4.5 Article

The correlation between serum selenium, zinc, and COVID-19 severity: an observational study

Journal

BMC INFECTIOUS DISEASES
Volume 21, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12879-021-06617-3

Keywords

COVID-19; Zinc; Selenium; Nutritional status; Immunity

Funding

  1. Tehran University of Medical Sciences (TUMS) COVID-19 Grant [99-1-118-47390]

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The study aimed to evaluate the correlation between serum selenium and zinc levels and COVID-19 severity. The results showed that increasing levels of selenium and zinc were associated with a decrease in serum CRP levels in COVID-19 patients. However, the significant association between selenium, zinc, and disease severity was lost after adjusting for confounding factors.
Background Without an adequate immune response, SARS-CoV2 virus can simply spread throughout the body of the host. Two of the well-known immunonutrients are selenium (Se) and zinc (Zn). Se and Zn deficiency might lead to inflammation, oxidative stress, and viral entry into the cells by decreasing ACE-2 expression; three factors that are proposed to be involved in COVID-19 pathogenesis. Thus, in the current study we aimed at evaluating the correlation between serum Se and Zn status and COVID-19 severity. Methods Eighty-four COVID-19 patients were enrolled in this observational study. Patients were diagnosed based on an infectious disease specialist diagnosis, using WHO interim guidance and the recommendations of the Iranian National Committee of Covid-19. The patients with acute respiratory tract infection symptoms were checked for compatibility of chest computed tomography (CT) scan results with that of Covid-19 and Real-time polymerase chain reaction (RT-PCR) for corona virus infection. The severity of Covid-19 was categorized into three groups (mild, moderate, and severe) using CDC criteria. Serum Zn and Se level of all subjects was measured. The severity of the disease was determined only once at the onset of disease. Results According to the results of linear regression test, there was a significant association between Zn and Se level and COVID-19 severity (beta = - 0.28, P-value = 0.01 for Se; beta = - 0.26, P-value = 0.02). However the significance disappeared after adjusting for confounding factors. Spearman correlation analysis showed a significant negative association between serum Zn, Se and CRP level (r = - 0.35, P-value = 0.001 for Se; r = - 0.41, P-value < 0.001 for Zn). Conclusion Results suggest that increasing levels of Se and Zn were accompanied by a decrease in serum CRP level. However, the significant association between Se, Zn, and disease severity was lost after adjusting for confounding factors.

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