Low Zinc Levels at Admission Associates with Poor Clinical Outcomes in SARS-CoV-2 Infection

Overview

Journal Nutrients

Date 2021 Feb 12

PMID 33572045

Citations 52

Authors

Marina Vogel-Gonzalez

Marc Tallo-Parra

Victor Herrera-Fernandez

Gemma Perez-Vilaro

Miguel Chillon

Xavier Nogues

Silvia Gomez-Zorrilla

Inmaculada Lopez-Montesinos

Isabel Arnau-Barres

Maria Luisa Sorli-Redo

Juan Pablo Horcajada

Natalia Garcia-Giralt

Julio Pascual

Juana Diez

Ruben Vicente

Robert Guerri-Fernandez

Affiliations

Soon will be listed here.

Abstract

Background: Zinc is an essential micronutrient that impacts host-pathogen interplay at infection. Zinc balances immune responses, and also has a proven direct antiviral action against some viruses. Importantly, zinc deficiency (ZD) is a common condition in elderly and individuals with chronic diseases, two groups with an increased risk for severe severe coronavirus disease 2019 (COVID-19) outcomes. We hypothesize that serum zinc content (SZC) influences COVID-19 disease progression, and thus might represent a useful biomarker.

Methods: We ran an observational cohort study with 249 COVID-19 patients admitted in Hospital del Mar. We have studied COVID-19 severity and progression attending to SZC at admission. In parallel, we have studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) replication in the Vero E6 cell line modifying zinc concentrations.

Findings: Our study demonstrates a correlation between serum zinc levels and COVID-19 outcome. Serum zinc levels lower than 50 µg/dL at admission correlated with worse clinical presentation, longer time to reach stability, and higher mortality. Our in vitro results indicate that low zinc levels favor viral expansion in SARS-CoV-2 infected cells.

Interpretation: Low SZC is a risk factor that determines COVID-19 outcome. We encourage performing randomized clinical trials to study zinc supplementation as potential prophylaxis and treatment with people at risk of zinc deficiency.

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