Combating COVID-19 and Building Immune Resilience: A Potential Role for Magnesium Nutrition?

Abstract

Background: In December 2019, the viral pandemic of respiratory illness caused by COVID-19 began sweeping its way across the globe. Several aspects of this infectious disease mimic metabolic events shown to occur during latent subclinical magnesium deficiency. Hypomagnesemia is a relatively common clinical occurrence that often goes unrecognized since magnesium levels are rarely monitored in the clinical setting. Magnesium is the second most abundant intracellular cation after potassium. It is involved in >600 enzymatic reactions in the body, including those contributing to the exaggerated immune and inflammatory responses exhibited by COVID-19 patients.

Methods: A summary of experimental findings and knowledge of the biochemical role magnesium may play in the pathogenesis of COVID-19 is presented in this perspective. The National Academy of Medicine's Standards for Systematic Reviews were independently employed to identify clinical and prospective cohort studies assessing the relationship of magnesium with interleukin-6, a prominent drug target for treating COVID-19.

Results: Clinical recommendations are given for prevention and treatment of COVID-19. Constant monitoring of ionized magnesium status with subsequent repletion, when appropriate, may be an effective strategy to influence disease contraction and progression. The peer-reviewed literature supports that several aspects of magnesium nutrition warrant clinical consideration. Mechanisms include its “calcium-channel blocking” effects that lead to downstream suppression of nuclear factor-Kβ, interleukin-6, c-reactive protein, and other related endocrine disrupters; its role in regulating renal potassium loss; and its ability to activate and enhance the functionality of vitamin D, among others.

Conclusion: As the world awaits an effective vaccine, nutrition plays an important and safe role in helping mitigate patient morbidity and mortality. Our group is working with the Academy of Nutrition and Dietetics to collect patient-level data from intensive care units across the United States to better understand nutrition care practices that lead to better outcomes.

Keywords:

• Magnesium
• COVID-19
• coronavirus
• COVID-19
• nutrition
• potassium
• vitamin D
• hypokalemia
• hypomagnesemia
• inflammation
• cytokine

Acknowledgments

The author thanks Andrea Rosanoff and Rebecca Costello for their expert input and critique of the draft manuscript prior to submission.

Disclosure statement

TCW declares no funding or support for the work. TCW is a co-investigator on an investigator-initiated unrestricted educational grant from New Capstone, Inc. to study the bioavailability of a new picometer-sized magnesium (ReMag®) supplement. TCW is a Senior Fellow of the Center for Magnesium Education & Research but does not receive financial compensation in this role.

Author contributions

TCW wrote the manuscript and is solely responsible for its contents. He has read, reviewed, and approved the final submission.