Serum zinc level independently predicts need for inpatient intubation among patients hospitalized with COVID‐19: A prospective observational study

DOI record: { "DOI": "10.1002/ncp.70070", "ISSN": [ "0884-5336", "1941-2452" ], "URL": "http://dx.doi.org/10.1002/ncp.70070", "abstract": "<jats:title>Abstract</jats:title>\n <jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>The coronavirus disease 2019 (COVID‐19) pandemic caused significant morbidity and mortality. Further study of modifiable factors influencing COVID‐19 severity and outcomes continues to be necessary. Serum zinc levels may play a role in modulating COVID‐19 virus replication and consequently influence clinical outcomes.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>This was a prospective observational study of adult patients hospitalized with COVID‐19 assessing the relationship between serum zinc levels and clinical outcomes. Serum zinc levels were measured within 7 days of admission. The primary outcome was the need for intubation at any time during inpatient stay. Secondary outcomes included hospital disposition and incidence of shock and acute kidney injury.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>\n Serum zinc levels could be obtained for 99 patients with COVID‐19. The 25 requiring intubation during hospitalization had a statistically significantly lower median (IQR) zinc concentration (51.6 µg/dl [46.3–62.3 µg/dl]) than those who did not (64.4 µg/dl [55.2–76.0 µg/dl];\n <jats:italic>P</jats:italic>\n  &lt; 0.01). Patients requiring more respiratory support on hospital day 1, having acute kidney injury on hospital day 8, or requiring pressors on hospital days 1 or 8 also had significantly lower zinc levels. In multivariable analysis including other clinical factors known to influence outcomes in COVID‐19 disease, serum zinc level remained an independent predictor of the need for intubation (odds ratio 0.941, 95% CI 0.885–0.999;\n <jats:italic>P</jats:italic>\n  = 0.048).\n </jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Conclusion</jats:title>\n <jats:p>In multivariable analysis, lower serum zinc level was an independent predictor of inpatient intubation in COVID‐19, but further investigation of zinc supplementation to prevent or reduce severity in COVID‐19 infection is warranted before routine clinical use.</jats:p>\n </jats:sec>", "alternative-id": [ "10.1002/ncp.70070" ], "article-number": "ncp.70070", "assertion": [ { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Received", "name": "received", "order": 0, "value": "2025-04-19" }, { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "2025-10-17" }, { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Published", "name": "published", "order": 3, "value": "2025-11-11" } ], "author": [ { "affiliation": [ { "name": "Department of Ophthalmology and Visual Neurosciences University of Minnesota Medical School Minneapolis Minnesota USA" } ], "family": "McPherson", "given": "Scott W.", "sequence": "first" }, { "affiliation": [ { "name": "Department of Ophthalmology and Visual Neurosciences University of Minnesota Medical School Minneapolis Minnesota USA" } ], "family": "van Kuijk", "given": "Frederik J.", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Neurology University of Minnesota Medical School Minneapolis Minnesota USA" }, { "name": "Department of Neurology University of Nebraska Medical Center Omaha Nebraska USA" } ], "family": "Ramezani", "given": "Solmaz", "sequence": "additional" }, { "affiliation": [ { "name": "Division of Epidemiology and Clinical Applications, National Eye Institute National Institutes of Health Bethesda Maryland USA" } ], "family": "Vitale", "given": "Susan", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Medicine, Division of Critical Care and Pulmonary Medicine Regions Hospital St. Paul Minnesota