The association between illness and electrolyte imbalances isn’t a new concept, but it’s come back into the spotlight more recently, with recent studies examining electrolyte imbalances and COVID-19.
The results are quite interesting, as they reveal possible diagnostic opportunities and therapeutic interventions to help reduce the severity of COVID-19. Also, a correlation has been found between low electrolyte levels in the year before someone contracted the virus and higher mortality.
The relationship between the severity of COVID-19 outcomes and low levels of specific electrolytes suggests that they could be an easy predictor for those who may develop severe disease. Also, early prediction of critical cases through testing for specific electrolyte imbalances may help identify patients who will likely benefit from early therapeutic and preventive measures that could reduce mortality.
Possible causes of electrolyte imbalance in COVID-19 patients include fever, sweating, vomiting, diarrhea, dietary changes, drug-related side effects, hyperventilation, the direct effect of the virus on infected host cells, and the malfunction of organs during the disease.
A balance of different electrolytes is crucial as many automatic processes in our body rely on them. When electrolytes get depleted, our cell signaling and communication functions weaken, further compromising our body at a time when it needs to be stronger and more resilient.
The Science Behind It
Multiple studies point to the importance of four electrolytes that are essential in the fight against COVID-19: sodium, magnesium, calcium, and potassium. A review of these studies, published in Annals of Clinical Biochemistry in 2020, suggests that low electrolyte levels are directly linked to disease severity and weakened recovery.
Clinical data from 12 studies show that 59 percent of people with COVID-19 have low levels of calcium (hypocalcemia), according to a review published in Immunity, Inflammation and Disease in 2021. The results show hypocalcemia is significantly associated with the severity of disease, mortality, the number of hospitalization days, and admission to the intensive care unit (ICU). Calcium is involved in the regulation of the inflammatory response, metabolic and signaling, and plays an important role in the survival and virulence of viruses.
Magnesium plays a role in immune response, reduces inflammation, is a muscle relaxant, is a vasodilator (widens blood vessels), has antioxidant effects, and protects the nervous system. As a result, magnesium levels affect the health of the cardiovascular, nervous, respiratory, and digestive systems. Low levels of magnesium (hypermagnesemia) in COVID-19 patients who were admitted to the ICU have been shown to be one of the signs of disease severity, according to a study from Iran. The study recommends that magnesium should be added to the panel of tests in routine COVID-19 testing.
In a study from China published in JAMA Network Open, a journal of the American Medical Association, 93 percent of severe and critically ill patients had below-normal levels of potassium (hypokalemia). The study found a direct relationship between the degree of hypokalemia and the severity of COVID-19.
Another smaller study published in the Canadian Journal of Kidney Health and Disease evaluated the prevalence of low levels of sodium (hyponatremia) in COVID-19 patients and the correlation between hyponatremia and the severity and outcome of COVID-19. It found that hyponatremia patients required significantly higher rates of ICU admissions and oxygen support.
Finally, an extensive study (published in Nature in 2021) was done in the United States that looked at the entire medical history of more than 100,000 COVID-19 patients to understand key markers associating mortality and health states that are more likely to lead to ICU admission and mortality. It concluded that those who experienced imbalances in their electrolyte or fluid levels in the year before they contracted the virus were more likely to die than those who didn’t.
How to Ensure Our Optimal Electrolyte Levels
Everyone’s body is different, and electrolyte levels are affected by many factors. Getting a serum electrolyte test done would be a great first step to see where you’re at and if you need therapeutic intervention.
Gatorade or most store-bought electrolyte-boosting sports drinks are definitely not the answer. Many contain toxic dyes and are packed with excessive sugar, making them more sugar-heavy than electrolyte-heavy, which is detrimental to your health.
Having a well-balanced diet is crucial for maintaining optimal electrolyte balance. There are excellent food sources for you to main electrolytes.
Good Sources of Potassium
- Beans: white beans
- Green leafy vegetables: spinach, chard, and kale
- Dried apricots
- Squash: acorn, butternut, and zucchini
- Red, yellow and orange fruits and vegetables: bananas, beets, oranges, bell peppers, and lemons (slightly lower in potassium)
- Coconut water
Good Sources of Natural Sodium
- Bok choy
- Bell peppers (red, yellow, and orange)
- Lemon juice
- Coconut water
Good Sources of Magnesium/Calcium:
- Nuts and seeds (magnesium mainly)
- Almond and cashew nuts (highest)
- Sunflower and sesame seeds (highest)
- Green leafy vegetables (calcium)
- Wheat-based grains (magnesium)
- Coconut water
- Lemon juice
- Lime juice
- Orange juice
Optimal electrolyte levels are crucial for COVID-19 recovery and mortality and can be part of the puzzle in mitigating severity. The good news is that we can help our bodies have a better chance of fighting off the virus and improve our general health with a good understanding of the importance of electrolytes and keeping them at optimal levels.