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0 0.5 1 1.5 2+ ICU admission 92% Improvement Relative Risk Selenium for COVID-19  Rozemeijer et al.  Sufficiency Are selenium levels associated with COVID-19 outcomes? Prospective study of 25 patients in Netherlands Lower ICU admission with higher selenium levels (not stat. sig., p=0.093) Rozemeijer et al., Nutrients, January 2024 Favors selenium Favors control

Micronutrient Status of Critically Ill Patients with COVID-19 Pneumonia

Rozemeijer et al., Nutrients, doi:10.3390/nu16030385
Jan 2024  
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Prospective pilot study of 20 critically ill COVID-19 ICU patients showing high deficiency rates of 50-100% for vitamins A, B6, and D; zinc; and selenium at admission. Deficiencies of vitamins B6 and D, and low iron status, persisted after 3 weeks. Plasma levels of vitamins A and E, zinc, and selenium increased over time as inflammation resolved, suggesting redistribution may explain some observed deficiencies. All patients received daily micronutrient administration. Additional intravenous and oral micronutrient administration for 10 patients did not significantly impact micronutrient levels or deficiency rates, however authors note that the administered doses may be too low. The form of vitamin D is not specified but may have been cholecalciferol which is expected to have a very long onset of action compared to more appropriate forms such as calcifediol or calcitriol.
Study covers vitamin A, vitamin D, zinc, and selenium.
risk of ICU admission, 92.5% lower, OR 0.08, p = 0.09, high selenium levels (≥0.70µmol/L) 9 of 20 (45.0%) cases, 5 of 5 (100.0%) controls, NNT 2.8, case control OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Rozemeijer et al., 29 Jan 2024, prospective, Netherlands, peer-reviewed, 9 authors.
This PaperSeleniumAll
Micronutrient Status of Critically Ill Patients with COVID-19 Pneumonia
Sander Rozemeijer, Henrike M Hamer, Annemieke C Heijboer, Robert De Jonge, Connie R Jimenez, Nicole P Juffermans, Romein W G Dujardin, Armand R J Girbes, Angélique M E De Man
Nutrients, doi:10.3390/nu16030385
Micronutrient deficiencies can develop in critically ill patients, arising from factors such as decreased intake, increased losses, drug interactions, and hypermetabolism. These deficiencies may compromise important immune functions, with potential implications for patient outcomes. Alternatively, micronutrient blood levels may become low due to inflammation-driven redistribution rather than consumption. This explorative pilot study investigates blood micronutrient concentrations during the first three weeks of ICU stay in critically ill COVID-19 patients and evaluates the impact of additional micronutrient administration. Moreover, associations between inflammation, disease severity, and micronutrient status were explored. We measured weekly concentrations of vitamins A, B6, D, and E; iron; zinc; copper; selenium; and CRP as a marker of inflammation state and the SOFA score indicating disease severity in 20 critically ill COVID-19 patients during three weeks of ICU stay. Half of the patients received additional (intravenous) micronutrient administration. Data were analyzed with linear mixed models and Pearson's correlation coefficient. High deficiency rates of vitamins A, B6, and D; zinc; and selenium (50-100%) were found at ICU admission, along with low iron status. After three weeks, vitamins B6 and D deficiencies persisted, and iron status remained low. Plasma levels of vitamins A and E, zinc, and selenium improved. No significant differences in micronutrient levels were found between patient groups. Negative correlations were identified between the CRP level and levels of vitamins A and E, iron, transferrin, zinc, and selenium. SOFA scores negatively correlated with vitamin D and selenium levels. Our findings reveal high micronutrient deficiency rates at ICU admission. Additional micronutrient administration did not enhance levels or expedite their increase. Spontaneous increases in vitamins A and E, zinc, and selenium levels were associated with inflammation resolution, suggesting that observed low levels may be attributed, at least in part, to redistribution rather than true deficiencies.
Conflicts of Interest: The authors declare no conflict of interest.
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