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Association between fatality rate of COVID-19 and selenium deficiency in China

Zhang et al., BMC Infectious Diseases, doi:10.1186/s12879-021-06167-8
May 2021  
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Ecological study of 14,045 COVID-19 cases from 147 cities in China, showing higher case fatality rates associated with selenium deficiency. Based on selenium content in crops, the case fatality rates (CFRs) were 1.17% in non-selenium-deficient areas, 1.28% in moderate-selenium-deficient areas, and 3.16% in severe-selenium-deficient areas. Using selenium content in topsoil, the CFRs were 0.76% in non-selenium-deficient areas, 1.70% in moderate-selenium-deficient areas, and 1.85% in severe-selenium-deficient areas. Regression analysis showed a significantly higher fatality risk in cities with severe selenium deficiency compared to non-deficient cities, with incidence rate ratios of 3.88 based on crops and 3.06 based on topsoil. The study is limited by the ecological design which cannot establish causality at an individual level. Selenium content measured from local crops or topsoil may not fully represent population selenium status due to non-local food supplies and varying dietary habits.
Zhang et al., 19 May 2021, China, peer-reviewed, 11 authors. Contact: (corresponding author),,
This PaperSeleniumAll
Association between fatality rate of COVID-19 and selenium deficiency in China
Hai-Yang Zhang, An-Ran Zhang, Qing-Bin Lu, Xiao-Ai Zhang, Zhi-Jie Zhang, Xiu-Gang Guan, Tian-Le Che, Yang Yang, Hao Li, Wei Liu, Li-Qun Fang
BMC Infectious Diseases, doi:10.1186/s12879-021-06167-8
Background: COVID-19 has impacted populations around the world, with the fatality rate varying dramatically across countries. Selenium, as one of the important micronutrients implicated in viral infections, was suggested to play roles. Methods: An ecological study was performed to assess the association between the COVID-19 related fatality and the selenium content both from crops and topsoil, in China. Results: Totally, 14,045 COVID-19 cases were reported from 147 cities during 8 December 2019-13 December 2020 were included. Based on selenium content in crops, the case fatality rates (CFRs) gradually increased from 1.17% in non-selenium-deficient areas, to 1.28% in moderate-selenium-deficient areas, and further to 3.16% in severeselenium-deficient areas (P = 0.002). Based on selenium content in topsoil, the CFRs gradually increased from 0.76% in non-selenium-deficient areas, to 1.70% in moderate-selenium-deficient areas, and further to 1.85% in severeselenium-deficient areas (P < 0.001). The zero-inflated negative binomial regression model showed a significantly higher fatality risk in cities with severe-selenium-deficient selenium content in crops than non-selenium-deficient cities, with incidence rate ratio (IRR) of 3.88 (95% CIs: 1.21-12.52), which was further confirmed by regression fitting the association between CFR of COVID-19 and selenium content in topsoil, with the IRR of 2.38 (95% CIs: 1.14-4.98) for moderate-selenium-deficient cities and 3.06 (1.49-6.27) for severe-selenium-deficient cities. Conclusions: Regional selenium deficiency might be related to an increased CFR of COVID-19. Future studies are needed to explore the associations between selenium status and disease outcome at individual-level.
