The association between serum levels of micronutrients and the severity of disease in patients with COVID-19
Mohammad Taghi Beigmohammadi, M.D Sama Bitarafan, Alireza Abdollahi, Laya Amoozadeh, Faeze Salahshour, Maedeh Mahmoodi Ali Abadi, Danesh Soltani, Zoya Asl Motallebnejad
Nutrition, doi:10.1016/j.nut.2021.111400
This study aimed to compare the serum level of micronutrients with normal amounts, and assess their association with the severity of disease and inflammatory cytokines in patients with coronavirus disease 2019 (COVID-19). Methods: The present cross-sectional study included 60 patients admitted to the intensive care unit with COVID-19. We recorded data on demographic characteristics, anthropometric information, and medical history. Serum levels of inflammatory markers (erythrocyte sedimentation rate, C-reactive protein, interferongamma, tumor necrosis factor-alpha, interleukin-6), vitamins (A, B 9 , B 12 , C, D, E), and minerals (magnesium, zinc, iron) were measured. A radiologist assessed the severity of lung involvement according to patient computed tomography scans. The severity of illness was evaluated with the Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, oxygen saturation, and body temperature. Independent associations among the serum levels of micronutrients with the severity of COVID-19 were measured. Results: Median patient age was 53.50 years (interquartile range, 12.75 years). Except for vitamin A and zinc, serum levels of other micronutrients were lower than the minimum normal. Patients with APACHE score 25 had a higher body mass index (P = 0.044), body temperature (P = 0.003), erythrocyte sedimentation rate (P = 0.008), C-reactive protein (P = 0.003), and lower oxygen saturation (P = 0.005), serum levels of vitamin D (P = < 0.001), and zinc (P = < 0.001) compared with patients with APACHE score <25. We found that lower serum levels of vitamin D, magnesium, and zinc were significantly and independently associated with higher APACHE scores (P = 0.001, 0.028, and < 0.001, respectively) and higher lung involvement (P = 0.002, 0.045, and < 0.001, respectively). Conclusions: Lower serum levels of vitamin D, zinc, and magnesium were involved in severe COVID-19.
Conclusions Low serum levels of some micronutrients, such as B9, B12, vitamins C and D, magnesium, and iron, were observed in patients with COVID-19. Furthermore, lower levels of vitamin D, zinc, and magnesium were correlated with more severe disease. We recommend identifying and addressing the deficiency of micronutrients that could be involved in immune system responses to prevent severe COVID-19 disease.
CRediT author statement Mohammad Taghi Beigmohammadi: Methodology, Investigation, Data Curation, Writing -Review & Editing; Sama Bitarafan: Conceptualization, Methodology, Visualization, Supervision, Project administration, Funding acquisition, Writing -Review & Editing; Alireza Abdollahi: Investigation, Resources; Laya Amoozadeh: Investigation, Data Curation, Visualization; Faeze Salahshour: Investigation, Resources, Data Curation; Maedeh Mahmoodi ali abadi: Investigation, Resources; Danesh Soltani: Formal analysis, Software, Writing -Review & Editing;Zoya Asl Motalebnegad: Formal analysis, Writing -Original Draft.
Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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