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Prediction of Survival Odds in COVID-19 by Zinc, Age and Selenoprotein P as Composite Biomarker
Heller et al., Redox Biology, doi:10.1016/j.redox.2020.101764
Heller et al., Prediction of Survival Odds in COVID-19 by Zinc, Age and Selenoprotein P as Composite Biomarker, Redox Biology, doi:10.1016/j.redox.2020.101764
Oct 2020   Source   PDF  
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Analysis of 35 COVID-19 patients showing a significant correlation for serum zinc levels between COVID-19 patients and controls, and between COVID-19 survivors and non-survivors.
Heller et al., 20 Oct 2020, peer-reviewed, 14 authors.
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Prediction of survival odds in COVID-19 by zinc, age and selenoprotein P as composite biomarker
Raban Arved Heller, Qian Sun, Julian Hackler, Julian Seelig, Linda Seibert, Asan Cherkezov, Waldemar B Minich, Petra Seemann, Joachim Diegmann, Maximilian Pilz, Manuel Bachmann, Alireza Ranjbar, Arash Moghaddam, Lutz Schomburg
Redox Biology, doi:10.1016/j.redox.2020.101764
SARS-CoV-2 infections cause the current coronavirus disease (COVID-19) pandemic and challenge the immune system with ongoing inflammation. Several redox-relevant micronutrients are known to contribute to an adequate immune response, including the essential trace elements zinc (Zn) and selenium (Se). In this study, we tested the hypothesis that COVID-19 patients are characterised by Zn deficiency and that Zn status provides prognostic information. Serum Zn was determined in serum samples (n = 171) collected consecutively from patients surviving COVID-19 (n = 29) or non-survivors (n = 6). Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study were used for comparison. Zn concentrations in patient samples were low as compared to healthy subjects (mean ± SD; 717.4 ± 246.2 vs 975.7 ± 294.0 μg/L, P < 0.0001). The majority of serum samples collected at different time points from the non-survivors (25/34, i.e., 73.5%) and almost half of the samples collected from the survivors (56/137, i.e., 40.9%) were below the threshold for Zn deficiency, i.e., below 638.7 μg/L (the 2.5th percentile in the EPIC cohort). In view that the Se status biomarker and Se transporter selenoprotein P (SELENOP) is also particularly low in COVID-19, we tested the prevalence of a combined deficit, i.e., serum Zn below 638.7 μg/L and serum SELENOP below 2.56 mg/L. This combined deficit was observed in 0.15% of samples in the EPIC cohort of healthy subjects, in 19.7% of the samples collected from the surviving COVID-19 patients and in 50.0% of samples from the non-survivors. Accordingly, the composite biomarker (SELENOP and Zn with age) proved as a reliable indicator of survival in COVID-19 by receiver operating characteristic (ROC) curve analysis, yielding an area under the curve (AUC) of 94.42%. We conclude that Zn and SELENOP status within the reference ranges indicate high survival odds in COVID-19, and assume that correcting a diagnostically proven deficit in Se and/or Zn by a personalised supplementation may support convalescence.
We acknowledge funding received towards the doctoral thesis of RAH from the Oskar-Helene-Heim Foundation, Berlin, Germany. Declaration of competing interest LS holds shares and PS serves as CEO of selenOmed GmbH, a company involved in Se status assessment and supplementation. The other authors declare no competing interest.
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