The correlation between serum selenium, zinc, and COVID-19 severity: an observational study
et al., BMC Infectious Diseases,
Prospective analysis of 84 patients in Iran, showing higher selenium and zinc levels associated with a decrease in serum CRP level. There was no statistically significant association between selenium/zinc levels and disease severity.
Razeghi Jahromi et al., 3 Sep 2021, prospective, Iran, peer-reviewed, 14 authors.
email@example.com (corresponding author).
Abstract: (2021) 21:899
Razeghi Jahromi et al. BMC Infect Dis
The correlation between serum selenium,
zinc, and COVID‑19 severity: an observational
Soodeh Razeghi Jahromi1†, Hedieh Moradi Tabriz2†, Mansoureh Togha3,4* , Shadi Ariyanfar1,3,
Zeinab Ghorbani5,6, Sima Naeeni4, Samaneh Haghighi3,4, Aboozar Jazayeri3, Mahnaz Montazeri7,
Mohammad Talebpour8, Haleh Ashraf9,10, Mehdi Ebrahimi11, Azita Hekmatdoost1 and Elham Jafari3
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
Keywords: COVID-19, Zinc, Selenium, Nutritional status, Immunity
Soodeh Razeghi Jahromi and Hedieh moradi tabriz have contributed
Headache Department, Iranian Center of Neurological Research,
Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Full list of author information is available at the end of the article
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