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Introduction: In the face of the global pandemic coronavirus disease 2019 (COVID-19) has created, readily available prognostic markers may be of great use. Purpose(s): To evaluate the association between serum magnesium levels (sMg) on admission and clinical outcomes in hospitalized COVID-19 patients. Method(s): We retrospectively analyzed all consecutive patients admitted to our medical center with a primary de novo diagnosis of COVID- 19.Demographic, clinical and laboratory data were extracted from the electronic medical record. Clinical outcomes were compared between five groups of patients according to the quintiles of sMg on hospital admission. Result(s): From 2,433 consecutive COVID-19 patients during the years 2020-2021, we included 1,522 patients with sMg on admission (1-3 day of hospitalization) (58% male, 69+/-17 years old). Patients were followed for a mean of 10+/-7 months. A low sMg level (1st quintile) was associated with higher rates of diabetes and steroid use, whereas a high sMg level (5th quintile) was associated with dyslipidemia, chronic kidney disease, andhigher levels of inflammatory markers (Table 1). Both low and high sMg levels were associated with lower oxygen saturation during hospitalization. All-cause in-hospital and long-term mortality was higher in patients with both low and high sMg levels, compared with mid-range sMg levels (2nd, 3rd and 4thquintiles;19% and 30% vs. 9.5%, 10.7% and 17.8% and 35% and 45.3% vs. 23%, 26.8% and 27.3% respectively;p<0.001 for all) (Figure 1). Conclusion(s): Both low and high sMg levels were associated with worse short- and long-term clinical outcomes and all-cause mortality in a large cohort of hospitalized COVID-19 patients. Thus, admission sMg levels may play a prognostic role in risk stratificationof COVID-19 patients. (Figure Presented).
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Introduction: Acute kidney injury (AKI) occurs in 0.5 to 25% of hospitalized COVID-19 patients. Clinical severity and renal involvement are due to inflammation, immune and endothelial dysfunction. On the other hand, risk factors such as age, comorbidities, mechanical ventilation requirement, hypovolemia and MAP <65 mm Hg are associated with AKI development. This study aim to evaluate the development of AKI and determine the relationship between serum creatinine and inflammatory. Method(s): A single center, retrospective study involving 166 patients under the diagnosis of moderate to severe COVID-19 infection in Hospital General Regional 110 Oblatos, Guadalajara, Mexico. A consecutive sample was approached. AKI was determined and classify when changes in serum creatinine met KDIGO definition. Demographics, clinical and biochemical data, risk factors for AKI and RRT prescription were assessed and reported during diagnosis and discharge. Outcome measures were renal recovery, mortality and causes of death. Differences were compared using 2-sample t test for continuous variables and chi-square for categorical variables. Relationship between creatinine changes and inflammation markers were assessed using Pearson correlation coefficients. All statistical tests were performed using SPSS 28.0 and a P < 0.05 level of significance. Result(s): Mean age 59 +/- 18.38 years. 60 cases (36%) were diagnose as AKI. 41% were in stage 1, whereas 35% and 24% made up stage 2 and 3, respectively. Changes in serum creatinine (SCr) correlated with gender (r=0.155, p 0.48), changes in hemoglobin (r= -0.384, p < 0.01), neutrophil/ lymphocyte ratio (NLR) (r= 0.229;p 0.003), serum phosphate (r= 0.555, p < 0.01), serum calcium (r= -0.210, p < 0.011), serum potassium (r= 0.555, p < 0.01), serum magnesium (r= 0.212, p < 0.012), D-dimer (r= 0.246, p 0.02) and (r= -0.322, p < 0.01). After adjusting model for cofounders, hospitalization length and age (OR: 3.03, CI 0.39, 11.56, p=0.033) trend to be a significant data, other cofounders in relation to the presence of AKI o changes in SCr were no significant with other potential outcomes. [Formula presented] Conclusion(s): The present study highlighted that the presence of AKI is associated the increased of inflammation, but the current evidence limits the outcomes in already none predictive factors. Further studies are needed to establish early strategies aimed to prevent AKI and its evolution in COVID-19 patients and pandemics ahead. No conflict of interestCopyright © 2023
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Unbalanced magnesium levels in the body, like other minerals, are a factor that is important in the severity and mortality of COVID-19. This study was designed to investigate the relationship between serum magnesium levels and clinical outcomes in COVID-19 patients. In this systematic review, a comprehensive search was performed in PubMed, Scopus, and Web of Science databases until September 2021 by using the keywords COVID-19, severe acute respiratory syndrome coronavirus 2, coronavirus disease, SARS- COV-infection 2, SARS-COV-2, COVID 19, and magnesium. End-Note X7 software was used to manage the studies. Articles that evaluated effect of magnesium on COVID-19 were included in the analysis. After reviewing several articles,12 studies were finally included in the ultimate analysis. The studies show that hypomagnesemia and hypermagnesemia are both factors that increase mortality in patients with COVID-19, even in one study, hypomagnesemia is the cause of doubling thedeaths in COVID-19 patients. Some studies have also found a negative correlation between magnesium deficiency and infectionseverity, while some others have reported no correlation between magnesium level and disease severity. According to the important role of magnesium in the body and its involvement in many physiological reactions, as well as differences in physical and physiological conditions of COVID-19 patients, in addition to the need for studies with larger sample sizes, monitoring and maintaining normal serum magnesium levels during the disease seems necessary as a therapeutic target, especially in patients admitted to the intensive care unit.
