Sonntag, 1. März 2020

Magnesium supplementation as a possible treatment of SARS-CoV-2 induced COVID-19 disease could reduce the case fatality rate of severe ARDS lung failure

Credits picture: CDC
This is a pre-print publication of a medical hypothesis of me about the possible reduction of devasting case fatality rate of SARS-Co-V-infectet patients which develope COVID-19 disease and severe ARDS leading to lung failure. NOTE: This hypothesis is not prooved until today,
Author: Cord Uebermuth - published on March 1, 2020 - 03:05 UTC+1 on as a preprint on the blockchain


The increasing number of deaths and increasing case fatality rate (CFR) with age of the infected patients of COVID-19 disease is a devasting event of SARS-CoV-2 infection. Little or nothing is known about the reason of the high CFR of the elderly population.
It has been reported the many fatalities at SARS-CoV-2-Syndrom are associated with other diseases like diabetes or lung affections as asthma. It is remarcable that male patients which are infected by the SARS-CoV-2 virus has a higher risk to die by the infection. It is even of interest to know the reason why young persons or chidren seldom develop a fatal outcome of the SARS-CoV-2 infection.
From the point of view of the author of this work a magnesium deficiency could be an important risk factor of fatal outcome of the COVID-19 diseas at infected patients. It is well known and decribed in the scientific literature that magnesium imbalance is leading to a disfunction of the immune system - for examble at theXMEN-disease. Cell-mediated immunity is the most effective immune response in removing virus-infected cells without causing a cytokine storm. A lack of magnesium and low serum levels of magnesium seems to be associated with immunodeficiency as we know by alterations of MAGT1 function at the XMEN disease.
Supplemention of Magnesium at patients with MAGT1-defect has shown many benefits to treated patients with XMEN disease - and even leads to tumor supression and is able to combat Ebstein Barr Virus infection. It is well known that with aging of the people and reduced activity the magnesium intake of old people is significant lower than in young people. Similar effects can be observed at patients which needs to use drugs - for example pantoprazol or omeprazol - or which have diabetes with kidney disease and often as a result of kidney dysfunction low magnesium levels.
Even alcohol intake is often combined with low magnesium levels of patients and injury of the liver leading to an imbalance of the immune system. The gender prevelance of alcohol dependence is more common in man than in women, so that alcohol induced low magnesium levels could cause deadly outcome of the SARS-CoV-2 infection.
At present there are no investigations of the SARS-CoV-2 induced COVID-19 disease which has measured the magnesium levels of patients and its correlation with fatality. If low magnesium levels are correlating with higher case fatality rates of COVID-19 patients, then a Mg-supplementation could from the authors point of view result in a better outcome of devasting acute respiratory distress syndrom (ARDS) of affected patients with SARS-CoV-2 infection and severe COVID-19 disease and even other Coronavirus disease such as MERS-CoV-Coronadisease or even SARS.
It is well described that low magnesium levels in vitro with HUVEC-cells are leading to enhancement of inflammation by increasing activity of NF-κB at low magnesium levels. (1) Such an inflammation induced by low magnesium levels could be responsible of devasting lung damage by ARDS in the background of the virus challenge.
On the other hand it is important to know that low NFkB activation leads to less virus replication in other viral diseases, which is able to cause severe inflammation. More clinical trials are necessary in order to find out if patients with low magnesium levels has more often a fatal outcome at COVID-19 than patients with normal or elevated mangensium levels a result of supplementation trials.
If so, then it should be discussed to improve the magnesium intake of infected patients at COVID-19 disease in order to avoid a fatal outcome ot ARDS at COVID-19 disease and similar avoid any kind of alcohol consumption. If not than - other reasons of the increased CFR in elderly and male patients should be discussed.
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[1.] Magnes Res. 2018 Aug 1;31(3):99-109. doi: 10.1684/mrh.2018.0439.
Varying magnesium concentration elicits changes in inflammatory response in human umbilical vein endothelial cells (HUVECs).
[2] Mg2+ regulates cytotoxic functions of NK and CD8 T cells in chronic EBV infection through NKG2D
[3.] Control of SARS infection by CD-4 lymphocytes
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