USA" }, { "name": "Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine University of Minnesota Medical School Minneapolis Minnesota USA" } ], "family": "Amundson", "given": "William H.", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Medicine, Division of Critical Care and Pulmonary Medicine Regions Hospital St. Paul Minnesota USA" }, { "name": "Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine University of Minnesota Medical School Minneapolis Minnesota USA" } ], "family": "Caraganis", "given": "Andrew", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine University of Minnesota Medical School Minneapolis Minnesota USA" } ], "family": "Mahan", "given": "Kathleen S.", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Ophthalmology and Visual Neurosciences University of Minnesota Medical School Minneapolis Minnesota USA" } ], "family": "Mundae", "given": "Rusdeep", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine University of Minnesota Medical School Minneapolis Minnesota USA" } ], "family": "Reilkoff", "given": "Ronald A.", "sequence": "additional" }, { "affiliation": [ { "name": "Division of Epidemiology and Clinical Applications, National Eye Institute National Institutes of Health Bethesda Maryland USA" } ], "family": "Chew", "given": "Emily Y.", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0002-1504-7819", "affiliation": [ { "name": "Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine University of Minnesota Medical School Minneapolis Minnesota USA" } ], "authenticated-orcid": false, "family": "Wacker", "given": "David A.", "sequence": "additional" } ], "container-title": "Nutrition in Clinical Practice", "container-title-short": "Nut in Clin Prac", "content-domain": { "crossmark-restriction": true, "domain": [ "aspenjournals.onlinelibrary.wiley.com" ] }, "created": { "date-parts": [ [ 2025, 11, 12 ] ], "date-time": "2025-11-12T03:51:58Z", "timestamp": 1762919518000 }, "deposited": { "date-parts": [ [ 2025, 11, 12 ] ], "date-time": "2025-11-12T03:52:08Z", "timestamp": 1762919528000 }, "indexed": { "date-parts": [ [ 2025, 11, 12 ] ], "date-time": "2025-11-12T03:55:43Z", "timestamp": 1762919743109, "version": "3.45.0" }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2025, 11, 11 ] ] }, "language": "en", "license": [ { "URL": "http://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2025, 11, 11 ] ], "date-time": "2025-11-11T00:00:00Z", "timestamp": 1762819200000 } } ], "link": [ { "URL": "https://aspenjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/ncp.70070", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "311", "original-title": [], "prefix": "10.1002", "published": { "date-parts": [ [ 2025, 11, 11 ] ] }, "published-online": { "date-parts": [ [ 2025, 11, 11 ] ] }, "publisher": "Wiley", "reference": [ { "DOI": "10.15585/mmwr.mm7218a4", "article-title": "COVID‐19 mortality update—United States, 2022", "author": "Ahmad FB", "doi-asserted-by": "crossref", "first-page": "493", "issue": "18", "journal-title": "MMWR Morb Mortal Wkly Rep", "key": "e_1_2_9_2_1", "volume": "72", "year": "2023" }, { "DOI": "10.1038/s41591-022-02185-4", "article-title": "A survey of COVID‐19 vaccine acceptance across 23 countries in 2022", "author": "Lazarus JV", "doi-asserted-by": "crossref", "first-page": "366", "issue": "2", "journal-title": "Nature Med", "key": "e_1_2_9_3_1", "volume": "29", "year": "2023" }, { "DOI": "10.7326/M23-1756", "article-title": "SARS‐CoV‐2 virologic rebound with nirmatrelvir‐ritonavir therapy: an observational study", "author": "Edelstein GE", "doi-asserted-by": "crossref", "first-page": "1577", "issue": "12", "journal-title": "Ann Intern Med", "key": "e_1_2_9_4_1", "volume": "176", "year": "2023" }, { "key": "e_1_2_9_5_1", "unstructured": "US Centers for Disease Control and PreventionCOVID data tracker. Accessed February 11 2025.https://covid.cdc.gov/covid-data-tracker" }, { "DOI": "10.1093/cid/ciaf046", "article-title": "Long‐COVID