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Serum trace elements levels and clinical outcomes among Iranian COVID-19 patients

Bagher Pour et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.08.053
Aug 2021  
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Prospective analysis of 114 ICU patients and 112 matched non-ICU patients in Iran, showing no significant difference in selenium levels.
Study covers selenium and zinc.
Bagher Pour et al., 25 Aug 2021, prospective, Iran, peer-reviewed, 7 authors, study period 10 October, 2020 - 10 December, 2020. Contact:,
This PaperSeleniumAll
Serum trace elements levels and clinical outcomes among Iranian COVID-19 patients
Ozra Bagher Pour, Yahya Yahyavi, Abbas Karimi, Amir Mehdi Khamaneh, Mortaza Milani, Majid Khalili, Akbar Sharifi
International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.08.053
Objectives : The relationship between immunity and trace elements levels is well known. We aimed to estimate the association of serum trace elements with severity and outcomes in the Coronavirus Disease-2019 (COVID-19) patients. Methods: In this single-centered, prospective, observational study, we enrolled 114 patients admitted to severe intensive care units (ICUs) and corresponding 112 sex and aged-matched non-ICU ward patients. Demographic data, clinical characteristics, and outcomes were all collected. We analyzed serum levels of zinc (Zn), copper (Cu), selenium (Se), and manganese (Mn) in both severity groups. Results : The serum levels of Cu, Se, and Mn in both groups were within the normal range while Zn serum levels were lower than normal values. Based on these findings, Zn, Cu, Se, and Mn serum levels were not associated with disease severity ( P > 0.05), while we found Zn serum levels were strongly associated with patient outcomes ( P = 0.005). Our results indicated lower Mn serum levels were associated with age more than 55 years ( P = 0.006). Our results were not in favor of a causal relationship between serum trace elements levels and disease severity. Conclusion : We found Zn level to be a strong indicator for patients' outcomes that can be considered for monitoring patient prognosis. Nutritional measures or supplementation can help reduce poor outcomes caused by low Zn levels in Iranian COVID-19 patients.
Ethics approval This study was performed in line with the principles of the Declaration of Helsinki. It was approved by the Ethics Committee of Tabriz University of Medical Sciences, Iran (Ref No: IR.TBZMED.REC.1399.711). Authors' contributions Conflicts of interest The authors have no conflicts of interest to declare relevant to the content of this article.
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