Abstract: Clinical Nutrition xxx (xxxx) xxx Contents lists available at ScienceDirect Clinical Nutrition journal homepage: http://www.elsevier.com/locate/clnu Short Communication Hypozincemia in the early stage of COVID-19 is associated with an increased risk of severe COVID-19 ant c, Julien Fromonot a, b, *, Mickael Gette a, Amin Ben Lassoued a, Jean-Louis Gue gis Guieu a, b ant-Rodriguez c, Re Rosa-Maria Gue a Service de Biochimie, Timone University Hospital, AP-HM, Marseille, France Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France Department Inserm, UMR_S 1256, Nutrition-Genetics-Environmental Risk Exposure, Universit e de Lorraine and University Regional hospital of Nancy, Nancy, France b c a r t i c l e i n f o s u m m a r y Article history: Received 9 October 2020 Accepted 21 April 2021 Background & aims: Nutritional predisposition to severe coronavirus disease 2019 (COVID-19) remains unclear. Zinc deficiency could be critical since it is associated with a higher susceptibility to infections. We evaluated the prevalence of hypozincemia in the early stage of COVID-19, its association with risk factors for severe COVID-19 and its prognostic value for hospitalization for respiratory complications within 10 days. Methods: For 152 COVID-19 patients and 88 non-COVID-19 patients admitted to COVID-19 screening centers, national early warning score for COVID-19 (NEWS) and laboratory analyses were performed to identify the risk for severe COVID-19. Multivariable logistic regression analysis assessed whether hypozincemia was an independent predictor of hospitalization for respiratory complications within 10 days (primary judgment criterion). The secondary judgment criteria were high NEWS score (
7), comorbidities and biomarkers associated with severe COVID-19. Results: Hypozincemia was more frequent in COVID-19 patients compared to non-COVID-19 patients (27.6% vs 11.4%; p ¼ 0.003). Older patients (
65 years) and medically assisted nursing home residents were at higher risk of hypozincemia (p < 0.01). Hypozincemia was associated with a worse NEWS score (p < 0.01) and lymphopenia (p < 0.001). Hypozincemia was independently associated with hospitalization for respiratory complications within 10 days (OR ¼ 10.9, 95% CI ¼ 2.3e51.6, p ¼ 0.002). Conclusions: In the early stage of COVID-19, the prevalence of hypozincemia exceeded 20%. Hypozincemia was an independent predictor of hospitalization for respiratory complications within 10 days. This may suggest the importance of early detection and treatment of zinc deficiency in the nutritional management of COVID-19, especially in older people. Therefore, intervention and adjuvant treatment trials are strongly needed. © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved. Keywords: COVID-19 Zinc Selenium Risk factor Lymphopenia Inflammation