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Plasma zinc status and hyperinflammatory syndrome in hospitalized COVID-19 patients: an observational study

Verschelden et al., medRxiv, doi:10.1101/2021.06.09.21258271
Jun 2021  
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Prospective study of 139 hospitalized COVID-19 patients, showing 96% had zinc deficiency. Higher zinc levels were associated with a shorter length of hospitalization. Mortality and ventilation was lower with higher zinc levels, but not reaching statistical significance.
Verschelden et al., 12 Jun 2021, preprint, 8 authors.
This PaperZincAll
Plasma zinc status and hyperinflammatory syndrome in hospitalized COVID-19 patients: an observational study
Gil Verschelden, Maxim Noeparast, Maryam Noparast, Maïlis Lauwers, Charlotte Michel, Frédéric Cotton, Cleo Goyvaerts, Maya Hites
doi:10.1101/2021.06.09.21258271
Deficiency of the element zinc is associated with cytokine releasing syndrome (CRS) and the related acute respiratory distress syndrome as well as impaired antiviral response. Similar complications associate with severe SARS-CoV-2. We conducted a prospective, single-center, observational study in a tertiary university hospital (CUB-Hopital Erasme, Brussels) to address the zinc status, the association between the plasma zinc concentration, development of CRS, and the clinical outcomes in PCR-confirmed and hospitalized COVID-19 patients. One hundred and thirty-nine eligible patients were included between May 2020 and November 2020 (median age of 65 years [IQR, 54 to 77]). Our cohort's mean plasma zinc concentration was 56.2 µg/dL (standard deviation [SD], 14.8) compared to 75.7 µg/dL (SD = 18.9 µg/dL) in the retrospective non-COVID-19 control group (N = 1513; P <.001). Markedly, the absolute majority of patients (96%) were zinc deficient (<80 µg/dL).
Ethics approval and consent to participate Informed consent was obtained from all participants. The study was approved by the ethics committee of Erasme Hospital, EC identifier P2020/261. Conflict of interest and funding: We hereby confirm that there is no conflict of interest associated with this publication and that this work did not receive any financial support that could have influenced its outcome. Author contributions G.V and M.Noep: conceived the idea, co-authored the research proposal, designed the study, analyzed the data, interpreted the results, generated the tables, and coauthored the manuscript. G.V: medical consultation and handling the patients' material. M.Nop: supervised the study design and the statistical analyses and critically revised and contributed to drafting the manuscript. M.L, C.M, F.C: handled the patients' material and performed the laboratory assessments. C.G: contributed to . Note: IQR = interquartile range, CI = confidence interval, OR = odds ratio
References
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Chen, Hoiland, Stukas, Wellington, Sekhon, Confronting the controversy: interleukin-6 and the COVID-19 cytokine storm syndrome, Eur. Respir. J
Davies, Musa, Dormandy, Measurements of plasma zinc. I. In health and disease, J. Clin. Pathol
Horby, Dexamethasone in Hospitalized Patients with Covid-19, N. Engl. J. Med
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Mehta, COVID-19: consider cytokine storm syndromes and immunosuppression, Lancet, doi:10.1016/S0140-6736(20)30628-0
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Prasad, Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress, Am. J. Clin. Nutr
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Similar complications associate with severe ' 'SARS-CoV-2.</jats:p><jats:p>We conducted a prospective, single-center, observational study in ' 'a tertiary university hospital (CUB-Hopital Erasme, Brussels) to address the zinc status, the ' 'association between the plasma zinc concentration, development of CRS, and the clinical ' 'outcomes in PCR-confirmed and hospitalized COVID-19 patients. One hundred and thirty-nine ' 'eligible patients were included between May 2020 and November 2020 (median age of 65 years ' '[IQR, 54 to 77]).</jats:p><jats:p>Our cohort’s mean plasma zinc concentration was 56.2 µg/dL ' '(standard deviation [SD], 14.8) compared to 75.7 µg/dL (SD = 18.9 µg/dL) in the retrospective ' 'non-COVID-19 control group (N = 1513;<jats:italic>P</jats:italic>&lt;.001). 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