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0 0.5 1 1.5 2+ Mortality 47% Improvement Relative Risk Septic shock 62% Zinc for COVID-19  Wozniak et al.  ICU PATIENTS Are zinc levels associated with COVID-19 outcomes? Retrospective 118 patients in Switzerland (March - May 2020) Lower mortality (p=0.3) and progression (p=0.06), not sig. Wozniak et al., Nutrients, July 2023 Favors zinc Favors control

Association of Trace Element Levels with Outcomes in Critically Ill COVID-19 Patients

Wozniak et al., Nutrients, doi:10.3390/nu15153308
Jul 2023  
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Retrospective 345 COVID-19 patients in Switzerland, showing significantly different zinc levels with ICU patients < hospitalized patients < outpatients.
For ICU patients, there was higher mortality, septic shock, and mechanical ventilation days with lower zinc levels, without statistical significance.
This study includes selenium and zinc.
risk of death, 47.4% lower, OR 0.53, p = 0.30, high zinc levels (≥8.2μmol/L) 59, low zinc levels (<8.2μmol/L) 59, adjusted per study, inverted to make OR<1 favor high zinc levels (≥8.2μmol/L), multivariable, RR approximated with OR.
septic shock, 61.5% lower, OR 0.38, p = 0.06, high zinc levels (≥8.2μmol/L) 59, low zinc levels (<8.2μmol/L) 59, adjusted per study, inverted to make OR<1 favor high zinc levels (≥8.2μmol/L), multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Wozniak et al., 26 Jul 2023, retrospective, Switzerland, peer-reviewed, 14 authors, study period 9 March, 2020 - 19 May, 2020.
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Association of Trace Element Levels with Outcomes in Critically Ill COVID-19 Patients
Hannah Wozniak, Christophe Le Terrier, Steve Primmaz, Noémie Suh, Sébastien Lenglet, Aurélien Thomas, Nicolas Vuilleumier, Sabrina Pagano, Aude De Watteville, Silvia Stringhini, Idris Guessous, Hervé Quintard, Claudia Paula Heidegger, Jérôme Pugin
Nutrients, doi:10.3390/nu15153308
The primary objective of this study was to compare the plasma levels of copper, selenium, and zinc between critically ill COVID-19 patients and less severe COVID-19 patients. The secondary objective was to investigate the association of these trace element levels with adverse outcomes, including the duration of mechanical ventilation, occurrence of septic shock, and mortality in critically ill COVID-19 patients. All COVID-19 patients admitted to the ICU of the Geneva University Hospitals between 9 March 2020 and 19 May 2020 were included in the study. Plasma levels of copper, selenium and zinc were measured on admission to the ICU and compared with levels measured in COVID-19 patients hospitalized on the ward and in non-hospitalized COVID-19 patients. To analyze the association of trace elements with clinical outcomes, multivariate linear and logistic regressions were performed. Patients in the ICU had significantly lower levels of selenium and zinc and higher levels of copper compared to COVID-19 patients hospitalized on the ward and in non-hospitalized COVID-19 patients. In ICU patients, lower zinc levels tended to be associated with more septic shock and increased mortality compared to those with higher zinc levels (p = 0.07 for both). Having lower copper or selenium levels was associated with a longer time under mechanical ventilation (p = 0.01 and 0.04, respectively). These associations remained significant in multivariate analyses (p = 0.03 for copper and p = 0.04 for selenium). These data support the need for interventional studies to assess the potential benefit of zinc, copper and selenium supplementation in severe COVID-19 patients.
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