incidence proportion in adults and children between 2020 and 2024: an electronic health record‐based study from the RECOVER initiative", "author": "Mandel H", "doi-asserted-by": "crossref", "first-page": "1247", "issue": "6", "journal-title": "Clin Infect Dis", "key": "e_1_2_9_6_1", "volume": "80", "year": "2025" }, { "DOI": "10.1596/0-1952-1606-7", "author": "World Health Organization", "doi-asserted-by": "crossref", "key": "e_1_2_9_7_1", "volume-title": "The World Health Report 2002: Reducing Risks, Promoting Healthy Life", "year": "2002" }, { "DOI": "10.1093/ije/dyp391", "article-title": "Zinc supplementation for the prevention of acute lower respiratory infection in children in developing countries: meta‐analysis and meta‐regression of randomized trials", "author": "Roth DE", "doi-asserted-by": "crossref", "first-page": "795", "issue": "3", "journal-title": "Int J Epidemiol", "key": "e_1_2_9_8_1", "volume": "39", "year": "2010" }, { "DOI": "10.1136/bmjopen-2020-047474", "article-title": "Zinc for the prevention or treatment of acute viral respiratory tract infections in adults: a rapid systematic review and meta‐analysis of randomised controlled trials", "author": "Hunter J", "doi-asserted-by": "crossref", "issue": "11", "journal-title": "BMJ Open", "key": "e_1_2_9_9_1", "volume": "11", "year": "2021" }, { "DOI": "10.1177/0884533616653832", "article-title": "Antioxidant vitamins and trace elements in critical illness", "author": "Koekkoek WAC", "doi-asserted-by": "crossref", "first-page": "457", "issue": "4", "journal-title": "Nutr Clin Pract", "key": "e_1_2_9_10_1", "volume": "31", "year": "2016" }, { "DOI": "10.1172/jci.insight.86507", "article-title": "Zinc deficiency primes the lung for ventilator‐induced injury", "author": "Boudreault F", "doi-asserted-by": "crossref", "issue": "11", "journal-title": "JCI Insight", "key": "e_1_2_9_11_1", "volume": "2", "year": "2017" }, { "DOI": "10.1111/j.1399-6576.2011.02425.x", "article-title": "Serum zinc in critically ill adult patients with acute respiratory failure", "author": "Linko R", "doi-asserted-by": "crossref", "first-page": "615", "issue": "5", "journal-title": "Acta Anaesthesiol Scand", "key": "e_1_2_9_12_1", "volume": "55", "year": "2011" }, { "DOI": "10.5604/16652681.1184191", "article-title": "The role of zinc in liver cirrhosis", "author": "Grüngreiff K", "doi-asserted-by": "crossref", "first-page": "7", "issue": "1", "journal-title": "Ann Hepatol", "key": "e_1_2_9_13_1", "volume": "15", "year": "2016" }, { "DOI": "10.3390/biomedicines11041094", "article-title": "Biological role of zinc in liver cirrhosis: an updated review", "author": "Ullah MI", "doi-asserted-by": "crossref", "first-page": "1094", "issue": "4", "journal-title": "Biomedicines", "key": "e_1_2_9_14_1", "volume": "11", "year": "2023" }, { "DOI": "10.1177/0884533611433534", "article-title": "Zinc and liver disease", "author": "Mohammad MK", "doi-asserted-by": "crossref", "first-page": "8", "issue": "1", "journal-title": "Nutr Clin Pract", "key": "e_1_2_9_15_1", "volume": "27", "year": "2012" }, { "DOI": "10.1016/j.aohep.2023.101152", "article-title": "Why a pinch of zinc in liver disease matters", "author": "Grüngreiff K", "doi-asserted-by": "crossref", "issue": "1", "journal-title": "Ann Hepatol", "key": "e_1_2_9_16_1", "volume": "29", "year": "2024" }, { "DOI": "10.3389/fnut.2022.894572", "article-title": "The impact of zinc supplementation on critically ill patients with acute kidney injury: a propensity score matching analysis", "author": "Xia W", "doi-asserted-by": "crossref", "journal-title": "Front Nutr", "key": "e_1_2_9_17_1", "volume": "9", "year": "2022" }, { "article-title": "Zinc and respiratory tract infections: perspectives for COVID‐19 (review)", "author": "Skalny A", "first-page": "17", "issue": "1", "journal-title": "Int J Mol