Correlation between Micronutrient plasma concentration and disease severity in COVID-19 patients
Pharm.D Abdullah Alkattan, Khaled Alabdulkareem, MBBS, MSc. Gynecology Amr Kamel, Heba Abdelseed, Yousef Almutairi, Eman Alsalameen
Alexandria Journal of Medicine, doi:10.1080/20905068.2020.1870788
Objectives: Coronavirus Disease 2019 (COVID-19) is caused by a new strain of betacoronavirus called SARS-CoV-2, which leads to mild to severe symptoms. Micronutrients in blood serum, namely, zinc, iron, copper, and selenium, play essential roles in the human body's various organs. This study investigates the association between micronutrient levels and the severity of symptoms in SARS-CoV-2 infected patients. Methods: A cross-section study was conducted during June-August 2020 in Riyadh city among 80 patients with confirmed SARS-CoV-2 infection. Within 24 hours of hospital admission, patients have been divided into non-severe and severe cases, and blood samples were drawn from each patient to measure the serum levels of copper, iron "in the form of ferritin," selenium, and zinc. Results: In both study groups, the mean copper and selenium serum levels were within the normal range, while the mean zinc and iron serum levels were elevated. A statistically significant difference was recorded between non-severe and severe cases regarding serum levels of iron and selenium (331.24 vs. 1174.95 ng/ml and 134 vs. 162 mcg/L, respectively, P < 0.0001). On the other hand, no significant difference was detected between both studied groups regarding serum level of zinc and copper (124.57 vs. 116.37 mcq/L and 18.35 vs. 18.2 mcmol/ L, respectively, P > 0.05). Conclusions: There was a significant elevation of selenium and iron serum levels among severe cases compared to non-severe cases of COVID-19. High levels of iron and selenium could be correlated with the disease severity during infection with SARS-CoV-2.
Disclosure statement The authors have no conflict of interest.
References
Bhattacharya, Misra, Hussain, Nutritional aspects of essential trace elements in oral health and disease: an extensive review, Scientifica
Chang, Bayeva, Taiwo, Palella, Jr et al., Short communication: high cellular iron levels are associated with increased HIV infection and replication, AIDS Res Hum Retroviruses
Gibson, Vanderkooy, Macdonald, A growth-limiting, mild zinc-deficiency syndrome in some southern Ontario boys with low height percentiles, Am J Clin Nutr
Gomes, Moreira, Mesquita, Modulation of iron metabolism in response to infection: twists for all tastes, Pharmaceuticals (Basel)
Hopkins, Failla, Copper deficiency reduces interleukin-2 (IL-2) production and IL-2 mRNA in human Tlymphocytes, J Nutr
Iwasaki, Medzhitov, Control of adaptive immunity by the innate immune system, Nat Immunol
Jin, Ren, Updating the diagnostic criteria of COVID-19 "suspected case" and "confirmed case" is necessary, Mil Med Res
Lai, Shih, Ko, Tang, Hj, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges, International journal of antimicrobial agents
Lee, Critical role of zinc as either an antioxidant or a prooxidant in cellular systems, Oxid Med Cell Longev
Maggini, Pierre, Calder, Immune function and micronutrient requirements change over the life course, Nutrients
Makker, Hanif, Bajantri, Dysmetabolic hyperferritinemia: all iron overload is not hemochromatosis. Case Rep Gastroenterol
Perricone, Bartoloni, Bursi, COVID-19 as part of the hyperferritinemic syndromes: the role of iron depletion therapy, Immunol Res
Plum, Rink, Haase, The essential toxin: impact of zinc on human health, Int J Environ Res Public Health,
doi:10.3390/ijerph7041342Rocourt, Cheng, Selenium supranutrition: are the potential benefits of chemoprevention outweighed by the promotion of diabetes and insulin resistance? Nutrients
Samanovic, Ding, Thiele, Copper in microbial pathogenesis: meddling with the metal, Cell Host Microbe
Singhal, A review of coronavirus disease-2019 (COVID-19), The Indian Journal of Pediatrics
Skrajnowska, Bobrowska-Korczak, Role of zinc in immune system and anti-cancer defense mechanisms, Nutrients
Thanawongnuwech, Thacker, Halbur, Increased production of proinflammatory cytokines following infection with porcine reproductive and respiratory syndrome virus and Mycoplasma hyopneumoniae, Clin Diagn Lab Immunol
Tonelli, Wiebe, Bello, Concentrations of trace elements and clinical outcomes in hemodialysis patients: a prospective cohort study, Clin J Am Soc Nephrol
Ye, Rouault, Human iron-sulfur cluster assembly, cellular iron homeostasis, and disease, Biochemistry
Zachariah, Maamoun, Milano, Endoplasmic reticulum stress and oxidative stress drive endothelial dysfunction induced by high selenium, J Cell Physiol,
doi:10.1002/jcp.30175Zoidis, Seremelis, Kontopoulos, Seleniumdependent antioxidant enzymes: actions and properties of selenoproteins. Antioxidants (Basel)