Abbreviation CFR: Case fatality rate Authors' contributions LQF and WL conceived and designed the study. HYZ and ARZ contributed to data collection. HL, QBL, LQF, HYZ, ARZ, XAZ, ZJZ, XGG, TLC and YY contributed to data analysis. LQF, LW, and HL contributed to the writing of the report. HYZ and ARZ contributed equally and share first authorship. The author(s) read and approved the final manuscript. Declarations Ethics approval and consent to participate The current study was approved by the ethics committees of Beijing Institute of Microbiology and Epidemiology in accordance with the medical research regulations of China. Consent for publication Not applicable. Competing interests All authors declare no competing interests. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Av, Bringing context back into epidemiology: variables and fallacies in multilevel analysis, Am J Public Health, doi:10.2105/AJPH.88.2.216
Avery, Hoffmann, Selenium, Selenoproteins, and Immunity, Nutrients
Beck, Levander, Dietary oxidative stress and the potentiation of viral infection, Annu Rev Nutr, doi:10.1146/annurev.nutr.18.1.93
Beck, Levander, Handy, Selenium deficiency and viral infection, J Nutr
Beck, Shi, Morris, Levander, Rapid genomic evolution of a nonvirulent coxsackievirus B3 in selenium-deficient mice results in selection of identical virulent isolates, Nat Med, doi:10.1038/nm0595-433
Beigel, Tomashek, Dodd, Mehta, Zingman et al., Remdesivir for the treatment of Covid-19 -final report, N Engl J Med, doi:10.1056/NEJMoa2007764
Calder, Carr, Gombart, Eggersdorfer, Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections, Nutrients
Cheng, Chen, Geng, Zhu, Liang et al., Preliminary analysis on COVID-19 case spectrum and spread intensity in different provinces in China except Hubei province. Zhonghua liu xing bing xue za zhi =, Zhonghua liuxingbingxue zazhi, doi:10.3760/cma.j.cn112338-20200314-00347
Dxy, Novel coronavirus global real-time outbreak map
Ersöz, Yakaryilmaz, Turan, Effect of sodium selenite treatment on platelet aggregation of streptozotocin-induced diabetic rats, Thromb Res, doi:10.1016/S0049-3848(03)00338-4
Fairweather-Tait, Bao, Broadley, Collings, Ford et al., Selenium in human health and disease, Antioxid Redox Signal, doi:10.1089/ars.2010.3275
Fawzi, Micronutrients and human immunodeficiency virus type 1 disease progression among adults and children, Clin Infect Dis, doi:10.1086/375882
Filippini, Michalke, Wise, Malagoli, Malavolti et al., Diet composition and serum levels of selenium species: a cross-sectional study, Food Chem Toxicol, doi:10.1016/j.fct.2018.03.048
Gassen, Papies, Bajaj, Dethloff, Emanuel et al., Analysis of SARS-CoV-2-controlled autophagy reveals spermidine, MK-2206, and niclosamide as putative antiviral therapeutics, bioRxiv, doi:10.1101/2020.04.15.997254
Gombart, Pierre, Maggini, A review of micronutrients and the immune system-working in harmony to reduce the risk of infection, Nutrients
Guillin, Vindry, Ohlmann, Chavatte, Selenium, Selenoproteins and viral infection, Nutrients
Harthill, Review: micronutrient selenium deficiency influences evolution of some viral infectious diseases, Biol Trace Elem Res, doi:10.1007/s12011-011-8977-1
Idrovo, Three criteria for ecological fallacy, Environ Health Perspect, doi:10.1289/ehp.1103768
Johnson, Fordyce, Rayman, Symposium on 'Geographical and geological influences on nutrition': factors controlling the distribution of selenium in the environment and their impact on health and nutrition, Proc Nutr Soc, doi:10.1017/S0029665109991807
Lee, Lee, Johnson, Isolation of the etiologic agent of Korean hemorrhagic fever, J Infect Dis, doi:10.1093/infdis/137.3.298
Loscalzo, Keshan disease, selenium deficiency, and the selenoproteome, N Engl J Med, doi:10.1056/NEJMcibr1402199
