# The Impact of Low Serum Magnesium Levels on COVID-19 Severity and Potential Therapeutic Benefits of Magnesium Supplementation: A Systematic Review

## TL;DR

This review explores how low magnesium levels may worsen COVID-19 outcomes and whether magnesium supplementation could help, based on findings from multiple studies.

## Contribution

The study systematically reviews evidence linking magnesium levels and supplementation to COVID-19 severity and recovery, highlighting potential therapeutic benefits.

## Key findings

- Lower serum magnesium levels are associated with increased severity and mortality in COVID-19 patients.
- Magnesium supplementation above 450 mg may improve recovery and reduce oxygen needs when combined with vitamins D and B12.
- Hypermagnesemia was also linked to poor outcomes in some populations, indicating a complex relationship.

## Abstract

In this review, our objective was to analyze the association between serum magnesium (Mg) levels, Mg supplementation, and coronavirus disease 2019 (COVID-19) outcomes. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching major databases until February 2023. Twenty-six studies (11,363 patients) were included: 22 examining serum Mg levels (8474 patients) and four investigating Mg supplementations (2889 patients).

Most studies indicated an association between lower serum Mg levels and increased COVID-19 severity, including higher mortality rates and prolonged recovery periods. Critical patients demonstrated significantly lower Mg levels compared to moderate/severe cases. However, some studies reported conflicting findings, with hypermagnesemia also associated with poor outcomes in specific patient populations. Regarding supplementation, higher dietary Mg intake correlated with shorter hospitalization duration and faster recovery. Mg supplementation exceeding 450 mg showed potential benefits, including increased antibody titers in pregnant women and reduced oxygen support requirements in elderly patients when combined with vitamins D and B12.

While evidence suggests a potential relationship between Mg status and COVID-19 outcomes, findings are heterogeneous. Further investigation through well-designed clinical trials is required to gain deeper insights into the role of Mg in COVID-19 pathophysiology and the therapeutic potential of Mg supplementation.