Prospective study of 57 consecutive hospitalized COVID-19 patients in Switzerland, showing higher risk of mortality/ICU admission with vitamin A, vitamin D, and zinc deficiency, with statistical significance only for vitamin A and zinc. Adjustments only considered age.
risk of death/ICU, 76.2% lower, RR 0.24, p = 0.004, treatment 4 of 35 (11.4%), control 11 of 22 (50.0%), NNT 2.6, adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk.
Prevalence of Micronutrient Deficiencies in Patients
Hospitalized with COVID-19: An Observational Cohort Study
Manyola Voelkle 1,2 , Claudia Gregoriano 1 , Peter Neyer 3 , Daniel Koch 1 , Alexander Kutz 1 ,
Luca Bernasconi 3 , Anna Conen 2,4 , Beat Mueller 1,2 and Philipp Schuetz 1,2, *
Citation: Voelkle, M.; Gregoriano, C.;
Neyer, P.; Koch, D.; Kutz, A.;
Bernasconi, L.; Conen, A.; Mueller, B.;
Schuetz, P. Prevalence of
Micronutrient Deficiencies in Patients
Hospitalized with COVID-19: An
Observational Cohort Study.
Nutrients 2022, 14, 1862. https://
Academic Editors: Omorogieva Ojo
and Amanda R Amorim Adegboye
Received: 30 March 2022
Accepted: 26 April 2022
Published: 29 April 2022
Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland;
firstname.lastname@example.org (M.V.); email@example.com (C.G.); firstname.lastname@example.org (D.K.);
email@example.com (A.K.); firstname.lastname@example.org (B.M.)
Faculty of Medicine, University of Basel, 4056 Basel, Switzerland; email@example.com
Institute of Laboratory Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland; firstname.lastname@example.org (P.N.);
Department of Infectious Diseases and Infection Prevention, Kantonsspital Aarau, 5001 Aarau, Switzerland
Correspondence: email@example.com; Tel.: +41-62-838-9524
Abstract: Background: A higher risk for severe clinical courses of coronavirus disease 2019 (COVID-19)
has been linked to deficiencies of several micronutrients. We therefore studied the prevalence of
deficiencies of eight different micronutrients in a cohort of hospitalized COVID-19-patients. Methods:
We measured admission serum/plasma levels of vitamins A, B12, D, and E, as well as folic acid,
zinc, selenium, and copper in 57 consecutively admitted adult patients with confirmed COVID-19
and analyzed prevalence of micronutrient deficiencies and correlations among micronutrient levels.
Further, we studied associations of micronutrient levels with severe disease progression, a composite
endpoint consisting of in-hospital mortality and/or need for intensive care unit (ICU) treatment with
logistic regression. Results: Median age was 67.0 years (IQR 60.0, 74.2) and 60% (n = 34) were male.
Overall, 79% (n = 45) of patients had at least one deficient micronutrient level and 33% (n = 19) had
≥3 deficiencies. Most prevalent deficiencies were found for selenium, vitamin D, vitamin A, and zinc
(51%, 40%, 39%, and 39%, respectively). We found several correlations among micronutrients with
correlation coefficients ranging from r = 0.27 to r = 0.42. The strongest associations with lower risk for
severe COVID-19 disease progression (adjusted odds ratios) were found for higher levels of vitamin
A (0.18, 95% CI 0.05–0.69, p = 0.01), zinc (0.73, 95% CI 0.55–0.98, p = 0.03), and folic acid (0.88, 95% CI
0.78–0.98, p = 0.02). Conclusions: We found a high prevalence of micronutrient deficiencies in mostly
older patients hospitalized for COVID-19, particularly regarding selenium, vitamin D, vitamin A,
and zinc. Several deficiencies were associated with a higher risk for more severe COVID-19 courses.
Whether supplementation of micronutrients is useful for prevention of severe clinical courses or
treatment of COVID-19 warrants further research.
Keywords: COVID-19; micronutrients; deficiency; SARS-CoV-2; hospital outcomes
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