraki F, Eseller KE, Berlo K, Bonito D, Chiklis GR, Xia W. Blood metal analysis of plasmas from donors with and without SARS-CoV-2 using laser-induced breakdown spectroscopy and logistic regression. BIOMEDICAL OPTICS EXPRESS 2024; 15:446-459. [PMID: 38223176 PMCID: PMC10783903 DOI: 10.1364/boe.513558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/16/2024]
Abstract
Research on the correlation between metal levels in blood and Covid-19 infection has been conducted primarily by assessing how each individual blood metal is linked to different aspects of the disease using samples from donors with various levels of severity to Covid-19 infection. Using logistics regression on LIBS spectra of plasma samples collected pre- and post- Covid-19 pandemic from donors known to have developed various levels of antibodies to the SARS-Cov-2 virus, we show that relying on the levels of Na, K, and Mg together is more efficient at differentiating the two types of plasma samples than any single blood alone.
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Affiliation(s)
- Noureddine Melikechi
- Kennedy College of Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Helmar G. Adler
- Kennedy College of Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Ali Safi
- Kennedy College of Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Joshua E. Landis
- Kennedy College of Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Farhad Pourkamali-Anaraki
- Kennedy College of Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Present address: University of Colorado Denver, Denver, CO 80204, USA
| | - Kemal Efe Eseller
- Kennedy College of Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Department of Electrical - Electronics Engineering, Atilim University, 06836, Ankara, Turkey
| | - Kim Berlo
- Department of Earth & Planetary Sciences, McGill University, Montreal H3A 0E, Canada
| | - Danielle Bonito
- MRN Diagnostics, 101 Constitution Blvd, Franklin, MA 02038, USA
| | | | - Weiming Xia
- Kennedy College of Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Bedford VA Healthcare System, Bedford, MA 01730, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
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Alizad G, Ayatollahi AA, Shariati Samani A, Samadizadeh S, Aghcheli B, Rajabi A, Nakstad B, Tahamtan A. Hematological and Biochemical Laboratory Parameters in COVID-19 Patients: A Retrospective Modeling Study of Severity and Mortality Predictors. BIOMED RESEARCH INTERNATIONAL 2023; 2023:7753631. [PMID: 38027038 PMCID: PMC10676280 DOI: 10.1155/2023/7753631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/08/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
Background It is well known that laboratory markers could help in identifying risk factors of severe illness and predicting outcomes of diseases. Here, we performed a retrospective modeling study of severity and mortality predictors of hematological and biochemical laboratory parameters in Iranian COVID-19 patients. Methods Data were obtained retrospectively from medical records of 564 confirmed Iranian COVID-19 cases. According to the disease severity, the patients were categorized into two groups (severe or nonsevere), and based on the outcome of the disease, patients were divided into two groups (recovered or deceased). Demographic and laboratory data were compared between groups, and statistical analyses were performed to define predictors of disease severity and mortality in the patients. Results The study identified a panel of hematological and biochemical markers associated with the severe outcome of COVID-19 and constructed different predictive models for severity and mortality. The disease severity and mortality rate were significantly higher in elderly inpatients, whereas gender was not a determining factor of the clinical outcome. Age-adjusted white blood cells (WBC), platelet cells (PLT), neutrophil-to-lymphocyte ratio (NLR), red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), erythrocyte sedimentation rate (ESR), mean corpuscular hemoglobin (MCHC), blood urea nitrogen (BUN), and creatinine (Cr) also showed high accuracy in predicting severe cases at the time of hospitalization, and logistic regression analysis suggested grouped hematological parameters (age, WBC, NLR, PLT, HGB, and international normalized ratio (INR)) and biochemical markers (age, BUN, and lactate dehydrogenase (LDH)) as the best models of combined laboratory predictors for severity and mortality. Conclusion The findings suggest that a panel of several routine laboratory parameters recorded on admission could be helpful for clinicians to predict and evaluate the risk of disease severity and mortality in COVID-19 patients.
