The correlation between serum selenium, zinc, and COVID-19 severity: an observational study
Soodeh Razeghi Jahromi, Hedieh Moradi Tabriz, Mansoureh Togha, Shadi Ariyanfar, Zeinab Ghorbani, Sima Naeeni, Samaneh Haghighi, Aboozar Jazayeri, Mahnaz Montazeri, Mohammad Talebpour, Haleh Ashraf, Mehdi Ebrahimi, Azita Hekmatdoost, Elham Jafari
BMC Infectious Diseases, doi:10.1186/s12879-021-06617-3
Background: 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. Methods: 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. Results: According to the results of linear regression test, there was a significant association between Zn and Se level and COVID-19 severity (β = − 0.28, P-value = 0.01 for Se; β = − 0.26, P-value = 0.02). 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 = − 0.35, P-value = 0.001 for Se; r = − 0.41, P-value < 0.001 for Zn).
Conclusion: 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.
Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1186/ s12879-021-06617-3. Additional file 1: Table . Biochemical assessments of the COVID-19 patients according to the severity of COVID-19.
Authors' contributions SR designed this study, wrote and edited the manuscript, HM conducted laboratory managements, MT designed the study, investigated data, and edited the manuscript. SA conducted data investigation, extraction, and edited the manuscript, ZG was responsible for analysis, and interpretation of results. SN, SH, and HA participated in data gathering. AJ and MM, MT, and ME participated in laboratory measurements. AH participated in study design. EJ edited the manuscript. All authors read and approved the final manuscript.
Declarations Ethics approval and consent to participate 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.
Consent for publication All participants provided informed written consent regarding publication of the results, which is attached to the medical documents of each hospitalized patient.
Competing interests The authors declare no potential competing interests with respect to the..
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