The correlation between serum selenium, zinc, and COVID-19 severity: an observational study

{ 'indexed': {'date-parts': [[2022, 12, 5]], 'date-time': '2022-12-05T08:19:05Z', 'timestamp': 1670228345671}, 'reference-count': 32, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2021, 9, 3]], 'date-time': '2021-09-03T00:00:00Z', 'timestamp': 1630627200000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2021, 9, 3]], 'date-time': '2021-09-03T00:00:00Z', 'timestamp': 1630627200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'funder': [ { 'DOI': '10.13039/501100004484', 'name': 'Tehran University of Medical Sciences and Health Services', 'doi-asserted-by': 'publisher', 'award': [ 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390', 'No: 99-1-118-47390']}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2021, 12]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' ' <jats:title>Background</jats:title>\n' ' <jats:p>Without an adequate immune response, SARS-CoV2 virus can simply ' 'spread throughout the body of the host. Two of the well-known immunonutrients are selenium ' '(Se) and zinc (Zn). Se and Zn deficiency might lead to inflammation, oxidative stress, and ' 'viral entry into the cells by decreasing ACE-2 expression; three factors that are proposed to ' 'be involved in COVID-19 pathogenesis. Thus, in the current study we aimed at evaluating the ' 'correlation between serum Se and Zn status and COVID-19 severity.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>Eighty-four COVID-19 patients were enrolled in this observational ' 'study. Patients were diagnosed based on an infectious disease specialist diagnosis, using WHO ' 'interim guidance and the recommendations of the Iranian National Committee of Covid-19. The ' 'patients with acute respiratory tract infection symptoms were checked for compatibility of ' 'chest computed tomography (CT) scan results with that of Covid-19 and Real-time polymerase ' 'chain reaction (RT-PCR) for corona virus infection. The severity of Covid-19 was categorized ' 'into three groups (mild, moderate, and severe) using CDC criteria. Serum Zn and Se level of ' 'all subjects was measured. The severity of the disease was determined only once at the onset ' 'of disease.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>According to the results of linear regression test, there was a ' 'significant association between Zn and Se level and COVID-19 severity (β\u2009=\u2009−\u2009' '0.28, P-value\u2009=\u20090.01 for Se; β\u2009=\u2009−\u20090.26, P-value\u2009=\u20090.02). ' 'However the significance disappeared after adjusting for confounding factors. Spearman ' 'correlation analysis showed a significant negative association between serum Zn, Se and CRP ' 'level (r\u2009=\u2009−\u20090.35, P-value\u2009=\u20090.001 for Se; r\u2009=\u2009−\u2009' '0.41, P-value\u2009&lt;\u20090.001 for Zn).</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Conclusion</jats:title>\n' ' <jats:p>Results suggest that increasing levels of Se and Zn were accompanied ' 'by a decrease in serum CRP level. However, the significant association between Se, Zn, and ' 'disease severity was lost after adjusting for confounding factors.</jats:p>\n' ' </jats:sec>', 'DOI': '10.1186/s12879-021-06617-3', 'type': 'journal-article', 'created': {'date-parts': [[2021, 9, 3]], 'date-time': '2021-09-03T12:28:04Z', 'timestamp': 1630672084000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 17, 'title': 'The correlation between serum selenium, zinc, and COVID-19 severity: an observational study', 'prefix': '10.1186', 'volume': '21', 'author': [ {'given': 'Soodeh', 'family': 'Razeghi Jahromi', 'sequence': 'first', 'affiliation': []}, {'given': 'Hedieh', 'family': 'Moradi Tabriz', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-9368-6835', 