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Aim: The assessment of serum electrolytes at the time of initial presentation of the patient with respiratory tract infection possibly causing lung parenchyma and pulmonary vasculature damage and serial monitoring during the stay could be beneficial in order to determine when and how to take remedial action when necessary. Methodology: A non-probability sampling was done on 139 subjects with suspected respiratory tract infection. For confirmation, culture, MTB PCR, COVID-19 testing was done to diagnose the nature of infection. Serum electrolytes were tested on chemical analyses Alinity instrument. Results: Most common infections found were COVID-19 and bacterial (n=59) collectively in a co-morbid state. Mycobacterium tuberculosis and fungal infections were also found in (n=8) each. Electrolytes imbalance was markedly observed in high prevalence amongst Tuberculosis and COVID-19 patients but also showed significant association with other respiratory investigated infections. Conclusion: A robust association of electrolyte imbalance was found in all cases presented with upper or lower respiratory tract infections.
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BACKGROUND AND AIMS: Electrolyte abnormalities are common among patients with coronavirus disease 2019 (COVID-19). This study aims to investigate the electrolyte changes in severe and non-severe COVID-19 patients. Hypocalcaemia, hypomagnesaemia and hypoalbuminemia and their relationship with the severity of symptoms and prognosis will also be determined. METHOD: We enrolled 270 COVID-19 patients. Serum tests were taken from each patient on the day of admission to check the level of variables. Thereon, calcium, magnesium and phosphorus levels were measured twice a week and albumin levels were measured once a week. Variables such as PTH and 25 (OH) D were measured once at the beginning of the study. Other laboratory results like complete blood count, C-reactive protein and clinical data such as arterial blood oxygen levels, length of stay in the ICU and the treatment regimen were extracted from patients' medical records and history. Finally, patients were categorized as mild, moderate, severe and critical group based on the severity of the disease. The data analyses were carried out via SPSS software (version 21.0). RESULTS: Of 270 patients, 135 people (50%) were men. The mean age of patients was 46.7 years. Based on the severity of the disease, 91 patients had mild disease, 90 patients presented with moderate disease, 54 patients were in severe condition and 35 patients were critical. Hypocalcaemia (Ca2+ ≤8.6 mg/dL) was detected in 49 patients (18.1%) on admission. The mean of serum magnesium, phosphorus and albumin levels on admission was 2.2 ± 0.22 mEq/L, 3.39 ± 0.79 mg/dL and 4.49 ± 0.66g/dL, respectively. Phosphorus level was lower than 2.63 mg/dL in 11 patients (4.07%) and 43 patients (15.92%) had hypoalbuminemia. The mean 25(OH) D level was 32.92 ± 10.29 μg/L;therefore, 182 patients (67.40%) fall within the normal range (>30 μg/L). CONCLUSION: Patients with mild and moderate disease tend to develop hypocalcaemia, hypoalbuminemia and hypomagnesaemia more often than severe and critical COVID-19 patients during treatment. 25(OH) D deficiency rate was higher in the moderate group. Patients with hypocalcaemia during treatment had higher mortality than other patients. We recommend electrolytes be measured at initial presentation and serially monitored during hospitalization in order to establish timely and appropriate corrective actions and prevent the serious complications of the disease.
