Low serum levels of zinc and 25-hydroxyvitmain D as potential risk factors for COVID-19 susceptibility: a pilot case-control study
Esmat Ghanei, Moein Baghani, Hamideh Moravvej, Atefeh Talebi, Ayda Bahmanjahromi, Fahimeh Abdollahimajd
European Journal of Clinical Nutrition, doi:10.1038/s41430-022-01095-5
BACKGROUND AND AIMS: This study aimed to evaluate serum 25-hydroxyvitmain D and zinc levels in coronavirus disease 2019 patients in comparison to healthy subjects. METHODS: This was a single-center case-control study performed from March 20, 2020, to January 20, 2021, in Tehran, Iran. All patients diagnosed with COVID-19 based on a positive nasopharyngeal swab polymerase chain reaction (PCR) test were included in the case group. Controls were selected from patients referred for routine checkups who had a negative COVID-19 PCR test. Age, sex, marital and educational status, comorbidities, and serum 25-hydroxyvitmain D and zinc levels of patients were recorded. RESULTS: Ninety patients in the case group and 95 subjects in the control group who were sex and age-matched were studied. 25hydroxyvitmain D levels higher than 20 ng/ml were observed in 58 (64%) cases and 72 (76%) controls (P = 0.09). The median 25hydroxyvitmain D level in the case group was significantly lower than controls (26 (interquartile range [IQR] = 24) ng/ml vs. 38 (IQR = 22) ng/ml, respectively, P < 0.01). The median zinc level in the case group was 56 (IQR = 23) mcg/dL, while it was 110 (IQR = 27) mcg/dL among the controls (P < 0.01). There was no significant difference in the level of 25-hydroxyvitmain D and zinc between cases with and without comorbidities (P > 0.05). Susceptibility to SARS-CoV-2 infection could be predicted by serum 25hydroxyvitmain D levels below 25.2 ng/ml (81% sensitivity; 48% specificity) or zinc levels below 86.3 mcg/dL (93% sensitivity; 92% specificity). CONCLUSIONS: Low serum zinc and 25-hydroxyvitmain D levels appear to be risk factors for COVID-19 affliction; thus, the treatment of individuals with such deficiencies is recommended.
AUTHOR CONTRIBUTIONS EG and FA contributed to the conception of the work. HM, EG, MB, AB and FA contributed to the acquisition of data and AT contributed to the analysis, and interpretation of data for the work. AB, MB and FA drafted the manuscript. FA and EG and HM critically revised the manuscript. All authors gave final approval and agreed to be accountable for all aspects of the work ensuring integrity and accuracy. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
COMPETING INTERESTS The authors declare no competing interests.
ETHICAL APPROVAL The study protocol was approved by our institute's Ethics Committee in Biomedical Research with reference code IR.SBMU.SRC.REC.1399.007.
ADDITIONAL INFORMATION Supplementary information The online version contains supplementary material available at https://doi.org/10.1038/s41430-022-01095-5. Correspondence and requests for materials should be addressed to Ayda bahmanjahromi or Fahimeh Abdollahimajd. Reprints and permission information is available at http://www.nature.com/ reprints Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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