ARYA Atherosclerosis Journal

Serum magnesium levels and the risk of acute viral cardiomyopathy in children: A case-control study

Document Type : Case Report

Authors

Fatemeh Doost-Mohammadi 1
Fateme Anjomshoaa 2
Reza Derakhshan 3

1 Clinical Research Development Unit, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

2 Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

3 Associate Professor of Pediatric Cardiology, Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

https://doi.org/10.48305/arya.2026.45968.3131
Abstract
BACKGROUND: Acute viral cardiomyopathy is a leading cause of heart failure in children. Although magnesium is essential for myocardial electrophysiology, its potential association with pediatric viral cardiomyopathy remains poorly characterized.
METHODS: This hospital-based frequency-matched case–control study (1:1 ratio, balanced for age) included 73 children with confirmed acute viral cardiomyopathy and 73 non-cardiac hospitalized controls at Afzalipour Hospital, Kerman, Iran (2023–2024). Serum total magnesium was measured on admission (reference 1.7–2.3 mg/dL); hypomagnesemia was defined as <1.7 mg/dL. Groups were compared using an independent-samples t-test and a χ² test. Multivariable logistic regression has been used to assess associated factors for acute viral cardiomyopathy.
RESULTS: Mean serum magnesium level was significantly lower in the cardiomyopathy group than the control group (1.80 ± 0.31 vs. 1.98 ± 0.31 mg/dL; P = 0.003). Hypomagnesemia prevalence was significantly higher in the cardiomyopathy group (39.7% vs. 9.6%; unadjusted OR (95% CI): 5.80 (2.28–14.75); P < 0.001). After adjustment for sex, BMI, fever, and underlying chronic disease, each 0.1 mg/dL decrease in serum magnesium was associated with 1.38-fold higher odds of cardiomyopathy (adjusted OR (95% CI): 1.38 (1.11–1.72); P = 0.004). Hospital stay was longer in cases (7.77 ± 2.42 vs. 5.39 ± 2.20 days; P < 0.001). In-hospital mortality was higher among the cardiomyopathy group (6.8% vs. 1.4%), though the difference was not statistically significant (P = 0.209).
CONCLUSION: Children with acute viral cardiomyopathy seem to have significantly lower serum magnesium compared with matched controls. Routine admission magnesium screening could be considered in management protocols.

Keywords

Acute Viral Cardiomyopathy
Hypomagnesemia
Magnesium
Pediatrics
Cardiology
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ARYA Atherosclerosis Journal
Volume 22, Issue 4
July and August 2026
Pages 1-10

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