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A Mechanistic Link Between Selenium and Coronavirus Disease 2019 (COVID-19)

Khatiwada et al., Current Nutrition Reports, doi:10.1007/s13668-021-00354-4
Apr 2021  
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Review discussing the link between selenium and COVID-19. Authors note that selenium deficiency is common in COVID-19 patients, with lower levels associated with higher mortality and lower cure rates. Selenium has a critical role in redox homeostasis, immunity, and preventing viral infections - enhancing synthesis of defensive proteins, improving phagocytic cell function, and modulating T cell activation and differentiation. Selenium deficiency is associated with increased inflammatory cytokines, while supplementation reduces inflammation and improves antioxidant capacity in critically ill patients. Therefore, selenium supplementation at appropriate doses may be beneficial for COVID-19.
Reviews covering selenium for COVID-19 include1-10.
Khatiwada et al., 9 Apr 2021, China, peer-reviewed, 2 authors. Contact: khatiwadasaroj22@gmail.com, asthasubedi22@gmail.com.
This PaperSeleniumAll
A Mechanistic Link Between Selenium and Coronavirus Disease 2019 (COVID-19)
Saroj Khatiwada, Astha Subedi
Current Nutrition Reports, doi:10.1007/s13668-021-00354-4
Purpose of Review Coronavirus disease 2019 (COVID-19) is a rapidly emerging disease caused by a highly contagious virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and this disease has affected millions of people across the world and led to hundreds of thousands of deaths worldwide. Nutrition is a key factor related to this disease, and nutritional status may determine the risk and outcomes of SARS-CoV-2 infection. Selenium is one of the major trace elements required for redox functions and has significant roles in viral infections. The purpose of this review was to examine the current evidence on the role of selenium in COVID-19. We reviewed studies on selenium and COVID-19, and other relevant studies to understand how selenium status can modify the risk of SARS-CoV-2 infection, and how selenium status might affect a person post-infection. Recent Findings We found that oxidative stress is a characteristic feature of COVID-19 disease, which is linked with the immunopathological disorder observed in individuals with severe COVID-19. Selenium plays a key role in strengthening immunity, reducing oxidative stress, preventing viral infections and supporting critical illness. Moreover, selenium deficiency is related to oxidative stress and hyperinflammation seen in critical illness, and selenium deficiency is found to be associated with the severity of COVID-19 disease. Summary Selenium supplementation at an appropriate dose may act as supportive therapy in COVID-19. Future studies in large cohorts of COVID-19 are warranted to verify the benefits of selenium supplementation for reducing risk and severity of COVID-19.
Author Contribution SK and AS generalised the concept. SK and AS conducted the literature search, analysed relevant literature and drafted the manuscript. All authors reviewed the manuscript. All authors read and approved the final version of the manuscript. Declarations Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors. Consent for Publication Not applicable. Competing Interests None. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Biol Trace Elem Res. 2020;194(1):237–43.', 'journal-title': 'Biol Trace Elem Res'}, { 'issue': '11', 'key': '354_CR70', 'doi-asserted-by': 'publisher', 'first-page': '1762', 'DOI': '10.1093/infdis/jiaa150', 'volume': '221', 'author': 'F Wang', 'year': '2020', 'unstructured': 'Wang F, Nie J, Wang H, Zhao Q, Xiong Y, Deng L, et al. Characteristics ' 'of peripheral lymphocyte subset alteration in COVID-19 pneumonia. J ' 'Infect Dis. 2020;221(11):1762–9.', 'journal-title': 'J Infect Dis'}, { 'issue': '6', 'key': '354_CR71', 'doi-asserted-by': 'publisher', 'first-page': '1155', 'DOI': '10.3945/jn.109.120725', 'volume': '140', 'author': 'FW Hoffmann', 'year': '2010', 'unstructured': 'Hoffmann FW, Hashimoto AC, Shafer LA, Dow S, Berry MJ, Hoffmann PR. ' 'Dietary selenium modulates activation and differentiation of CD4+ T ' 'cells in mice through a mechanism involving cellular free thiols. 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' 'Metallomics. 2020;12:1576–84.', 'journal-title': 'Metallomics.'}, { 'issue': '3', 'key': '354_CR74', 'first-page': '271', 'volume': '55', 'author': 'P Erkekoğlu', 'year': '2013', 'unstructured': 'Erkekoğlu P, Aşçı A, Ceyhan M, Kızılgün M, Schweizer U, Ataş C, et al. ' 'Selenium levels, selenoenzyme activities and oxidant/antioxidant ' 'parameters in H1N1-infected children. Turk J Pediatr. 2013;55(3):271–82.', 'journal-title': 'Turk J Pediatr'}, { 'key': '354_CR75', 'doi-asserted-by': 'crossref', 'unstructured': 'Fakhrolmobasheri M, Nasr-Esfahany Z, Khanahmad H, Zeinalian M. Selenium ' 'supplementation can relieve the clinical complications of COVID-19 and ' 'other similar viral infections. Int J Vitam Nutr Res. 2020:1–3.', 'DOI': '10.1024/0300-9831/a000663'}, { 'key': '354_CR76', 'doi-asserted-by': 'crossref', 'unstructured': '• Zhang J, Saad R, Taylor EW, Rayman MP. Selenium and selenoproteins in ' 'viral infection with potential relevance to COVID-19. Redox Biol. ' '2020;37:101715. This review highlights the importance of selenium in ' 'COVID-19 pathogenesis.', 'DOI': '10.1016/j.redox.2020.101715'}, { 'issue': '2', 'key': '354_CR77', 'doi-asserted-by': 'publisher', 'first-page': '147', 'DOI': '10.1080/08820139.2018.1496098', 'volume': '48', 'author': 'A Mahmoodpoor', 'year': '2019', 'unstructured': '• Mahmoodpoor A, Hamishehkar H, Shadvar K, Ostadi Z, Sanaie S, ' 'Saghaleini SH, et al. The effect of intravenous selenium on oxidative ' 'stress in critically ill patients with acute respiratory distress ' 'syndrome. Immunol Investig. 2019;48(2):147–59 This clinical trial found ' 'that selenium supplementation can enhance antioxidant capacity of lungs ' 'and lower inflammation.', 'journal-title': 'Immunol Investig'}, { 'key': '354_CR78', 'doi-asserted-by': 'crossref', 'unstructured': 'Alamdari DH, Moghaddam AB, Amini S, Keramati MR, Zarmehri AM, Alamdari ' 'AH, et al. Application of methylene blue -vitamin C –N-acetyl cysteine ' 'for treatment of critically ill COVID-19 patients, report of a phase-I ' 'clinical trial. Eur J Pharmacol. 2020;885:173494.', 'DOI': '10.1016/j.ejphar.2020.173494'}, { 'key': '354_CR79', 'doi-asserted-by': 'crossref', 'unstructured': 'De Flora S, Balansky R, La Maestra S. Rationale for the use of ' 'N-acetylcysteine in both prevention and adjuvant therapy of COVID-19. ' 'FASEB J. 2020;34:13185–93.', 'DOI': '10.1096/fj.202001807'}, { 'issue': '26', 'key': '354_CR80', 'doi-asserted-by': 'publisher', 'first-page': '16292', 'DOI': '10.1021/acsomega.0c02125', 'volume': '5', 'author': 'S Hati', 'year': '2020', 'unstructured': 'Hati S, Bhattacharyya S. Impact of thiol-disulfide balance on the ' 'binding of Covid-19 spike protein with angiotensin-converting enzyme 2 ' 'receptor. ACS Omega. 2020;5(26):16292–8.', 'journal-title': 'ACS Omega'}, { 'key': '354_CR81', 'first-page': '101063', 'volume': '30', 'author': 'RI Horowitz', 'year': '2020', 'unstructured': 'Horowitz RI, Freeman PR, Bruzzese J. Efficacy of glutathione therapy in ' 'relieving dyspnea associated with COVID-19 pneumonia: a report of 2 ' 'cases. Respir Med Case Rep. 2020;30:101063.', 'journal-title': 'Respir Med Case Rep'}, { 'issue': '3', 'key': '354_CR82', 'doi-asserted-by': 'publisher', 'first-page': '280', 'DOI': '10.1007/s12603-012-0376-6', 'volume': '17', 'author': 'CK Tseng', 'year': '2013', 'unstructured': 'Tseng CK, Ho CT, Hsu HS, Lin CH, Li CI, Li TC, et al. Selenium is ' 'inversely associated with interleukin-6 in the elderly. J Nutr Health ' 'Aging. 