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For decades, the macrovascular system was in the focus of diagnostic and therapeutic medicine. The relevance of microvascular pathology was widely underestimated but is revealed in a new break-through cardiological study. Increasing knowledge reveals the microvascular system as the essential target structure of chronic magnesium-depletion, mediating smoldering chronic disease processes. Microvascular dysfunction could be the common basis for the association of chronic magnesium deficiency and polytopic diseases of high-energy dependent organs: diabetic retinopathy, renal failure - diabetic and other -, microvascular = non-Alzheimer dementia, diastolic cardiac dysfunction (HFpEF - heart failure with preserved ejection fraction) - analog arterial hypertension - microvascular angina, atrial fibrillation but also diabetic foot and diabetic neuropathy. In early studies the actual COVID-19 pandemic is related to microvascular pathomechanisms. Following earlier results reporting better survival of intensive care patients with highly normal magnesium as well as epidemiological associations we recommended for all patients from the beginning of the COVID 19 epidemic high-dose magnesium supplementation 15 - 25 mmol (and zinc 20 mg, vitamin D 2,000 IE each/day). In the context of COVID-19, we can assume four constellations of possibly positive effects of this magnesium strategy: 1. Due to our own limited cohorts the most evident: Tolerance of immunization with Biontech/Pfizer COVID-19 vaccine was distinctly better in our cohort of over 412 vaccinations compared with published data. 2. Rare, but a few patients with more intense adverse reactions had low magnesium and/or abnormal microvascular results in pulse wave analysis. 3. COVID patients (also elderly) with documented high serum magnesium - and pre-supplemented - recovered well from the disease. 4. Two post-Corona, long-COVID patients with symptoms of fatigue, reduced mental concentration, and dizziness reacted well after repeated parenteral magnesium infusion. Whether SARS-Cov-2-antibody formation correlates with magnesium or zinc values is topic of running investigations. Systematic prospective investigations are warranted. But due to the circumstances - considering that there are no evidence-based alternatives - for healthy individuals, for persons at risk, for patients at risk of magnesium depletion as well as for COVID-19 vaccination candidates, optimizing of magnesium is justified (Global Mg COVID-19 project) - and in terms of other health concerns, the prevention of chronic microvascular disease entities also justifies supplementation. Personalized magnesium dosage in medical office should be oriented by practical serum Mg/Ca (mmol/mmol) target 0.4 - including calcium. This approach seems to us to be expedient and more successful didactically. (outpatient medicine: Mg/Ca in serum;intensive care: ionized magnesium).
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The proceedings contain 4 papers. The topics discussed include: relevance of magnesium for the fresh cow;ionized magnesium: update 2021;serum magnesium assessment needs for standardization;and microvascular dysfunction and magnesium - impact in COVID times and further on.
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Introduction: Asthma control is the extent to which symptoms of asthma observed in patients and reduction in symptoms after treatment. Simple screening tools are available to assess asthma control. Asthma control test is a simple numerical scoring system that can be easily used on a routine basis. Latest GINA guidelines stress that asthma control is the main objective of asthma treatment. In this COVID pandemic situation there is a hesitancy in performing and undergoing pulmonary function tests among physicians and the patients. Hence in this study was planned to correlate the asthma control test values with FEV1 and other parameters like PEFR, AEC and serum magnesium. Methods: This study was conducted at Department of Pulmonary Medicine, SRM Hospital & Research centre, Chennai. It is a retrospective cross-sectional observational study. Patients of Bronchial Asthma in line with GINA Guidelines were included in the study. AIMS and OBJECTIVES: To study the correlation between asthma control test and FEV1, To study the correlation between asthma control test and other parameters like Peak expiratory flow rate, Absolute eosinophil count and Serum magnesium. Results: Asthma control test had positive correlation with FEV1 with a spearman's correlation of 0.2758 and P value of 0.0414 which was statistically significant. The spearman's correlation between Asthma control test and AEC was -0.4583 with a P value of 0.00043, which was significant. The correlation of asthma control test with serum magnesium was 0.3414 with a p value of 0.010. Conclusion: Asthma control test score had a significant positive correlation with FEV1 and serum magnesium levels. It also had significant negative correlation with Absolute eosinophil count (inflammatory marker). Hence Asthma control test can be used as tool for treatment response in the current COVID pandemic situation and also in resource limited settings.
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The proceedings contain 32 papers. The topics discussed include: recent advances in magnesium research - from cell biology to human disease;assessment of changing global human magnesium status - needs for updating methodology and standardization;when magnesium is assessed in clinical setting?;serum magnesium assessment needs for standardization;systematic review and meta-analysis to determine a reference range for ionized magnesium;magnesium transporters: discovering new potential biomarkers in digestive cancers;TRPM7 is protective against hypertension, cardiovascular inflammation and fibrosis induced by aldosterone and salt;dietary magnesium deficiency impairs hippocampus-dependent memories and induces neuroinflammation in mouse;and the effects of combination of green tea, rhodiola, magnesium and B vitamins on brain activity and the effects of a laboratory social stressor in healthy volunteers.