Nutritional Immunity, Zinc Sufficiency, and COVID-19 Mortality in Socially Similar European Populations
Singh et al.,
Nutritional Immunity, Zinc Sufficiency, and COVID-19 Mortality in Socially Similar European Populations,
Frontiers in Immunology, doi:10.3389/fimmu.2021.699389
Analysis of zinc sufficiency showing a positive correlation between sufficiency and COVID-19 within European countries.
Unmeasured confounders are likely to be significant, for example the higher sufficiency countries also have significantly higher tourism and international travel on average. This confounder is not mentioned and could more than account for the observation.
Sufficiency levels were relatively high in all countries. Zinc sufficiency estimates were from 2005.
Higher sufficiency countries: Iceland France Ireland Finland UK Switzerland Netherlands Spain Italy Sweden Norway Denmark
Lower sufficiency countries: Portugal Belgium Lithuania Hungary Germany Poland Estonia Czechia Ukraine Bulgaria Slovakia
Singh et al., 17 Sep 2021, peer-reviewed, 4 authors.
Contact:
samer.singh10@bhu.ac.in.
Abstract: BRIEF RESEARCH REPORT
published: 17 September 2021
doi: 10.3389/fimmu.2021.699389
Nutritional Immunity, Zinc
Sufficiency, and COVID-19
Mortality in Socially Similar
European Populations
Samer Singh 1*, Amita Diwaker 2, Brijesh P. Singh 3 and Rakesh K. Singh 4
1
Centre of Experimental Medicine & Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India,
Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India,
3 Department of Statistics, Institute of Science, Banaras Hindu University, Varanasi, India, 4 Department of Biochemistry,
Institute of Science, Banaras Hindu University, Varanasi, India
2
Edited by:
Julio Villena,
Centro de Referencia para
Lactobacilos (CERELA) (CONICET),
Argentina
Reviewed by:
Ivan Milos Stankovic,
University of Belgrade, Serbia
Leonardo Albarracin,
Centro de Referencia para
Lactobacilos (CERELA) (CONICET),
Argentina
*Correspondence:
Samer Singh
samer.singh10@bhu.ac.in
orcid.org/0000-0002-0921-1686
Specialty section:
This article was submitted to
Nutritional Immunology,
a section of the journal
Frontiers in Immunology
Received: 16 May 2021
Accepted: 18 August 2021
Published: 17 September 2021
Citation:
Singh S, Diwaker A, Singh BP
and Singh RK (2021) Nutritional
Immunity, Zinc Sufficiency, and
COVID-19 Mortality in Socially
Similar European Populations.
Front. Immunol. 12:699389.
doi: 10.3389/fimmu.2021.699389
The impact of zinc (Zn) sufficiency/supplementation on COVID-19-associated mortality
and incidence (SARS-CoV-2 infections) remains unknown. During an infection, the levels
of free Zn are reduced as part of “nutritional immunity” to limit the growth and replication of
pathogen and the ensuing inflammatory damage. Considering its key role in immune
competency and frequently recorded deficiency in large sections of different populations,
Zn has been prescribed for both prophylactic and therapeutic purposes in COVID-19
without any corroborating evidence for its protective role. Multiple trials are underway
evaluating the effect of Zn supplementation on COVID-19 outcome in patients getting
standard of care treatment. However, the trial designs presumably lack the power to
identify negative effects of Zn supplementation, especially in the vulnerable groups of
elderly and patients with comorbidities (contributing 9 out of 10 deaths; up to >8,000-fold
higher mortality). In this study, we have analyzed COVID-19 mortality and incidence (case)
data from 23 socially similar European populations with comparable confounders
(population: 522.47 million; experiencing up to >150-fold difference in death rates) and
at the matching stage of the pandemic (March 12 to June 26, 2020; first wave of COVID19 incidence and mortality). Our results suggest a positive correlation between
populations’ Zn-sufficiency status and COVID-19 mortality [r (23): 0.7893–0.6849, pvalue < 0.0003] as well as incidence [r (23):0.8084–0.5658; p-value < 0.005]. The
observed association is contrary to what would be expected if Zn sufficiency was
protective in COVID-19. Thus, controlled trials or retrospective analyses of the adverse
event patients’ data should be undertaken to correctly guide the practice of Zn
supplementation in COVID-19.
Keywords: COVID-19, nutritional immunity, zinc supplementation, infection, oxidative stress, redox, SARSCoV-2, mortality
Frontiers in Immunology | www.frontiersin.org
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September 2021 | Volume 12 | Article 699389
Singh et..
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