Med", "key": "e_1_2_9_18_1", "volume": "46", "year": "2020" }, { "DOI": "10.3389/fimmu.2020.01736", "article-title": "A hypothesis for the possible role of zinc in the immunological pathways related to COVID‐19 infection", "author": "Mayor‐Ibarguren A", "doi-asserted-by": "crossref", "first-page": "1736", "journal-title": "Front Immunol", "key": "e_1_2_9_19_1", "volume": "11", "year": "2020" }, { "DOI": "10.3389/fimmu.2020.01712", "article-title": "The potential impact of zinc supplementation on COVID‐19 pathogenesis", "author": "Wessels I", "doi-asserted-by": "crossref", "first-page": "1712", "journal-title": "Front Immunol", "key": "e_1_2_9_20_1", "volume": "11", "year": "2020" }, { "DOI": "10.1039/D1CC03563K", "article-title": "Zinc(2+) ion inhibits SARS‐CoV‐2 main protease and viral replication in vitro", "author": "Panchariya L", "doi-asserted-by": "crossref", "first-page": "10083", "issue": "78", "journal-title": "Chem Commun", "key": "e_1_2_9_21_1", "volume": "57", "year": "2021" }, { "DOI": "10.1371/journal.ppat.1001176", "article-title": "Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture", "author": "te Velthuis AJW", "doi-asserted-by": "crossref", "issue": "11", "journal-title": "PLoS Pathog", "key": "e_1_2_9_22_1", "volume": "6", "year": "2010" }, { "DOI": "10.3892/ijmm.2020.4790", "article-title": "Zinc and SARS‐CoV‐2: a molecular modeling study of Zn interactions with RNA‐dependent RNA‐polymerase and 3C‐like proteinase enzymes", "author": "Pormohammad A", "doi-asserted-by": "crossref", "first-page": "326", "issue": "1", "journal-title": "Int J Mol Med", "key": "e_1_2_9_23_1", "volume": "47", "year": "2020" }, { "DOI": "10.1016/j.ajo.2020.04.028", "article-title": "Investigate oral zinc as a prophylactic treatment for those at risk for COVID‐19", "author": "McPherson SW", "doi-asserted-by": "crossref", "first-page": "A5", "journal-title": "Am J Ophthalmol", "key": "e_1_2_9_24_1", "volume": "216", "year": "2020" }, { "DOI": "10.1007/s12011-020-02496-y", "article-title": "The relation between trace element status (zinc, copper, magnesium) and clinical outcomes in COVID‐19 infection during pregnancy", "author": "Anuk AT", "doi-asserted-by": "crossref", "first-page": "3608", "issue": "10", "journal-title": "Biol Trace Elem Res", "key": "e_1_2_9_25_1", "volume": "199", "year": "2021" }, { "DOI": "10.1016/j.clnesp.2021.03.040", "article-title": "Serum vitamin D, calcium, and zinc levels in patients with COVID‐19", "author": "Elham AS", "doi-asserted-by": "crossref", "first-page": "276", "journal-title": "Clin Nutr ESPEN", "key": "e_1_2_9_26_1", "volume": "43", "year": "2021" }, { "DOI": "10.1016/j.ijid.2020.09.014", "article-title": "COVID‐19: poor outcomes in patients with zinc deficiency", "author": "Jothimani D", "doi-asserted-by": "crossref", "first-page": "343", "journal-title": "Int J Infect Dis", "key": "e_1_2_9_27_1", "volume": "100", "year": "2020" }, { "DOI": "10.3390/nu15020340", "article-title": "Association of serum zinc and inflammatory markers with the severity of COVID‐19 infection in adult patients", "author": "Almasaud AS", "doi-asserted-by": "crossref", "first-page": "340", "issue": "2", "journal-title": "Nutrients", "key": "e_1_2_9_28_1", "volume": "15", "year": "2023" }, { "DOI": "10.1007/s12011-022-03124-7", "article-title": "Comparative analysis of serum zinc, copper and magnesium level and their relations in association with severity and mortality in SARS‐CoV‐2 patients", "author": "Pvsn KK", "doi-asserted-by": "crossref", "first-page": "23", "issue": "1", "journal-title": "Biol Trace Elem Res", "key": "e_1_2_9_29_1", "volume": "201", "year": "2023" }, { "DOI": "10.1007/s12011-022-03400-6", "article-title": "Evaluation of the relationship between aquaporin‐1, hepcidin, zinc, copper, and iron levels and oxidative stress in the serum of critically ill patients with COVID‐19", "author": "Bayraktar