Post-Covid-syndrome and transient microvascular pathology in pulse-waveanalysis - association with Mg/Ca ratio and magnesium therapy-options

ABSTRACT

Post-COVID-syndromes have a high impact on incapacity for work a mean of over 100 days has been reported in Germany [1]. Magnesium deficiency is documented as a riskincreasing factor for fatal outcome of acute covid disease [2, 3]. A first case report of post-COVID treatment with hybrid magnesium parenteral/ oral was presented in February 2021 during the Global Magnesium COVID 19 online conference. As of yet, there is no established explanation for post-COVID or long-COVID syndrome as well as there being no established treatment. In recourse to the hypothesis that magnesiumdepletion might favour microvascular early-aging and so favour neuro- degenerative prozesses [4] now preliminary observations of these parameters in post-covid patients in our primary care office result. This is done in connection with long years documentation of pulsewave-analysis (pwv), magnesium and Mg/Caprofiles in patients who suffered covid- disease. Figure 1 shows an over 6-year series of pulse-wave-analyses in a 59-year-old female patient who suffered from post-COVID syndrome. Her augmentation index (AIX) as an indicator of the actual microvascular condition increased from favorable 8% (2020) to highly pathological 39% in the post-COVID disease period - corresponding with the mean value of an 80-year-old person [5]. Another 67-year-old female post-COVID patient recovered clinically very well and quickly with high-dosed magnesium therapy and showed coincident positive decrease of AIX to 4%. Further case reports in the context of magnesium pretests and AIX are presented. Late controlled studies concerning magnesium supplementation and PWV focus on the other parameter - the (macrovascular determined) pulse-wave-velocity (PWV) and found no association of PWV with several months of magnesium supplementation [6]. Therefore, it must be emphasized that all our observations of the last years where not based on PWV but rather focused on AIX as a volatile but more magnesium-dependent parameter. Furthermore, our patients where mostly supplemented over years and not only 24 weeks. Evident is the overall small number of clinically manifesting post-COVID cases among our COVID patients (n= 10 when writing the ) among actually 470 Corona-context treatment cases. We have two working hypotheses for this. I Persistently high magnesium levels may contrib- ute to reducing the number of post- COVID cases - and II In the case of post-COVID syndrome, high-dose possibly hybrid magnesium therapy might favorably influence the course of the disease. The Corona pandemic and its microvascular consequences are possibly and unfortunately a non-intended turbo-experiment for microvascular early aging in a great number of undetected magnesium- depletion patients. Facing the burden of disease for individuals - and society as a whole - this justifies not only controlled studies but also the increased attention of medical doctors to the optimal magnesium status of these patients.