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COVID-19 and Selenium Deficiency: a Systematic Review

Fakhrolmobasheri et al., Biological Trace Element Research, doi:10.1007/s12011-021-02997-4
Nov 2021  
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Review of 11 studies, 9 showing lower serum selenium levels associated with worse COVID-19 outcomes. Two studies reported no significant association between serum selenium level and COVID-19. In one study, urinary selenium level was reported to be higher in severe and fatal cases compared to non-severe and recovered patients, respectively. In most cases, selenium deficiency was associated with worse outcomes, and selenium levels in COVID-19 patients were lower than in healthy individuals. Authors conclude that cautious selenium supplementation may be helpful to prevent disease progression.
Currently there are 4 selenium treatment studies and meta analysis shows:
Mortality35% lower [-273‑89%]
Hospitalization22% lower [-106‑70%]
Cases41% fewer [-98‑82%]
Fakhrolmobasheri et al., 5 Nov 2021, peer-reviewed, 7 authors. Contact:,
This PaperSeleniumAll
COVID-19 and Selenium Deficiency: a Systematic Review
Mohammad Fakhrolmobasheri, Sadegh Mazaheri-Tehrani, Marek Kieliszek, Mehrdad Zeinalian, Mehdi Abbasi, Fateme Karimi, Amir Mohamad Mozafari
Biological Trace Element Research, doi:10.1007/s12011-021-02997-4
Several studies have indicated that selenium deficiency may be detrimental in the context of various viral disorders, and in the case of COVID-19, several studies have reported heterogeneous results concerning the association of selenium deficiency with the severity of disease. To summarize the available data surrounding the association of body selenium levels with the outcomes of COVID-19, a systematic search was performed in the Medline database (PubMed), Scopus, Cochrane Library, Embase, and Web of Science using keywords including "SARS-CoV-2," "COVID-19," and "selenium," Studies evaluating the association of COVID-19 with body selenium levels were included. Among 1,862 articles viewed in the database search, 10 articles were included after title, abstract, and full-text review. One study was further included after searching the literature again for any newly published articles. Out of 11 included studies, 10 studies measured serum selenium level, and one study investigated urinary selenium level. Three of 10 studies measured serum SELENOP level as well as selenium level. Glutathione peroxidase-3 level in serum was also assessed in one study. The reported outcomes were severity, mortality, and risk of COVID-19. Nine studies indicated that a lower serum selenium level is associated with worse outcomes. Two studies reported no significant association between serum selenium level and COVID-19. In one study, urinary selenium level was reported to be higher in severe and fatal cases compared to non-severe and recovered patients, respectively. In most cases, selenium deficiency was associated with worse outcomes, and selenium levels in COVID-19 patients were lower than in healthy individuals. Thus, it could be concluded that cautious selenium supplementation in COVID-19 patients may be helpful to prevent disease progression. However, randomized clinical trials are needed to confirm this.
Author Contribution M. F. contributed to the main idea development, designing the article review and data extraction process, and writing of the article. S. M.-T., M. K., and M. Z. had contributed in the article review and data extraction process and article writing. M. K., F. K., and M. A. contributed in the database screening and article review process. A. M. as the medical librarian had developed the search strategy of the study. All authors have read and approved the manuscript. Declarations Ethics Approval and Consent to Participate Not applicable. Conflict of Interest The authors declare no competing interests. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/.
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