N", "doi-asserted-by": "crossref", "first-page": "5013", "issue": "12", "journal-title": "Biol Trace Elem Res", "key": "e_1_2_9_30_1", "volume": "200", "year": "2022" }, { "DOI": "10.1016/j.ijid.2021.08.053", "article-title": "Serum trace elements levels and clinical outcomes among Iranian COVID‐19 patients", "author": "Bagher Pour O", "doi-asserted-by": "crossref", "first-page": "164", "journal-title": "Int J Infect Dis", "key": "e_1_2_9_31_1", "volume": "111", "year": "2021" }, { "DOI": "10.1038/s41430-022-01095-5", "article-title": "Low serum levels of zinc and 25‐hydroxyvitmain D as potential risk factors for COVID‐19 susceptibility: a pilot case‐control study", "author": "Ghanei E", "doi-asserted-by": "crossref", "first-page": "1297", "issue": "9", "journal-title": "Eur J Clin Nutr", "key": "e_1_2_9_32_1", "volume": "76", "year": "2022" }, { "DOI": "10.1016/j.clnu.2021.04.042", "article-title": "Hypozincemia in the early stage of COVID‐19 is associated with an increased risk of severe COVID‐19", "author": "Fromonot J", "doi-asserted-by": "crossref", "first-page": "3115", "issue": "12", "journal-title": "Clin Nutr", "key": "e_1_2_9_33_1", "volume": "41", "year": "2022" }, { "DOI": "10.3390/nu12123679", "article-title": "Malnutrition: percentage and association with prognosis in patients hospitalized for coronavirus disease 2019", "author": "Allard L", "doi-asserted-by": "crossref", "first-page": "3679", "issue": "12", "journal-title": "Nutrients", "key": "e_1_2_9_34_1", "volume": "12", "year": "2020" }, { "DOI": "10.1016/j.nut.2021.111400", "article-title": "The association between serum levels of micronutrients and the severity of disease in patients with COVID‐19", "author": "Beigmohammadi MT", "doi-asserted-by": "crossref", "journal-title": "Nutrition", "key": "e_1_2_9_35_1", "volume": "91", "year": "2021" }, { "DOI": "10.1016/j.jmii.2021.01.012", "article-title": "Low blood zinc concentrations in patients with poor clinical outcome during SARS‐CoV‐2 infection: is there a need to supplement with zinc COVID‐19 patients?", "author": "Dubourg G", "doi-asserted-by": "crossref", "first-page": "997", "issue": "5", "journal-title": "J Microbiol Immunol Infect", "key": "e_1_2_9_36_1", "volume": "54", "year": "2021" }, { "DOI": "10.1016/j.redox.2020.101764", "article-title": "Prediction of survival odds in COVID‐19 by zinc, age and selenoprotein P as composite biomarker", "author": "Heller RA", "doi-asserted-by": "crossref", "journal-title": "Redox Biol", "key": "e_1_2_9_37_1", "volume": "38", "year": "2021" }, { "DOI": "10.1016/j.ijid.2020.09.008", "article-title": "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", "author": "Yasui Y", "doi-asserted-by": "crossref", "first-page": "230", "journal-title": "Int J Infect Dis", "key": "e_1_2_9_38_1", "volume": "100", "year": "2020" }, { "DOI": "10.1096/fj.202002346RR", "article-title": "Associations of essential and toxic metals/metalloids in whole blood with both disease severity and mortality in patients with COVID‐19", "author": "Zeng HL", "doi-asserted-by": "crossref", "issue": "3", "journal-title": "FASEB J", "key": "e_1_2_9_39_1", "volume": "35", "year": "2021" }, { "DOI": "10.1186/s12879-021-06617-3", "article-title": "The correlation between serum selenium, zinc, and COVID‐19 severity: an observational study", "author": "Razeghi Jahromi S", "doi-asserted-by": "crossref", "first-page": "899", "issue": "1", "journal-title": "BMC Infect Dis", "key": "e_1_2_9_40_1", "volume": "21", "year": "2021" }, { "DOI": "10.1002/jmv.27277", "article-title": "Evaluation of the relationship between serum levels of zinc, vitamin B12, vitamin D, and clinical outcomes in patients with COVID‐19", "author": "Shakeri H", "doi-asserted-by": "crossref", "first-page": "141", "issue": "1", "journal-title": "J Med Virol", "key": "e_1_2_9_41_1", "volume": "94", "year": "2022" }, { "DOI": "10.1016/j.jtemb.2023.127200", "article-title": "Zinc