'authenticated-orcid': False, 'given': 'Mansoureh', 'family': 'Togha', 'sequence': 'additional', 'affiliation': []}, {'given': 'Shadi', 'family': 'Ariyanfar', 'sequence': 'additional', 'affiliation': []}, {'given': 'Zeinab', 'family': 'Ghorbani', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sima', 'family': 'Naeeni', 'sequence': 'additional', 'affiliation': []}, {'given': 'Samaneh', 'family': 'Haghighi', 'sequence': 'additional', 'affiliation': []}, {'given': 'Aboozar', 'family': 'Jazayeri', 'sequence': 'additional', 'affiliation': []}, {'given': 'Mahnaz', 'family': 'Montazeri', 'sequence': 'additional', 'affiliation': []}, {'given': 'Mohammad', 'family': 'Talebpour', 'sequence': 'additional', 'affiliation': []}, {'given': 'Haleh', 'family': 'Ashraf', 'sequence': 'additional', 'affiliation': []}, {'given': 'Mehdi', 'family': 'Ebrahimi', 'sequence': 'additional', 'affiliation': []}, {'given': 'Azita', 'family': 'Hekmatdoost', 'sequence': 'additional', 'affiliation': []}, {'given': 'Elham', 'family': 'Jafari', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2021, 9, 3]]}, 'reference': [ { 'key': '6617_CR1', 'doi-asserted-by': 'publisher', 'first-page': '164', 'DOI': '10.3389/fnut.2020.00164', 'volume': '7', 'author': 'L Hiffler', 'year': '2020', 'unstructured': 'Hiffler L, Rakotoambinina B. Selenium and RNA virus interactions: ' 'potential implications for SARS-CoV-2 infection (COVID-19). Front Nutr. ' '2020;7:164.', 'journal-title': 'Front Nutr'}, { 'key': '6617_CR2', 'doi-asserted-by': 'publisher', 'first-page': '390', 'DOI': '10.1016/j.ijid.2020.08.018', 'volume': '100', 'author': 'JH Im', 'year': '2020', 'unstructured': 'Im JH, Je YS, Baek J, Chung M-H, Kwon HY, Lee J-S. Nutritional status of ' 'patients with COVID-19. Int J Infect Dis. 2020;100:390–3.', 'journal-title': 'Int J Infect Dis'}, { 'key': '6617_CR3', 'doi-asserted-by': 'publisher', 'first-page': '143', 'DOI': '10.3389/fnut.2020.00143', 'volume': '7', 'author': 'EW Taylor', 'year': '2020', 'unstructured': 'Taylor EW, Radding W. Understanding selenium and glutathione as ' 'antiviral factors in COVID-19: does the viral Mpro protease target host ' 'selenoproteins and glutathione synthesis? Front Nutr. 2020;7:143.', 'journal-title': 'Front Nutr'}, { 'key': '6617_CR4', 'doi-asserted-by': 'publisher', 'author': 'T Hirano', 'year': '2020', 'unstructured': 'Hirano T, Murakami M. COVID-19: a new virus, but a familiar receptor and ' 'cytokine release syndrome. Immunity. 2020. ' 'https://doi.org/10.1016/j.immuni.2020.04.003.', 'journal-title': 'Immunity', 'DOI': '10.1016/j.immuni.2020.04.003'}, { 'key': '6617_CR5', 'volume-title': 'The world health report 2002: reducing risks, promoting healthy life', 'author': 'World Health Organization', 'year': '2002', 'unstructured': 'World Health Organization. The world health report 2002: reducing risks, ' 'promoting healthy life. Geneva: World Health Organization; 2002.'}, { 'issue': '6', 'key': '6617_CR6', 'doi-asserted-by': 'publisher', 'first-page': '1297', 'DOI': '10.1093/ajcn/nqaa095', 'volume': '111', 'author': 'J Zhang', 'year': '2020', 'unstructured': 'Zhang J, Taylor EW, Bennett K, Saad R, Rayman MP. Association between ' 'regional selenium status and reported outcome of COVID-19 cases in ' 'China. Am J Clin Nutr. 2020;111(6):1297–9.', 'journal-title': 'Am J Clin Nutr'}, { 'issue': '7', 'key': '6617_CR7', 'doi-asserted-by': 'publisher', 'first-page': '2098', 'DOI': '10.3390/nu12072098', 'volume': '12', 'author': 'A Moghaddam', 'year': '2020', 'unstructured': 'Moghaddam A, Heller RA, Sun Q, Seelig J, Cherkezov A, Seibert L, et al. ' 'Selenium deficiency is associated with mortality risk from COVID-19. ' 'Nutrients. 