Abstract: Analysis of trace elements (Zn and Cu) levels in COVID-19 patients with ICU and Non-ICU hospitalization Sant Ram (  drsantram2016@gmail.com ) Post Graduate Institute of Medical Education and Research Neha Saini Post Graduate Institute of Medical Education and Research Ram Krishan Saini Post Graduate Institute of Medical Education and Research Sandeep Kaur Post Graduate Institute of Medical Education and Research Piyush Pathak Post Graduate Institute of Medical Education and Research Ravjit Jassal Post Graduate Institute of Medical Education and Research Mohana Kumari Chidananda Post Graduate Institute of Medical Education and Research Deepy Zohmangaihi Post Graduate Institute of Medical Education and Research Shiv lal Soni Post Graduate Institute of Medical Education and Research Vikas Suri Post Graduate Institute of Medical Education and Research Research Article Keywords: Posted Date: January 3rd, 2023 DOI: https://doi.org/10.21203/rs.3.rs-2418159/v1 License:   This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/17 Abstract Background: The persistence of the COVID-19 pandemic besides its current resurgence and continuously increasing fatalities indicates a vital need for severity assessment at its early stages. Recent studies have already ascribed mortality to chronic inflammation. But the part of trace elements, especially zinc and copper that have been known to possess antiviral roles for a long time is least studied in COVID-19. Methods: The study comprised 122 COVID-19-positive participants admitted to the tertiary care hospital. Among them, eighty-one (~66%) were admitted to ICU under high severity. Levels of Zn and Cu along with CRP were analyzed and compared among ICU and non-ICU admitted patients. Using ROC analysis, the potential and precise levels for defining severity were determined. Results: We found a significant reduction in Zn levels (p=0.001) in ICU-admitted patients compared to the non-ICU group which was more pronounced in females and patients aged above 50 years. Reduction in the levels of Zn is accompanied by elevated CRP levels (p<0.001) in ICU patients with no effect on Cu levels. Upon ROC analysis, Zn and CRP were found to have significant AUC (p<0.0001). Further, CRP to Zn ratio displayed improved AUC with 90% sensitivity indicating their applicability to predict ICU requirements. Conclusions: The present study was primarily aimed to predict the status of zinc and copper in COVID-19 patients and their utility as a prognostic tool for deciding the severity. Our findings indicate that CRP to Zn ratio might feasibly be used to predict the progression of COVID-19 toward severity. Keywords: COVID-19, Severity, Zinc, Copper, CRP