Association of serum zinc level and clinical outcome in Egyptian COVID-19 patients
Ahmed M F Mansour, Noha El Nakeeb, Norhan Khaled Mohamed Kamal, Ahmed Mohamed Elghandour
The Egyptian Journal of Internal Medicine, doi:10.1186/s43162-022-00159-z
Background: Zinc is an anti-inflammatory and antioxidant micronutrient found in food. Due to its well-established role in immunity, it is currently being used in some clinical trials against coronavirus disease-2019 . This study aimed to assess the association between the mean serum zinc level in COVID-19 Egyptian patients and its relationship with disease severity. This cross-sectional study was conducted on sixty patients with confirmed COVID-19 infection. These patients were divided into two groups according to clinical outcome, group 1 which included 30 intensive care unit (ICU) patients and group 2 which included 30 patients who were admitted to the ward. Mean serum levels of zinc were compared between the two groups. Results: There was a statistically significant difference noted among study groups regarding the serum zinc level (p < 0.039), where lower mean serum zinc levels were noted in ICU patients compared to ward patients (70.6 ± 5.7 vs 73.8 ± 6.1).
Conclusion: Low serum zinc level is associated with the severe outcome of COVID-19 infection.
Abbreviations Authors' contributions NE, AME, and AMFM made the design for the study. NMMK collected the data of the patients. Analysis of the data was done by AME and AMFM. All authors provided critical feedback and helped shape the research, analysis, and manuscript. All authors have read and approved the final manuscript.
Funding The authors did not receive support from any organization for the submitted work.
Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Declarations Ethics approval and consent to participate All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Research Ethics Committee of Ain Shams University (No. FMASU M S 82/2021). Informed consent was obtained from all individual participants included in the study.
Consent for publication Not applicable.
Competing interests The authors declare that they have no competing interests.
Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Abd-Elsalam, Soliman, Esmail, Do zinc supplements enhance the clinical efficacy of hydroxychloroquine? A randomized, multicenter trial, Biol Trace Elem Res
Alexander, Tinkov, Strand, Alehagen, Skalny et al., Early nutritional interventions with zinc, selenium, and vitamin D for raising anti-viral resistance against progressive COVID-19, Nutrients
Anuk, Polat, Akdas, The relation between trace element status (zinc, copper, magnesium) and clinical outcomes in COVID-19 infection during pregnancy, Biol Trace Elem Res, doi:10.1007/s12011-020-02496-y
Arentz, Hunter, Yang, Zinc for the prevention and treatment of SARS-CoV-2 and other acute viral respiratory infections: a rapid review, Adv Integr Med
Carlucci, Ahuja, Petrilli, Rajagopalan, Jones et al., Zinc sulfate, in combination with a zinc ionophore, may improve outcomes in hospitalized COVID-19 patients, J Med Microbiol
Devaux, Rolain, Raoult, ACE2 receptor polymorphism: susceptibility to SARS-CoV-2, hypertension, multi-organ failure, and COVID-19 disease outcome, J Microbiol Immunol Infect
Elhama, Azamb, Azam, Serum vitamin D, calcium, and zinc levels in patients with COVID-19, Clinical Nutrition ESPEN
Foster, Samman, Zinc and regulation of inflammatory cytokines: implications for cardiometabolic disease, Nutrients
González, Talló-Parra, Herrera-Fernández, Pérez-Vilaró, Chillón et al., Low zinc levels at admission (2022) 34:72 associates with poor clinical outcomes in SARS-CoV-2 infection, Nutrients
Gupta, Read, Shackel, Hebbard, George et al., The role of micronutrients in the infection and subsequent response to hepatitis C virus, Cells
Hemilä, Common cold treatment using zinc, JAMA
Jothimani, Kailasam, Danielraj, Nallathambi, Ramachandran et al., COVID-19: poor outcomes in patients with zinc deficiency, Int J Infect Dis
Kumssa, Joy, Ander, Watts, Young et al., Dietary calcium and zinc deficiency risks are decreasing but remain prevalent, Sci Rep
Li, Li, Zhang, Wang, Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues, Infect Dis Poverty
Maret, Zinc and the zinc proteome, Met Ions Life Sci
Name, Souza, Vasconcelos, Prado, Pereira et al., perspectives for COVID-19 with a focus on physical tissue barrier integrity, Front Nutr
Read, Obeid, Ahlenstiel, Ahlenstiel, The role of zinc in antiviral immunity, Adv Nutr
Rondanelli, Miccono, Lamburghini, Self-care for common colds: the pivotal role of vitamin D, vitamin C, zinc, and echinacea in three main immune interactive clusters (physical barriers, innate and adaptive immunity) involved during an episode of common coldspractical advice on dosages and on the time to take these nutrients/ botanicals in order to prevent or treat common colds, Evid Based Complement Alternat Med
Shakoor, Feehan, Dhaheri, Ali, Platat et al., Immune-boosting role of vitamins D, C, E, zinc, selenium and omega-3 fatty acids: could they help against COVID-19?, Maturitas
Taheri, Bahrami, Habibi, A review on the serum electrolytes and trace elements role in the pathophysiology of COVID-19, Biol Trace Elem Res
Velthuis, Van Den Worm, Sims, Baric, Snijder et al., Zn2+ inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture, PLoS Pathog
Wessells, Brown, Estimating the global prevalence of zinc deficiency: results based on zinc availability in national food supplies and the prevalence of stunting, PLoS ONE
Yasui, Yasui, Suzuki, Analysis of the predictive factors for a critical illness of COVID-19 during treatment-relationship between serum zinc level and critical illness of COVID-19, Int J Infect Dis