Abstract: H OH OH metabolites Article Low Levels of Few Micronutrients May Impact COVID-19 Disease Progression: An Observational Study on the First Wave Teresa-Maria Tomasa-Irriguible 1, * , Lara Bielsa-Berrocal 1 , Luisa Bordejé-Laguna 1 , Cristina Tural-Llàcher 2 , Jaume Barallat 3 , Josep-Maria Manresa-Domínguez 4 and Pere Torán-Monserrat 4 1 2 3 4 *



 Citation: Tomasa-Irriguible, T.-M.; Bielsa-Berrocal, L.; Bordejé-Laguna, L.; Tural-Llàcher, C.; Barallat, J.; Manresa-Domínguez, J.-M.; Torán-Monserrat, P. Low Levels of Few Micronutrients May Impact COVID-19 Disease Progression: An Observational Study on the First Wave. Metabolites 2021, 11, 565. https://doi.org/10.3390/ metabo11090565 Academic Editors: Amedeo Lonardo, Elena Planells, Yenifer Gamarra and Jorge Molina-López Received: 29 June 2021 Accepted: 20 August 2021 Published: 24 August 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Intensive Care Unit, University Hospital Germans Trias i Pujol, 08916 Badalona, Spain; larabielsa@gmail.com (L.B.-B.); luisabordeje@gmail.com (L.B.-L.) Internal Medicine Department, University Hospital Germans Trias i Pujol, 08916 Badalona, Spain; ctural.germanstrias@gencat.cat Biochemical Department, University Hospital Germans Trias i Pujol, 08916 Badalona, Spain; jbarallat.germanstrias@gencat.cat North Metropolitan Research Support Unit, Jordi Gol i Gurina Foundation Institute for Research in Primary Health Care (IDIAPJGol), 08303 Mataró, Spain; jmanresa@idiapjgol.info (J.-M.M.-D.); ptoran.bnm.ics@gencat.cat (P.T.-M.) Correspondence: teresatomasa@gmail.com Abstract: We report an observational study performed between March and May 2020 in a Spanish university hospital during the SARS-CoV-2 pandemic. The main objective was to analyse the association between the levels of micronutrients in severe COVID-19 patients and their outcome. Adult patients with a positive polymerase-chain-reaction (PCR) for SARS-CoV-2 in the nasopharyngeal swab or in tracheal aspirate culture in the case of intubation were included. Micronutrient data were obtained from plasma analysis of a standard nutritional assessment performed within the first 24 h of hospital admission. Vitamins A, B6 , C and E were analysed with HPLC methods; 25-OH-vitamin D by immunoassay and zinc by colorimetric measurements. One hundred and twenty patients were included. We found that 74.2% patients had low levels of zinc (normal levels >84 µg/dL) with a mean value of 63.5 (SD 13.5); 71.7% patients had low levels of vitamin A (normal levels >0.3 mg/L) with a mean value of 0.17 (SD 0.06); 42.5% patients had low levels of vitamin B6 (normal levels >3.6 ng/mL) with a mean value of 2.2 (SD 0.9); 100% patients had low levels of vitamin C (normal levels >0.4 mg/dL) with a mean value of 0.14 (SD 0.05); 74.3% patients had low values of vitamin D (normal levels >20 ng/mL) with mean value of 11.4 (SD 4.3); but only 5.8% of patients had low levels of vitamin E (normal levels >5 mg/L) with a mean value of 3.95 (SD 0.87). The variables associated with the need for ICU admission were low levels of zinc (standard error 0.566, 95% CI 0.086 to 0.790, p = 0.017), low levels of vitamin A (standard error 0.582, 95% CI 0.061 to 0.594, p = 0.004), age over 65 (standard error 0.018, 95% CI 0.917 to 0.985, p = 0.005) and male gender (standard error 0.458, 95% CI 1.004 to 6.040, p = 0.049). The only variable that was..