levels of patients with a moderate to severe COVID‐19 infection at hospital admission and after 4th days of ward hospitalization and their clinical outcome", "author": "Rodelgo Jimenez L", "doi-asserted-by": "crossref", "journal-title": "J Trace Elem Med Biol", "key": "e_1_2_9_42_1", "volume": "79", "year": "2023" }, { "DOI": "10.3390/nu13103304", "article-title": "Course and survival of COVID‐19 patients with comorbidities in relation to the trace element status at hospital admission", "author": "Du Laing G", "doi-asserted-by": "crossref", "first-page": "3304", "issue": "10", "journal-title": "Nutrients", "key": "e_1_2_9_43_1", "volume": "13", "year": "2021" }, { "DOI": "10.1002/ncp.10612", "article-title": "Association between low zinc levels and severity of acute respiratory distress syndrome by new coronavirus SARS‐CoV‐2", "author": "Gonçalves TJM", "doi-asserted-by": "crossref", "first-page": "186", "issue": "1", "journal-title": "Nutr Clin Pract", "key": "e_1_2_9_44_1", "volume": "36", "year": "2021" }, { "DOI": "10.3390/metabo11090565", "article-title": "Low levels of few micronutrients may impact COVID‐19 disease progression: an observational study on the first wave", "author": "Tomasa‐Irriguible TM", "doi-asserted-by": "crossref", "first-page": "565", "issue": "9", "journal-title": "Metabolites", "key": "e_1_2_9_45_1", "volume": "11", "year": "2021" }, { "DOI": "10.1016/j.ijid.2020.08.018", "article-title": "Nutritional status of patients with COVID‐19", "author": "Im JH", "doi-asserted-by": "crossref", "first-page": "390", "journal-title": "Int J Infect Dis", "key": "e_1_2_9_46_1", "volume": "100", "year": "2020" }, { "DOI": "10.1016/j.intimp.2021.108163", "article-title": "Plasma zinc status and hyperinflammatory syndrome in hospitalized COVID‐19 patients: an observational study", "author": "Verschelden G", "doi-asserted-by": "crossref", "journal-title": "Int Immunopharmacol", "key": "e_1_2_9_47_1", "volume": "100", "year": "2021" }, { "DOI": "10.1515/med-2022-0469", "article-title": "Serum zinc associated with immunity and inflammatory markers in Covid‐19", "author": "Joulaei H", "doi-asserted-by": "crossref", "first-page": "702", "issue": "1", "journal-title": "Open Med", "key": "e_1_2_9_48_1", "volume": "17", "year": "2022" }, { "DOI": "10.3390/nu15061516", "article-title": "Minerals and antioxidant micronutrients levels and clinical outcome in older patients hospitalized for COVID‐19 during the first wave of the pandemic", "author": "Lahaye C", "doi-asserted-by": "crossref", "first-page": "1516", "issue": "6", "journal-title": "Nutrients", "key": "e_1_2_9_49_1", "volume": "15", "year": "2023" }, { "DOI": "10.3390/nu13020562", "article-title": "Low zinc levels at admission associates with poor clinical outcomes in SARS‐CoV‐2 infection", "author": "Vogel‐González M", "doi-asserted-by": "crossref", "first-page": "562", "issue": "2", "journal-title": "Nutrients", "key": "e_1_2_9_50_1", "volume": "13", "year": "2021" }, { "DOI": "10.3390/nu15153308", "article-title": "Association of trace element levels with outcomes in critically ill COVID‐19 patients", "author": "Wozniak H", "doi-asserted-by": "crossref", "first-page": "3308", "issue": "15", "journal-title": "Nutrients", "key": "e_1_2_9_51_1", "volume": "15", "year": "2023" }, { "DOI": "10.3390/nu14020233", "article-title": "The effect of circulating zinc, selenium, copper and vitamin K(1) on COVID‐19 outcomes: a mendelian randomization study", "author": "Sobczyk MK", "doi-asserted-by": "crossref", "first-page": "233", "issue": "2", "journal-title": "Nutrients", "key": "e_1_2_9_52_1", "volume": "14", "year": "2022" }, { "DOI": "10.1001/jama.2009.1754", "article-title": "International study of the prevalence and outcomes of infection in intensive care units", "author": "Vincent