Manzanares, Biestro, Galusso, Torre, Mañay et al., Serum selenium and glutathione peroxidase-3 activity: biomarkers of systemic inflammation in the critically ill?, Intensive Care Med, doi:10.1007/s00134-008-1356-5
Moghaddam, Heller, Sun, Seelig, Cherkezov et al., Selenium Deficiency Is Associated with Mortality Risk from COVID-19, Nutrients
Muzembo, Ngatu, Januka, Huang, Nattadech et al., Selenium supplementation in HIV-infected individuals: a systematic review of randomized controlled trials, Clin Nutr ESPEN, doi:10.1016/j.clnesp.2019.09.005
Ning, Wang, Zhang, Anatoly, Prakash et al., Imbalance of dietary nutrients and the associated differentially expressed genes and pathways may play important roles in juvenile Kashin-Beck disease, J Trace Elements Med Biol, doi:10.1016/j.jtemb.2018.01.012
Papp, Lu, Holmgren, Khanna, From selenium to selenoproteins: synthesis, identity, and their role in human health, Antioxid Redox Signal, doi:10.1089/ars.2007.1528
Perona, Schiavon, Guidi, Veneri, Minuz, Selenium dependent glutathione peroxidase: a physiological regulatory system for platelet function, Thromb Haemost
Ramanathan, Taylor, Computational genomic analysis of hemorrhagic fever viruses. Viral selenoproteins as a potential factor in pathogenesis, Biol Trace Elem Res, doi:10.1007/BF02778985
Rayman, Selenium and human health, Lancet
Rees, Hartley, Day, Flowers, Clarke et al., Selenium supplementation for the primary prevention of cardiovascular disease, Cochrane Database Syst Rev
Shu, Wang, Duan, Lu, Liu, A distribution map of selenium content of crops in mainland China
Steinbrenner, Al-Quraishy, Dkhil, Wunderlich, Sies, Dietary selenium in adjuvant therapy of viral and bacterial infections, Adv Nutr
Sun, Meharg, Li, Chen, Yang et al., Distribution of soil selenium in China is potentially controlled by deposition and volatilization?, Sci Rep, doi:10.1038/srep20953
Tang, Li, Wang, Sun, Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia, J Thrombosis Haemostasis, doi:10.1111/jth.14768
Taylor, Ruzicka, Premadasa, Zhao, Cellular Selenoprotein mRNA tethering via antisense interactions with Ebola and HIV-1 mRNAs may impact host selenium biochemistry, Curr Top Med Chem, doi:10.2174/1568026615666150915121633
Taylor, Zhao, Zhang, Genomic analysis of SARS coronavirus reveals two hidden genes whose predicted functions suggest a molecular basis for selenium-related abnormalities in SARS, International Science Symposium on SARS, doi:10.6084/m9.figshare.12133581
Tong, Migration bias in ecologic studies, Eur J Epidemiol, doi:10.1023/A:1007698700119
Touat-Hamici, Legrain, Bulteau, Chavatte, Selective up-regulation of human selenoproteins in response to oxidative stress, J Biol Chem, doi:10.1074/jbc.M114.551994
Vinceti, Filippini, Giovane, Dennert, Zwahlen et al., Selenium for preventing cancer, Cochrane Database Syst Rev
Vinceti, Filippini, Rothman, Selenium exposure and the risk of type 2 diabetes: a systematic review and meta-analysis, Eur J Epidemiol, doi:10.1007/s10654-018-0422-8
Visser, Durao, Sinclair, Irlam, Siegfried, Micronutrient supplementation in adults with HIV infection, Cochrane Database Syst Rev
Wang, Rijntjes, Wu, Lv, Gao et al., Selenium deficiency is linearly associated with hypoglycemia in healthy adults, Redox Biol, doi:10.1016/j.redox.2020.101709
Yang, Yao, Wu, Sun, Yang et al., Status and risks of selenium deficiency in a traditional selenium-deficient area in Northeast China, Sci Total Environ, doi:10.1016/j.scitotenv.2020.144103
Zhang, Saad, Taylor, Rayman, Selenium and selenoproteins in viral infection with potential relevance to COVID-19, Redox Biol, doi:10.1016/j.redox.2020.101715
Zhang, Taylor, Bennett, Saad, Rayman, Association between regional selenium status and reported outcome of COVID-19 cases in China, Am J Clin Nutr, doi:10.1093/ajcn/nqaa095
Zhang, Zhang, Xu, Tian, Yao et al., Development of China digital soil maps (CDSM) at 1: 50000 scale, Sci Agric Sin
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