2020;12(7):2098.', 'journal-title': 'Nutrients'}, { 'key': '6617_CR8', 'doi-asserted-by': 'publisher', 'author': 'I Wessels', 'year': '2020', 'unstructured': 'Wessels I, Rolles B, Rink L. The potential impact of zinc ' 'supplementation on COVID-19 pathogenesis. Front Immunol. 2020. ' 'https://doi.org/10.3389/fimmu.2020.01712.', 'journal-title': 'Front Immunol', 'DOI': '10.3389/fimmu.2020.01712'}, { 'issue': '5', 'key': '6617_CR9', 'doi-asserted-by': 'publisher', 'first-page': 'e0176069', 'DOI': '10.1371/journal.pone.0176069', 'volume': '12', 'author': 'J Hoeger', 'year': '2017', 'unstructured': 'Hoeger J, Simon T-P, Beeker T, Marx G, Haase H, Schuerholz T. Persistent ' 'low serum zinc is associated with recurrent sepsis in critically ill ' 'patients—a pilot study. PLoS ONE. 2017;12(5):e0176069.', 'journal-title': 'PLoS ONE'}, { 'issue': '3', 'key': '6617_CR10', 'doi-asserted-by': 'publisher', 'first-page': '253', 'DOI': '10.1136/thoraxjnl-2019-213357', 'volume': '75', 'author': 'I Wessels', 'year': '2020', 'unstructured': 'Wessels I, Pupke JT, von Trotha K-T, Gombert A, Himmelsbach A, Fischer ' 'HJ, et al. Zinc supplementation ameliorates lung injury by reducing ' 'neutrophil recruitment and activity. Thorax. 2020;75(3):253–61.', 'journal-title': 'Thorax'}, { 'key': '6617_CR11', 'doi-asserted-by': 'publisher', 'first-page': '3503', 'DOI': '10.2147/COPD.S149589', 'volume': '12', 'author': 'E Roscioli', 'year': '2017', 'unstructured': 'Roscioli E, Jersmann HP, Lester S, Badiei A, Fon A, Zalewski P, et al. ' 'Zinc deficiency as a codeterminant for airway epithelial barrier ' 'dysfunction in an ex vivo model of COPD. Int J Chron Obstruct Pulmon ' 'Dis. 2017;12:3503.', 'journal-title': 'Int J Chron Obstruct Pulmon Dis'}, { 'key': '6617_CR12', 'doi-asserted-by': 'publisher', 'author': 'F Boudreault', 'year': '2017', 'unstructured': 'Boudreault F, Pinilla-Vera M, Englert JA, Kho AT, Isabelle C, Arciniegas ' 'AJ, et al. Zinc deficiency primes the lung for ventilator-induced ' 'injury. JCI Insight. 2017. https://doi.org/10.1172/jci.insight.86507.', 'journal-title': 'JCI Insight', 'DOI': '10.1172/jci.insight.86507'}, { 'key': '6617_CR13', 'doi-asserted-by': 'publisher', 'author': 'E Gavriilaki', 'year': '2020', 'unstructured': 'Gavriilaki E, Brodsky RA. Severe COVID-19 infection and thrombotic ' 'microangiopathy: success doesn’t come easily. Br J Haematol. 2020. ' 'https://doi.org/10.1111/bjh.16783.', 'journal-title': 'Br J Haematol', 'DOI': '10.1111/bjh.16783'}, { 'issue': '10234', 'key': '6617_CR14', 'doi-asserted-by': 'publisher', 'first-page': '1417', 'DOI': '10.1016/S0140-6736(20)30937-5', 'volume': '395', 'author': 'Z Varga', 'year': '2020', 'unstructured': 'Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel ' 'AS, et al. Endothelial cell infection and endotheliitis in COVID-19. The ' 'Lancet. 2020;395(10234):1417–8.', 'journal-title': 'The Lancet'}, { 'key': '6617_CR15', 'doi-asserted-by': 'publisher', 'author': 'ME Lopes-Pires', 'year': '2020', 'unstructured': 'Lopes-Pires ME, Ahmed NS, Vara D, Gibbins JM, Pula G, Pugh N. Zinc ' 'regulates reactive oxygen species generation in platelets. Platelets. ' '2020. https://doi.org/10.1080/09537104.2020.1742311.', 'journal-title': 'Platelets', 'DOI': '10.1080/09537104.2020.1742311'}, { 'issue': '2', 'key': '6617_CR16', 'doi-asserted-by': 'publisher', 'first-page': '144', 'DOI': '10.1039/C5MT00251F', 'volume': '8', 'author': 'K Taylor', 'year': '2016', 'unstructured': 'Taylor K, Pugh N. The contribution of zinc to platelet behaviour during ' 'haemostasis and thrombosis. Metallomics. 