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Affiliation(s)
- Ghazaleh Alizad
- Department of Immunology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ali Asghar Ayatollahi
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Saeed Samadizadeh
- Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Bahman Aghcheli
- Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolhalim Rajabi
- Environmental Health Research Center, Biostatistics & Epidemiology Department, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Britt Nakstad
- Division of Paediatric and Adolescent Medicine, University of Oslo, Oslo, Norway
- Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana
| | - Alireza Tahamtan
- School of International, Golestan University of Medical Sciences, Gorgan, Iran
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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Guerrero-Romero F, Micke O, Simental-Mendía LE, Rodríguez-Morán M, Vormann J, Iotti S, Banjanin N, Rosanoff A, Baniasadi S, Pourdowlat G, Nechifor M. Importance of Magnesium Status in COVID-19. BIOLOGY 2023; 12:biology12050735. [PMID: 37237547 DOI: 10.3390/biology12050735] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/17/2023] [Accepted: 05/01/2023] [Indexed: 05/28/2023]
Abstract
A large amount of published research points to the interesting concept (hypothesis) that magnesium (Mg) status may have relevance for the outcome of COVID-19 and that Mg could be protective during the COVID disease course. As an essential element, Mg plays basic biochemical, cellular, and physiological roles required for cardiovascular, immunological, respiratory, and neurological functions. Both low serum and dietary Mg have been associated with the severity of COVID-19 outcomes, including mortality; both are also associated with COVID-19 risk factors such as older age, obesity, type 2 diabetes, kidney disease, cardiovascular disease, hypertension, and asthma. In addition, populations with high rates of COVID-19 mortality and hospitalization tend to consume diets high in modern processed foods, which are generally low in Mg. In this review, we review the research to describe and consider the possible impact of Mg and Mg status on COVID-19 showing that (1) serum Mg between 2.19 and 2.26 mg/dL and dietary Mg intakes > 329 mg/day could be protective during the disease course and (2) inhaled Mg may improve oxygenation of hypoxic COVID-19 patients. In spite of such promise, oral Mg for COVID-19 has thus far been studied only in combination with other nutrients. Mg deficiency is involved in the occurrence and aggravation of neuropsychiatric complications of COVID-19, including memory loss, cognition, loss of taste and smell, ataxia, confusion, dizziness, and headache. Potential of zinc and/or Mg as useful for increasing drug therapy effectiveness or reducing adverse effect of anti-COVID-19 drugs is reviewed. Oral Mg trials of patients with COVID-19 are warranted.
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Affiliation(s)
| | - Oliver Micke
- Department of Radiation Therapy and Radiation Oncology, Franziskus Hospital, 33615 Bielefeld, Germany
| | | | | | - Juergen Vormann
- Institute for Prevention and Nutrition, 85737 Ismaning, Germany
| | - Stefano Iotti
- Department of Pharmacy and Biotechnology, Universita di Bologna, 40126 Bologna, Italy
- National Institute of Biostructures and Biosystems, 00136 Rome, Italy
| | - Nikolina Banjanin
- Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Andrea Rosanoff
- CMER Center for Magnesium Education & Research, Pahoa, HI 96778, USA
| | - Shadi Baniasadi
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran
| | - Guitti Pourdowlat
- Chronic Respiratory Diseases Research Centre, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran
| | - Mihai Nechifor
- Department of Pharmacology, Gr. T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
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Muacevic A, Adler JR, Haq MA, Ahmad R, Sinha S, Adnan N, Haque M. Electrolyte Imbalance Among Bangladeshi Patients With COVID-19. Cureus 2023; 15:e35352. [PMID: 36860825 PMCID: PMC9970400 DOI: 10.7759/cureus.35352] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction Infection with SARS-CoV-2 begins in the lower respiratory tract, but COVID-19 often involves the renal system, resulting in serum electrolyte imbalance. Monitoring serum electrolyte levels and parameters of liver and kidney function is essential to understand disease prognosis. Objectives This study aimed to determine the effect of imbalances in serum electrolytes and other parameters on COVID-19 severity. Material and method This retrospective study comprised 241 patients, ages 14 years and older, including 186 patients who were moderately affected and 55 who were categorized as severely affected by COVID-19. Serum electrolytes (sodium (Na+), potassium (K+), and chloride (Cl-)) and biomarkers of kidney and liver function (creatinine and alanine aminotransferase (ALT)) were measured and correlated with disease severity. This research was conducted among admitted patients of Holy Family Red Crescent Medical College Hospital designated into two groups based on retrospective hospital records. Individuals with moderate illness had evidence of lower respiratory tract infection (cough, cold, breathless, etc.) during clinical assessment or imaging (chest X-ray and computed tomography (CT) scan of the lungs) and have an oxygen saturation by pulse oximetry (SpO2) ≥ 94% on room air at sea level. The severely ill group involved individuals with SpO2 ≤94% on room air at sea level and respiratory rate ≥ 30 breaths/minute, and critically ill patients are those who needed mechanical ventilation or required intensive care unit (ICU) care. This categorization was based on the Coronavirus Disease 2019 (COVID-19) Treatment Guidelines (https://www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new/). Results Average Na+ and creatinine increased by 2.30 parts (95% confidence interval (CI) = 0.20, 4.81, P = 0.041) and 0.35 units (95% CI = 0.03, 0.68, P = 0.043) in severe cases compared with moderate cases. Older participants had relatively Na+ lowered to -0.06 parts (95% CI = -0.12, -0.001, P = 0.045), significant Cl- reduction by 0.09 units (95% CI = -0.14, -0.04, P = 0.001), and ALT by 0.47 units (95% CI = -0.88, -0.06, P = 0.024), whereas serum creatinine was increased by 0.01 parts (95% CI = 0.001, 0.02, P = 0.024). The creatinine and ALT of COVID-19 participants were significantly higher in males by 0.34 units and 23.2 units, respectively, compared with females. In severe COVID-19 cases compared with moderate cases, the risks of hypernatremia, elevated chloride levels, and elevated serum creatinine levels were increased by 2.83-fold (95% CI = 1.26, 6.36, P = 0.012), 5.37-fold (95% CI = 1.90, 15.3, P = 0.002), and 2.00-fold (95% CI = 1.08, 4.31, P = 0.039), respectively. Conclusion Serum electrolyte and biomarker levels can serve as good indicators of the condition and disease prognosis of patients with COVID-19. Our purpose in this study was to determine the association between serum electrolyte imbalance and disease severity. We collected data from ex post facto hospital records and did not intend to assess the mortality rate. Consequently, this study expects that the prompt diagnosis of electrolyte disparity or disturbance possibly minimizes COVID-19-related morbidity and mortality.
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Vasheghani M, Rekabi M, Sadr M. Protective role of vitamin D status against COVID-19: a mini-review. Endocrine 2023; 79:235-242. [PMID: 36258153 PMCID: PMC9579655 DOI: 10.1007/s12020-022-03203-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/17/2022] [Indexed: 02/04/2023]
Abstract
An outbreak of pneumonia caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is called COVID-19 and has led to a pandemic worldwide. It is reasonable to investigate and control factors affecting disease severity and mortality. The relation between vitamin D and viral pneumonia has been previously reported. Vitamin D deficiency is common and may increase hospital admission and mortality rate in patients with COVID-19. This mini-review examines the pathways that show the association between vitamin D and COVID-19. On the other hand, it deals with the available evidence related to the relationship between vitamin D deficiency and the effect of vitamin D supplementation on the prevalence, severity, and mortality of COVID-19. Also, we described the pathophysiology of the organs' involvement in COVID-19 and the effect of vitamin D on these outcomes. Vitamin D strengthens the innate and adaptive immune system, modulates immune responses, prevents lung and cardiovascular system damage, and reduces thrombotic events. Vitamin D exerts these effects in several pathways. Vitamin D prevents virus entry and replication by maintaining the integrity of the body's physical barrier. Vitamin D reduces the damage to vital organs and thrombotic events by increasing the level of Angiotensin-converting enzyme 2 (ACE2), nitric oxide, and antioxidants or by reducing inflammatory cytokines and free radicals. Sufficient vitamin D may be reduced morbidity and mortality due to COVID-19. However, this issue should be investigated and confirmed by further research in the future.
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Affiliation(s)
- Maryam Vasheghani
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Rekabi
- Pediatric Respiratory Disease Research Center (PRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Makan Sadr
- Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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