JL", "doi-asserted-by": "crossref", "first-page": "2323", "issue": "21", "journal-title": "JAMA", "key": "e_1_2_9_53_1", "volume": "302", "year": "2009" }, { "DOI": "10.1016/j.jamda.2020.05.045", "article-title": "The effect of age on mortality in patients with COVID‐19: a meta‐analysis with 611,583 subjects", "author": "Bonanad C", "doi-asserted-by": "crossref", "first-page": "915", "issue": "7", "journal-title": "J Am Med Dir Assoc", "key": "e_1_2_9_54_1", "volume": "21", "year": "2020" }, { "DOI": "10.1136/bmjgh-2021-006434", "article-title": "The isolated effect of age on the risk of COVID‐19 severe outcomes: a systematic review with meta‐analysis", "author": "Romero Starke K", "doi-asserted-by": "crossref", "issue": "12", "journal-title": "BMJ Glob Health", "key": "e_1_2_9_55_1", "volume": "6", "year": "2021" }, { "DOI": "10.1099/jmm.0.001250", "article-title": "Zinc sulfate in combination with a zinc ionophore may improve outcomes in hospitalized COVID‐19 patients", "author": "Carlucci PM", "doi-asserted-by": "crossref", "first-page": "1228", "issue": "10", "journal-title": "J Med Microbiol", "key": "e_1_2_9_56_1", "volume": "69", "year": "2020" }, { "DOI": "10.1016/j.cdnut.2023.101971", "article-title": "Vitamin D and zinc supplementation to improve treatment outcomes among COVID‐19 patients in India: results from a double‐blind randomized placebo‐controlled trial", "author": "Partap U", "doi-asserted-by": "crossref", "issue": "8", "journal-title": "Curr Dev Nutr", "key": "e_1_2_9_57_1", "volume": "7", "year": "2023" }, { "article-title": "Does prophylactic oral zinc reduce the risk of contracting COVID‐19?", "author": "Adrean SD", "issue": "10", "journal-title": "Cureus", "key": "e_1_2_9_58_1", "volume": "14", "year": "2022" }, { "DOI": "10.3389/fmed.2021.756707", "article-title": "A case‐control study for the effectiveness of oral zinc in the prevention and mitigation of COVID‐19", "author": "Gordon AM", "doi-asserted-by": "crossref", "journal-title": "Front Med (Lausanne)", "key": "e_1_2_9_59_1", "volume": "8", "year": "2021" }, { "DOI": "10.1001/jamanetworkopen.2021.0369", "article-title": "Effect of high‐dose zinc and ascorbic acid supplementation vs usual care on symptom length and reduction among ambulatory patients with SARS‐CoV‐2 infection: the COVID A to Z randomized clinical trial", "author": "Thomas S", "doi-asserted-by": "crossref", "issue": "2", "journal-title": "JAMA Netw Open", "key": "e_1_2_9_60_1", "volume": "4", "year": "2021" }, { "DOI": "10.1093/jn/132.4.697", "article-title": "The effect of five‐year zinc supplementation on serum zinc, serum cholesterol and hematocrit in persons randomly assigned to treatment group in the age‐related eye disease study: AREDS Report No. 7", "author": "Age‐Related Eye Disease Study Research Group", "doi-asserted-by": "crossref", "first-page": "697", "issue": "4", "journal-title": "J Nutr", "key": "e_1_2_9_61_1", "volume": "132", "year": "2002" }, { "DOI": "10.1017/S0007114512004382", "article-title": "The relationship between zinc intake and serum/plasma zinc concentration in adults: a systematic review and dose‐response meta‐analysis by the EURRECA Network", "author": "Lowe NM", "doi-asserted-by": "crossref", "first-page": "1962", "issue": "11", "journal-title": "Br J Nutr", "key": "e_1_2_9_62_1", "volume": "108", "year": "2012" }, { "DOI": "10.1002/jmv.26895", "article-title": "A pilot double‐blind safety and feasibility randomized controlled trial of high‐dose intravenous zinc in hospitalized COVID‐19 patients", "author": "Patel O", "doi-asserted-by": "crossref", "first-page": "3261", "issue": "5", "journal-title": "J Med Virol", "key": "e_1_2_9_63_1", "volume": "93", "year": "2021" }, { "DOI": "10.1016/j.autrev.2014.11.008", "article-title": "Zinc and its role in immunity and inflammation", "author": "Bonaventura P", "doi-asserted-by": "crossref", "first-page": "277", "issue": "4", "journal-title": "Autoimmun