2013;17(3):280–4.', 'journal-title': 'J Nutr Health Aging'}, { 'issue': '2', 'key': '354_CR83', 'doi-asserted-by': 'publisher', 'first-page': '506', 'DOI': '10.1007/s12011-018-1396-9', 'volume': '187', 'author': 'PA Khoso', 'year': '2019', 'unstructured': 'Khoso PA, Zhang Y, Yin H, Teng X, Li S. Selenium deficiency affects ' 'immune function by influencing selenoprotein and cytokine expression in ' 'chicken spleen. Biol Trace Elem Res. 2019;187(2):506–16.', 'journal-title': 'Biol Trace Elem Res'}, { 'issue': '12', 'key': '354_CR84', 'doi-asserted-by': 'publisher', 'first-page': '1826', 'DOI': '10.1016/j.freeradbiomed.2007.03.017', 'volume': '42', 'author': 'I Jaspers', 'year': '2007', 'unstructured': 'Jaspers I, Zhang W, Brighton LE, Carson JL, Styblo M, Beck MA. Selenium ' 'deficiency alters epithelial cell morphology and responses to influenza. ' 'Free Radic Biol Med. 2007;42(12):1826–37.', 'journal-title': 'Free Radic Biol Med'}, { 'issue': '11', 'key': '354_CR85', 'doi-asserted-by': 'publisher', 'first-page': '1234', 'DOI': '10.1038/ng1655', 'volume': '37', 'author': 'JE Curran', 'year': '2005', 'unstructured': 'Curran JE, Jowett JBM, Elliott KS, Gao Y, Gluschenko K, Wang J, et al. ' 'Genetic variation in selenoprotein S influences inflammatory response. ' 'Nat Genet. 2005;37(11):1234–41.', 'journal-title': 'Nat Genet'}, { 'issue': '2', 'key': '354_CR86', 'doi-asserted-by': 'publisher', 'first-page': '281', 'DOI': '10.1017/S0954422418000124', 'volume': '31', 'author': 'JB Belsky', 'year': '2018', 'unstructured': 'Belsky JB, Wira CR, Vinitha J, Sather JE, Lee PJ. A review of ' 'micronutrients in sepsis: the role of thiamine, l-carnitine, vitamin C, ' 'selenium and vitamin D. Nutr Res Rev. 2018;31(2):281–90.', 'journal-title': 'Nutr Res Rev'}, { 'issue': '6', 'key': '354_CR87', 'doi-asserted-by': 'publisher', 'first-page': '990', 'DOI': '10.1093/bja/aev073', 'volume': '114', 'author': 'K Mertens', 'year': '2015', 'unstructured': 'Mertens K, Lowes DA, Webster NR, Talib J, Hall L, Davies MJ, et al. Low ' 'zinc and selenium concentrations in sepsis are associated with oxidative ' 'damage and inflammation. Br J Anaesth. 2015;114(6):990–9.', 'journal-title': 'Br J Anaesth'}, { 'issue': '3', 'key': '354_CR88', 'doi-asserted-by': 'publisher', 'first-page': '226', 'DOI': '10.1016/j.jtemb.2012.11.001', 'volume': '27', 'author': 'D Viezeliene', 'year': '2013', 'unstructured': 'Viezeliene D, Beekhof P, Gremmer E, Rodovicius H, Sadauskiene I, Jansen ' 'E, et al. Selective induction of IL-6 by aluminum-induced oxidative ' 'stress can be prevented by selenium. J Trace Elem Med Biol. ' '2013;27(3):226–9.', 'journal-title': 'J Trace Elem Med Biol'}, { 'issue': '2', 'key': '354_CR89', 'doi-asserted-by': 'publisher', 'first-page': '85', 'DOI': '10.1016/S1096-2190(00)00009-3', 'volume': '2', 'author': 'SM Wood', 'year': '2000', 'unstructured': 'Wood SM, Beckham C, Yosioka A, Darban H, Watson RR. β-Carotene and ' 'selenium supplementation enhances immune response in aged humans. Integr ' 'Med. 2000;2(2):85–92.', 'journal-title': 'Integr Med'}, { 'issue': '1-3', 'key': '354_CR90', 'doi-asserted-by': 'publisher', 'first-page': '254', 'DOI': '10.1007/s12011-010-8726-x', 'volume': '141', 'author': 'L Yu', 'year': '2011', 'unstructured': 'Yu L, Sun L, Nan Y, Zhu LY. Protection from H1N1 influenza virus ' 'infections in mice by supplementation with selenium: a comparison with ' 'selenium-deficient mice. Biol Trace Elem Res. 2011;141(1-3):254–61.', 'journal-title': 'Biol Trace Elem Res'}, { 'key': '354_CR91', 'doi-asserted-by': 'publisher', 'first-page': '62', 'DOI': '10.1016/j.vetimm.2018.12.002', 'volume': '207', 'author': 'B Shojadoost', 'year': '2019', 'unstructured': 'Shojadoost B, Kulkarni RR, Yitbarek A, Laursen A, Taha-Abdelaziz K, ' 'Negash Alkie T, et al. Dietary selenium supplementation enhances ' 'antiviral immunity in chickens challenged with low pathogenic avian ' 'influenza virus subtype H9N2. Vet Immunol Immunopathol. 