2016;8(2):144–55.', 'journal-title': 'Metallomics'}, { 'key': '6617_CR17', 'doi-asserted-by': 'publisher', 'first-page': '102763', 'DOI': '10.1016/j.ebiom.2020.102763', 'volume': '55', 'author': 'J Liu', 'year': '2020', 'unstructured': 'Liu J, Li S, Liu J, Liang B, Wang X, Wang H, et al. Longitudinal ' 'characteristics of lymphocyte responses and cytokine profiles in the ' 'peripheral blood of SARS-CoV-2 infected patients. EBioMedicine. ' '2020;55:102763.', 'journal-title': 'EBioMedicine'}, { 'issue': '4', 'key': '6617_CR18', 'doi-asserted-by': 'publisher', 'first-page': '1808', 'DOI': '10.4049/jimmunol.1301261', 'volume': '191', 'author': 'A Brieger', 'year': '2013', 'unstructured': 'Brieger A, Rink L, Haase H. Differential regulation of TLR-dependent ' 'MyD88 and TRIF signaling pathways by free zinc ions. J Immunol. ' '2013;191(4):1808–17.', 'journal-title': 'J Immunol'}, { 'key': '6617_CR19', 'doi-asserted-by': 'publisher', 'first-page': '343', 'DOI': '10.1016/j.ijid.2020.09.014', 'volume': '100', 'author': 'D Jothimani', 'year': '2020', 'unstructured': 'Jothimani D, Kailasam E, Danielraj S, Nallathambi B, Ramachandran H, ' 'Sekar P, et al. COVID-19: Poor outcomes in patients with zinc ' 'deficiency. Int J Infectious Dis. 2020;100:343–9.', 'journal-title': 'Int J Infectious Dis'}, { 'issue': '2s', 'key': '6617_CR20', 'first-page': 'e53', 'volume': '4', 'author': 'M Talebpour', 'year': '2020', 'unstructured': 'Talebpour M, Hadadi A, Oraii A, Ashraf H. Rationale and design of a ' 'registry in a referral and educational medical center in Tehran, Iran: ' 'Sina Hospital Covid-19 Registry (SHCo-19R). Adv J Emerg Med. ' '2020;4(2s):e53.', 'journal-title': 'Adv J Emerg Med'}, {'key': '6617_CR21', 'unstructured': 'https://www.cdc.gov/.'}, { 'key': '6617_CR22', 'doi-asserted-by': 'crossref', 'unstructured': 'Tan CW, Ho LP, Kalimuddin S, Cherng BPZ, Teh YE, Thien SY, et al. A ' 'cohort study to evaluate the effect of combination vitamin D, magnesium ' 'and vitamin B12 (DMB) on progression to severe outcome in older COVID-19 ' 'patients. medRxiv. 2020.', 'DOI': '10.1101/2020.06.01.20112334'}, { 'key': '6617_CR23', 'unstructured': 'https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/9765.'}, { 'issue': '3', 'key': '6617_CR24', 'doi-asserted-by': 'publisher', 'first-page': 'R101', 'DOI': '10.1186/cc13877', 'volume': '18', 'author': 'SB de Oliveira Iglesias', 'year': '2014', 'unstructured': 'de Oliveira Iglesias SB, Leite HP, Paes ÂT, de Oliveira SV, Sarni ROS. ' 'Low plasma selenium concentrations in critically ill children: the ' 'interaction effect between inflammation and selenium deficiency. Crit ' 'Care. 2014;18(3):R101.', 'journal-title': 'Crit Care'}, { 'issue': '1', 'key': '6617_CR25', 'doi-asserted-by': 'publisher', 'first-page': '237', 'DOI': '10.1007/s12011-019-01775-7', 'volume': '194', 'author': 'J Xu', 'year': '2020', 'unstructured': 'Xu J, Gong Y, Sun Y, Cai J, Liu Q, Bao J, et al. Impact of selenium ' 'deficiency on inflammation, oxidative stress, and phagocytosis in mouse ' 'macrophages. Biol Trace Elem Res. 2020;194(1):237–43.', 'journal-title': 'Biol Trace Elem Res'}, { 'issue': '1', 'key': '6617_CR26', 'doi-asserted-by': 'publisher', 'first-page': '1', 'DOI': '10.1002/rmv.2146', 'volume': '31', 'author': 'B Gallo Marin', 'year': '2021', 'unstructured': 'Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, ' 'Salazar‐Mather TP, Dumenco L, Savaria MC, Aung SN, Flanigan T. ' 'Predictors of COVID‐19 severity: A literature review. Rev med virol. ' '2021;31(1):1–0.', 'journal-title': 'Rev med virol'}, { 'issue': '2', 'key': '6617_CR27', 'doi-asserted-by': 'publisher', 'first-page': '98', 'DOI': '10.1159/000177984', 'volume': '41', 'author': 'F Girodon', 'year': '1997', 'unstructured': 'Girodon F, Lombard M, Galan P, Brunet-Lecomte P, Monget A-L, Arnaud J, ' 'et al. Effect of micronutrient supplementation on infection in ' 'institutionalized elderly subjects: a controlled trial. Ann Nutr Metab. ' '1997;41(2):98–107.', 'journal-title': 'Ann Nutr Metab'}, { 'issue': '6', 'key': '6617_CR28', 'doi-asserted-by': 'publisher', 'first-page': '803', 'DOI': '10.1111/aas.13573', 'volume': '64', 'author': 'LM Broman', 'year': '2020', 'unstructured': 'Broman LM, Bernardson A, Bursell K, Wernerman J, Fläring U, Tjäder I. ' 'Serum selenium in critically ill patients: profile and supplementation ' 'in a depleted region. Acta Anaesthesiol Scand. 