Rev", "key": "e_1_2_9_64_1", "volume": "14", "year": "2015" }, { "DOI": "10.3390/nu9060624", "article-title": "Zinc in infection and inflammation", "author": "Gammoh N", "doi-asserted-by": "crossref", "first-page": "624", "issue": "6", "journal-title": "Nutrients", "key": "e_1_2_9_65_1", "volume": "9", "year": "2017" }, { "DOI": "10.3945/ajcn.110.008417", "article-title": "A comparison of zinc metabolism, inflammation, and disease severity in critically ill infected and noninfected adults early after intensive care unit admission", "author": "Besecker BY", "doi-asserted-by": "crossref", "first-page": "1356", "issue": "6", "journal-title": "Am J Clin Nutr", "key": "e_1_2_9_66_1", "volume": "93", "year": "2011" }, { "DOI": "10.1111/jgs.14048", "article-title": "The natural history of changes in preferences for life‐sustaining treatments and implications for inpatient mortality in younger and older hospitalized adults", "author": "Kim YS", "doi-asserted-by": "crossref", "first-page": "981", "issue": "5", "journal-title": "J Am Geriatr Soc", "key": "e_1_2_9_67_1", "volume": "64", "year": "2016" }, { "DOI": "10.1016/j.resuscitation.2018.06.020", "article-title": "Factors associated with combined do‐not‐resuscitate and do‐not‐intubate orders: a retrospective chart review at an urban tertiary care center", "author": "Stream S", "doi-asserted-by": "crossref", "first-page": "1", "journal-title": "Resuscitation", "key": "e_1_2_9_68_1", "volume": "130", "year": "2018" }, { "DOI": "10.1007/s00134-019-05828-2", "article-title": "Do‐not‐intubate orders in patients with acute respiratory failure: a systematic review and meta‐analysis", "author": "Wilson ME", "doi-asserted-by": "crossref", "first-page": "36", "issue": "1", "journal-title": "Intensive Care Med", "key": "e_1_2_9_69_1", "volume": "46", "year": "2020" }, { "DOI": "10.1093/jn/nxy105", "article-title": "Serum zinc concentrations in the us population are related to sex, age, and time of blood draw but not dietary or supplemental zinc", "author": "Hennigar SR", "doi-asserted-by": "crossref", "first-page": "1341", "issue": "8", "journal-title": "J Nutr", "key": "e_1_2_9_70_1", "volume": "148", "year": "2018" }, { "DOI": "10.1093/jn/nxy190", "article-title": "Yet again, serum zinc concentrations are unrelated to zinc intakes", "author": "King JC", "doi-asserted-by": "crossref", "first-page": "1399", "issue": "9", "journal-title": "J Nutr", "key": "e_1_2_9_71_1", "volume": "148", "year": "2018" }, { "DOI": "10.1016/S2213-2600(21)00046-1", "article-title": "Geography, generalisability, and susceptibility in clinical trials", "author": "Clougherty JE", "doi-asserted-by": "crossref", "first-page": "330", "issue": "4", "journal-title": "Lancet Respir Med", "key": "e_1_2_9_72_1", "volume": "9", "year": "2021" }, { "DOI": "10.1056/NEJMra1510065", "article-title": "Interpreting geographic variations in results of randomized, controlled trials", "author": "Yusuf S", "doi-asserted-by": "crossref", "first-page": "2263", "issue": "23", "journal-title": "N Engl J Med", "key": "e_1_2_9_73_1", "volume": "375", "year": "2016" }, { "DOI": "10.1093/eurheartj/eht071", "article-title": "International differences in treatment effect: do they really exist and why?", "author": "Pocock S", "doi-asserted-by": "crossref", "first-page": "1846", "issue": "24", "journal-title": "Eur Heart J", "key": "e_1_2_9_74_1", "volume": "34", "year": "2013" } ], "reference-count": 73, "references-count": 73, "relation": {}, "resource": { "primary": { "URL": "https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.70070" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [], "subtitle": [], "title": "Serum zinc level independently predicts need for inpatient intubation among patients hospitalized with COVID‐19: A prospective observational study", "type": "journal-article", "update-policy": "https://doi.org/10.1002/crossmark_policy" }