Abstract: nutrients Article The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study Sahar Golabi 1 , Maryam Adelipour 2 , Sara Mobarak 3 , Maghsud Piri 4 , Maryam Seyedtabib 5 , Reza Bagheri 6 , Katsuhiko Suzuki 7 , Damoon Ashtary-Larky 8 , Fatemeh Maghsoudi 9 and Mahshid Naghashpour 10, * 1 2 3



 4 5 Citation: Golabi, S.; Adelipour, M.; Mobarak, S.; Piri, M.; Seyedtabib, M.; 6 Bagheri, R.; Suzuki, K.; 7 Ashtary-Larky, D.; Maghsoudi, F.; Naghashpour, M. The Association 8 between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study. Nutrients 2021, 13, 3368. https://doi.org/ 10.3390/nu13103368 Academic Editors: William B. Grant, Ronan Lordan and Lutz Schomburg Received: 2 September 2021 Accepted: 21 September 2021 Published: 25 September 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. 9 10 * Department of Medical Physiology, School of Medicine, Abadan University of Medical Sciences, Abadan 6313833177, Iran; s.golabi@abadanums.ac.ir Department of Clinical Biochemistry, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6135715794, Iran; adelipour-m@ajums.ac.ir Department of Infectious Diseases, School of Medicine, Abadan University of Medical Sciences, Abadan 6313833177, Iran; s.mobarak@abadanums.ac.ir Vice Chancellor for Health, Abadan University of Medical Sciences, Abadan 6313833177, Iran; maghsudpiri@gmail.com Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6135715794, Iran; m.stabib3@gmail.com Department of Exercise Physiology, University of Isfahan, Isfahan 8174673441, Iran; will.fivb@yahoo.com Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa 359-1192, Japan; katsu.suzu@waseda.jp Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6135715794, Iran; damoon_ashtary@yahoo.com Department of Public Health, School of Health, Abadan University of Medical Sciences, Abadan 6313833177, Iran; fatemehmagh627@gmail.com Department of Nutrition, School of Medicine, Abadan University of Medical Sciences, Abadan 6313833177, Iran Correspondence: m.naghashpour@abadanums.ac.ir; Tel.: +98-9166157338 Abstract: Vitamin D and zinc are important components of nutritional immunity. This study compared the serum concentrations of 25-hydroxyvitamin D (25(OH)D) and zinc in COVID-19 outpatients with those of potentially non-infected participants. The association of clinical symptoms with vitamin D and zinc status was also examined. A checklist and laboratory examination were applied to collect data in a cross-sectional study conducted on 53 infected outpatients with COVID-19 and 53 potentially non-infected participants. Serum concentration of 25(OH)D were not significantly lower in patients with moderate illness (19 ± 12 ng/mL) than patients with asymptomatic or mild illness (29 ± 18 ng/mL), with a trend noted for a lower serum concentration of 25(OH)D in moderate than asymptomatic or mild illness patients (p = 0.054). Infected patients (101 ±..