2019;207:62–8.', 'journal-title': 'Vet Immunol Immunopathol'}, { 'issue': '4', 'key': '354_CR92', 'doi-asserted-by': 'publisher', 'first-page': '653', 'DOI': '10.1002/jmv.24366', 'volume': '88', 'author': 'Z Cheng', 'year': '2016', 'unstructured': 'Cheng Z, Zhi X, Sun G, Guo W, Huang Y, Sun W, et al. Sodium selenite ' 'suppresses hepatitis B virus transcription and replication in human ' 'hepatoma cell lines. J Med Virol. 2016;88(4):653–63.', 'journal-title': 'J Med Virol'}, { 'key': '354_CR93', 'doi-asserted-by': 'publisher', 'first-page': '107', 'DOI': '10.1016/j.freeradbiomed.2020.06.032', 'volume': '156', 'author': 'H Sies', 'year': '2020', 'unstructured': '• Sies H, Parnham MJ. Potential therapeutic use of ebselen for COVID-19 ' 'and other respiratory viral infections. Free Radic Biol Med. ' '2020;156:107–12 This article discusses the potential benefits of ' 'organoselenium drug, ebselen for improving COVID-19 disease.', 'journal-title': 'Free Radic Biol Med'}, { 'issue': '7', 'key': '354_CR94', 'doi-asserted-by': 'publisher', 'first-page': '269', 'DOI': '10.1111/1348-0421.12715', 'volume': '63', 'author': 'B Maqbool', 'year': '2019', 'unstructured': 'Maqbool B, Wang Y, Cui X, He S, Guan R, Wang S, et al. Ginseng stem-leaf ' 'saponins in combination with selenium enhance immune responses to an ' 'attenuated pseudorabies virus vaccine. Microbiol Immunol. ' '2019;63(7):269–79.', 'journal-title': 'Microbiol Immunol'}, { 'key': '354_CR95', 'first-page': '2714257', 'volume': '2020', 'author': 'Y Wang', 'year': '2020', 'unstructured': 'Wang Y, Cui X, Yuan L, Maqbool B, Xu W, He S, et al. A Solution with ' 'ginseng saponins and selenium as vaccine diluent to increase Th1/Th2 ' 'immune responses in mice. J Immunol Res. 2020;2020:2714257.', 'journal-title': 'J Immunol Res'}, { 'key': '354_CR96', 'doi-asserted-by': 'publisher', 'first-page': '109878', 'DOI': '10.1016/j.mehy.2020.109878', 'volume': '143', 'author': 'M Kieliszek', 'year': '2020', 'unstructured': 'Kieliszek M, Lipinski B. Selenium supplementation in the prevention of ' 'coronavirus infections (COVID-19). Med Hypotheses. 2020;143:109878.', 'journal-title': 'Med Hypotheses'}, { 'issue': 'Suppl 1', 'key': '354_CR97', 'doi-asserted-by': 'publisher', 'first-page': '62', 'DOI': '10.1016/j.jtemb.2007.09.021', 'volume': '21', 'author': 'X Forceville', 'year': '2007', 'unstructured': 'Forceville X. Effects of high doses of selenium, as sodium selenite, in ' 'septic shock patients a placebo-controlled, randomized, double-blind, ' 'multi-center phase II study--selenium and sepsis. J Trace Elem Med Biol. ' '2007;21(Suppl 1):62–5.', 'journal-title': 'J Trace Elem Med Biol'}, { 'key': '354_CR98', 'doi-asserted-by': 'crossref', 'unstructured': '• Bermano G, Méplan C, Mercer DK, Hesketh JE. Selenium and viral ' 'infection: are there lessons for COVID-19? Br J Nutr. ' '2021;125(6):618–27. This review discusses the potential influence of ' 'selenium status on COVID-19 disease.', 'DOI': '10.1017/S0007114520003128'}, { 'issue': '2', 'key': '354_CR99', 'doi-asserted-by': 'publisher', 'first-page': 'e0115833', 'DOI': '10.1371/journal.pone.0115833', 'volume': '10', 'author': 'G Liu', 'year': '2015', 'unstructured': 'Liu G, Yang G, Guan G, Zhang Y, Ren W, Yin J, et al. Effect of dietary ' 'selenium yeast supplementation on porcine circovirus type 2 (PCV2) ' 'infections in mice. PLoS One. 2015;10(2):e0115833.', 