Reduction in Serum Magnesium Levels and Renal Function Are Associated with Increased Mortality in Obese COVID-19 Patients

• Published in: Nutrients 2022-09, Vol.14 (19), p.4054
• Main Authors: Pulido Perez, Patricia, Póndigo de Los Angeles, Jorge Alberto, Perez Peralta, Alonso, Ramirez Mojica, Eloisa, Torres Rasgado, Enrique, Hernandez-Hernandez, Maria Elena, Romero, Jose R
• Format: Article
• Language: English
• Subjects: Analysis; Body mass; Body mass index; Body size; circulating magnesium levels; Confidence intervals; Coronaviruses; COVID-19; COVID-19 - complications; Death; Glomerular filtration rate; Glomerular Filtration Rate - physiology; Hospital patients; Humans; Kidney - physiology; Magnesium; Medical research; Medicine, Experimental; Mexico; Mortality; Obesity; Obesity - complications; Patient outcomes; Patients; Renal function; Renal Insufficiency - complications; Retrospective Studies; Risk analysis; Risk Factors; SARS-CoV-2; Statistical analysis; Type 2 diabetes
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14194054

Several studies provide evidence that obesity is a significant risk factor for adverse outcomes in coronavirus disease 2019 (COVID-19). Altered renal function and disturbances in magnesium levels have been reported to play important pathophysiological roles in COVID-19. However, the relationship between obesity, renal function, circulating magnesium levels, and mortality in patients with COVID-19 remains unclear. In this retrospective cohort study, we characterized 390 hospitalized patients with COVID-19 that were categorized according to their body mass index (BMI). Patients were clinically characterized and biochemical parameters, renal function, and electrolyte markers measured upon admission. We found that in patients who died, BMI was associated with reduced estimated glomerular filtration rate (eGFR, Rho: −0.251, p = 0.001) and serum magnesium levels (Rho: −0.308, p < 0.0001). Multiple linear regression analyses showed that death was significantly associated with obesity (p = 0.001). The Cox model for obese patients showed that magnesium levels were associated with increased risk of death (hazard ratio: 0.213, 95% confidence interval: 0.077 to 0.586, p = 0.003). Thus, reduced renal function and lower magnesium levels were associated with increased mortality in obese COVID-19 patients. These results suggest that assessment of kidney function, including magnesium levels, may assist in developing effective treatment strategies to reduce mortality among obese COVID-19 patients.