Hypozincemia in the early stage of COVID-19 is associated with an increased risk of severe COVID-19
Fromonot et al.
, Hypozincemia in the early stage of COVID-19 is associated with an increased risk of severe COVID-19
, Clinical Nutrition, doi:10.1016/j.clnu.2021.04.042
Analysis of 240 consecutive patients in France, showing significantly higher zinc deficiency in COVID-19 patients, and significantly greater risk of hospitalization for COVID-19 patients with zinc deficiency. 2020PI087.
risk of hospitalization, 89.2% lower, RR 0.11, p = 0.002, high zinc levels 6 of 110 (5.5%), low zinc levels 7 of 42 (16.7%), NNT 8.9, inverted to make RR<1 favor high zinc levels, odds ratio converted to relative risk, within COVID-19 patients.
risk of case, 27.6% lower, RR 0.72, p = 0.003, high zinc levels 110 of 188 (58.5%), low zinc levels 42 of 52 (80.8%), NNT 4.5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Fromonot et al., 3 May 2021, prospective, France, peer-reviewed, 6 authors.
Abstract: Clinical Nutrition xxx (xxxx) xxx
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Hypozincemia in the early stage of COVID-19 is associated with an
increased risk of severe COVID-19
Julien Fromonot a, b, *, Mickael Gette a, Amin Ben Lassoued a, Jean-Louis Gue
gis Guieu a, b
ant-Rodriguez c, Re
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,
a r t i c l e i n f o
s u m m a r y
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.
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