'journal-title': 'PLoS One'}, { 'issue': '1', 'key': '354_CR100', 'doi-asserted-by': 'publisher', 'first-page': '29', 'DOI': '10.1186/s13613-015-0071-y', 'volume': '5', 'author': 'L Chelkeba', 'year': '2015', 'unstructured': '• Chelkeba L, Ahmadi A, Abdollahi M, Najafi A, Ghadimi MH, Mosaed R, et ' 'al. The effect of parenteral selenium on outcomes of mechanically ' 'ventilated patients following sepsis: a prospective randomized clinical ' 'trial. Ann Intensive Care. 2015;5(1):29 Selenium supplementation ' 'improved activity of antioxidant enzyme, glutathione peroxidase in ' 'septic patients.', 'journal-title': 'Ann Intensive Care'}, { 'issue': '7', 'key': '354_CR101', 'doi-asserted-by': 'publisher', 'first-page': '1120', 'DOI': '10.1007/s00134-011-2212-6', 'volume': '37', 'author': 'W Manzanares', 'year': '2011', 'unstructured': '•• Manzanares W, Biestro A, Torre MH, Galusso F, Facchin G, Hardy G. ' 'High-dose selenium reduces ventilator-associated pneumonia and illness ' 'severity in critically ill patients with systemic inflammation. ' 'Intensive Care Med. 2011;37(7):1120–7 This clinical trial found ' 'improvement in illness severity of critically ill patients Further ' 'reduction in incidence of hospital acquired pneumonia was observed after ' 'selenium supplementation.', 'journal-title': 'Intensive Care Med'}, { 'key': '354_CR102', 'doi-asserted-by': 'publisher', 'first-page': '357', 'DOI': '10.1016/j.jcrc.2017.12.016', 'volume': '44', 'author': 'A Mahmoodpoor', 'year': '2018', 'unstructured': '•• Mahmoodpoor A, Hamishehkar H, Sanaie S, Behruzizad N, Iranpour A, ' 'Koleini E, et al. Antioxidant reserve of the lungs and ' 'ventilator-associated pneumonia: a clinical trial of high dose selenium ' 'in critically ill patients. J Crit Care. 2018;44:357–62 This clinical ' 'trial tested the effect of a high dose of selenium in critically ill ' 'patients on the incidence of ventilator-associated pneumonia. Selenium ' 'supplement increased the antioxidant capacity but not the incidence of ' 'ventilator-associated pneumonia.', 'journal-title': 'J Crit Care'}], 'container-title': 'Current Nutrition Reports', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1007/s13668-021-00354-4.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1007/s13668-021-00354-4/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1007/s13668-021-00354-4.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 5, 6]], 'date-time': '2021-05-06T11:27:38Z', 'timestamp': 1620300458000}, 'score': 1, 'resource': {'primary': {'URL': 'https://link.springer.com/10.1007/s13668-021-00354-4'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 4, 9]]}, 'references-count': 102, 'journal-issue': {'issue': '2', 'published-print': {'date-parts': [[2021, 6]]}}, 'alternative-id': ['354'], 'URL': 'http://dx.doi.org/10.1007/s13668-021-00354-4', 'relation': {}, 'ISSN': ['2161-3311'], 'subject': [], 'container-title-short': 'Curr Nutr Rep', 'published': {'date-parts': [[2021, 4, 9]]}, 'assertion': [ { 'value': '23 March 2021', 'order': 1, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '9 April 2021', 'order': 2, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'This article does not contain any studies with human or animal subjects ' 'performed by any of the authors.', 'order': 2, 'name': 'Ethics', 'group': { 'name': 'EthicsHeading', 'label': 'Human and Animal Rights and Informed Consent'}}, { 'value': 'Not applicable.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for Publication'}}, { 'value': 'None.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing Interests'}}, { 'value': 'This content has been made available to all.', 'name': 'free', 'label': 'Free to read'}]}
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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