2020;64(6):803–9.', 'journal-title': 'Acta Anaesthesiol Scand'}, { 'key': '6617_CR29', 'doi-asserted-by': 'publisher', 'author': 'A Pal', 'year': '2020', 'unstructured': 'Pal A, Squitti R, Picozza M, Pawar A, Rongioletti M, Dutta AK, et al. ' 'Zinc and COVID-19: basis of current clinical trials. Biol Trace Elem ' 'Res. 2020. https://doi.org/10.1007/s12011-020-02437-9.', 'journal-title': 'Biol Trace Elem Res', 'DOI': '10.1007/s12011-020-02437-9'}, { 'key': '6617_CR30', 'doi-asserted-by': 'publisher', 'author': 'S Arentz', 'year': '2020', 'unstructured': 'Arentz S, Hunter J, Yang G, Goldenberg J, Beardsley J, Myers SP, et al. ' 'Zinc for the prevention and treatment of SARS-CoV-2 and other acute ' 'viral respiratory infections: a rapid review. Adv Integr Med. 2020. ' 'https://doi.org/10.1016/j.aimed.2020.07.009.', 'journal-title': 'Adv Integr Med', 'DOI': '10.1016/j.aimed.2020.07.009'}, { 'issue': '8', 'key': '6617_CR31', 'doi-asserted-by': 'publisher', 'first-page': '1487', 'DOI': '10.1093/clinchem/25.8.1487', 'volume': '25', 'author': 'J Smith Jr', 'year': '1979', 'unstructured': 'Smith J Jr, Butrimovitz G, Purdy W. Direct measurement of zinc in plasma ' 'by atomic absorption spectroscopy. Clin Chem. 1979;25(8):1487–91.', 'journal-title': 'Clin Chem'}, { 'key': '6617_CR32', 'volume-title': 'StatPearls [Internet]', 'author': 'L Maxfield', 'year': '2019', 'unstructured': 'Maxfield L, Crane JS. Zinc deficiency. In: StatPearls [Internet]. ' 'Treasure Island: StatPearls Publishing; 2019.'}], 'container-title': 'BMC Infectious Diseases', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12879-021-06617-3.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s12879-021-06617-3/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12879-021-06617-3.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 9, 3]], 'date-time': '2021-09-03T12:30:03Z', 'timestamp': 1630672203000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06617-3'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 9, 3]]}, 'references-count': 32, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2021, 12]]}}, 'alternative-id': ['6617'], 'URL': 'http://dx.doi.org/10.1186/s12879-021-06617-3', 'relation': {}, 'ISSN': ['1471-2334'], 'subject': ['Infectious Diseases'], 'container-title-short': 'BMC Infect Dis', 'published': {'date-parts': [[2021, 9, 3]]}, 'assertion': [ { 'value': '13 March 2021', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '22 August 2021', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '3 September 2021', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'All methods were carried out in accordance with relevant guidelines and ' 'regulations. The study was approved by the ethics committee of Tehran ' 'University of Medical Sciences (IR.TUMS.VCR.REC.1399.134). All participants ' 'provided informed written consent to participate in this study, which is ' 'attached to the medical documents of each hospitalized patient.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'All participants provided informed written consent regarding publication of the ' 'results, which is attached to the medical documents of each hospitalized ' 'patient.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'The authors declare no potential competing interests with respect to the ' 'research, authorship, and/or publication of this article.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '899'}