A comparative study of serum Zn, Cu, Mg, Mn, Cr, and Fe levels and their association with the vulnerability of Iraqi COVID-19 patients
Falah S Al-Fartusie, Safaa I Kader, Sara Jassim Mohammed, Majeed N Farhan, Fahim Muhsin Mahmood, Anwar A Algaber
Journal of Trace Elements in Medicine and Biology, doi:10.1016/j.jtemb.2023.127242
Background: For the immune system to protect the body from infectious diseases such as COVID-19, it needs the ideal amount of vital trace elements. Trace element levels, especially, zinc (Zn), copper (Cu), magnesium (Mg), manganese (Mn), chromium (Cr), and iron (Fe) levels, may affect how sensitive an individual is to COVID-19 and other viruses. The current study evaluated the level of those trace elements during stays in the isolation center and investigated their association with vulnerability to COVID-19. Methods: A total of 120 individuals, 49 males and 71 females aged between 20 and 60 years, were included in this study. Forty individuals infected with COVID-19, 40 individuals who had recovered from it, and 40 healthy individuals, were all evaluated and studied. By using a flame atomic absorption spectrophotometer, levels of Zn, Cu, and Mg were assessed for all samples, whereas levels of Mn, and Cr were determined by a flameless atomic absorption spectrophotometer. Results: The infected individuals had significantly lower levels of Zn, Mg, Mn, Cr, and Fe than recovered individuals and healthy control individuals (P < 0.0001). On the other hand, the total number of infected patients was found to have much higher levels of Cu than those in the recovered group and the control group. For the recovered and healthy control groups, no significant differences were observed in the levels of trace elements (P > 0.05), except for Zn (P < 0.01). Also, the findings indicated no association of trace elements with age and BMI (P > 0.05). Conclusion: These results show that an imbalance in the levels of essential trace elements could be associated with increasing the risk of COVID-19 infection. However, additional thorough research of greater scope is required considering the severity of the infection.
Ethical Approval All procedures performed in studies involving human Participants were following the ethical standards of the research committee of Mustansiriyah University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Statements & declarations The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.
Compliance with Ethical Standards Conflict of Interest The authors declare that they have no conflict of interest.
Informed Consent Informed consent was obtained from all individual participants included in the study.
CRediT authorship contribution statement All authors contributed to the study's conception and design. Material preparation, data collection, and analysis were performed by the authors. The first draft of the manuscript was written by Safaa Kader and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Declaration of Competing Interest The authors have no relevant financial or non-financial interests to disclose.
Appendix A. Supporting information Supplementary data associated with this article can be found in the online version at doi:10.1016/j.jtemb.2023.127242.
References
Al-Fartusie, Evaluation of some trace elements and vitamins in major depressive disorder patients: a case-control study, Biol. Trace Elem. Res
Al-Saleh, Essential metals, vitamins and antioxidant enzyme activities in COVID-19 patients and their potential associations with the disease severity, Biometals
Arancibia-Hernandez, Antioxidant/anti-inflammatory effect of Mg(2+) in coronavirus disease 2019 (COVID-19), Rev. Med. Virol
Arrieta, Serum zinc and copper in people with COVID-19 and zinc supplementation in parenteral nutrition, Nutrition
Bego, Association of trace element status in COVID-19 patients with disease severity, J. Trace Elem. Med. Biol
Beigmohammadi, The association between serum levels of micronutrients and the severity of disease in patients with COVID-19, Nutrition
Chen, Aging in COVID-19: Vulnerability, immunity and intervention, Ageing Res. Rev
Chen, Association of serum trace elements with schizophrenia and effects of antipsychotic treatment, Biol. Trace Elem. Res
Dharmalingam, Trace elements as immunoregulators in SARS-CoV-2 and other viral infections, Indian J. Clin. Biochem
Eskander, Razzaque, Can maintaining optimal magnesium balance reduce the disease severity of COVID-19 patients?, Front. Endocrinol. (Lausanne)
Fooladi, Matin, Mahmoodpoor, Copper as a potential adjunct therapy for critically ill COVID-19 patients, Clin. Nutr. ESPEN
Gombart, Pierre, Maggini, A review of micronutrients and the immune system-working in harmony to reduce the risk of infection, Nutrients
Im, Nutritional status of patients with COVID-19, Int. J. Infect. Dis
Ivanova, Evaluation of zinc, copper, and Cu:Zn ratio in serum, and their implications in the course of COVID-19, J. Trace Elem. Med. Biol
Kader, Serum levels of copper, zinc, iron and magnesium in Iraqi's women with HCMV infection, Al-Mustansiriyah J. Sci
Khadim, Al-Fartusie, Evaluation of some trace elements and antioxidants in sera of patients with rheumatoid arthritis: a case-control study, Clin. Rheumatol
Kocak, Evaluation of serum trace element levels and biochemical parameters of COVID-19 patients according to disease severity, Biol. Trace Elem. Res
Lee, Serum concentrations of trace elements zinc, copper, selenium, and manganese in critically Ill patients, Biol. Trace Elem. Res
Li, Luo, Liang, Circulating trace elements status in COVID-19 disease: a meta-analysis, Front. Nutr
Maares, Free zinc as a predictive marker for COVID-19 mortality risk, Nutrients
Maggini, Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses, Br. J. Nutr
Mansour, Association of serum zinc level and clinical outcome in Egyptian COVID-19 patients, Egypt J. Intern. Med
Mazdak, The comparative study of serum iron, copper, and zinc levels between bladder cancer patients and a control group, Int. Urol. Nephrol
Noor, Ali, Kader, Aldabagh, Serum levels of copper, zinc, iron and magnesium in Iraqi's patient with chronic hepatitis C. Karbala, J. Med
Noor, Ali, Wahab, Safaa, Kader, Serum and hair reference levels of zinc, copper, and vitamins E& A in healthy Iraqi.s female, Al-Mustansiriyah J. Sci
Oh, Coadministration of HIV vaccine vectors with vaccinia viruses expressing IL-15 but not IL-2 induces long-lasting cellular immunity, Proc. Natl. Acad. Sci. USA
Pvsn, Comparative analysis of serum zinc, copper and magnesium level and their relations in association with severity and mortality in SARS-CoV-2 patients, Biol. Trace Elem. Res
Shrivastava, Effects of chromium on the immune system, FEMS Immunol. Med. Microbiol
Skalny, Serum zinc, copper, and other biometals are associated with COVID-19 severity markers, Metabolites
Soleimanian, Yaghobi, Harnessing memory NK cell to protect against COVID-19, Front. Pharmacol
Taneri, Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis, Eur. J. Epidemiol
Tang, Possibility of magnesium supplementation for supportive treatment in patients with COVID-19, Eur. J. Pharmacol
Trapani, Rosanoff, Baniasadi, The relevance of magnesium homeostasis in COVID-19, Eur. J. Nutr
Wessling-Resnick, Crossing the iron gate: why and how transferrin receptors mediate viral entry, Annu. Rev. Nutr
Yadav, Association of iron-related biomarkers with severity and mortality in COVID-19 patients, J. Trace Elem. Med. Biol
Zeng, Associations of essential and toxic metals/metalloids in whole blood with both disease severity and mortality in patients with COVID-19, FASEB J
Zhao, Serum iron level as a potential predictor of coronavirus disease 2019 severity and mortality: a retrospective study, Open Forum Infect. Dis
