The Relation Between Trace Element Status (Zinc, Copper, Magnesium) and Clinical Outcomes in COVID-19 Infection During Pregnancy

Anuk, Ali Taner; Polat, Naci; Akdas, Sevginur; Erol, Seyit Ahmet; Tanaçan, Atakan; Biriken, Derya; Keskin, Hüseyin Levent; Tekın, Özlem Moraloğlu; Yazıhan, Nuray; Şahın, Dilek

doi:10.1007/s12011-020-02496-y

Cited by 61 publications

(80 citation statements)

References 30 publications

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“…Our finding is consistent with that of a prospective observational study conducted on COVID-19 inpatients at the time of hospitalization, which reported that the serum concentration of zinc was significantly lower in patients compared to healthy controls [48]. Additionally, a recent study in Turkey reported that in the first trimester of pregnancy, the serum concentration of zinc was significantly lower in pregnant women with COVID-19 compared to controls [49]. Moreover, a single-center study carried out on hospitalized patients with COVID-19 found that the serum concentration of zinc was significantly lower in patients who died than those who were admitted to an intensive care unit (ICU) or non-ICU and survived.…”

Section: Discussionsupporting

confidence: 92%

The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study

Golabi¹,

Adelipour

Mobarak³

et al. 2021

Nutrients

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Vitamin D and zinc are important components of nutritional immunity. This study compared the serum concentrations of 25-hydroxyvitamin D (25(OH)D) and zinc in COVID-19 outpatients with those of potentially non-infected participants. The association of clinical symptoms with vitamin D and zinc status was also examined. A checklist and laboratory examination were applied to collect data in a cross-sectional study conducted on 53 infected outpatients with COVID-19 and 53 potentially non-infected participants. Serum concentration of 25(OH)D were not significantly lower in patients with moderate illness (19 ± 12 ng/mL) than patients with asymptomatic or mild illness (29 ± 18 ng/mL), with a trend noted for a lower serum concentration of 25(OH)D in moderate than asymptomatic or mild illness patients (p = 0.054). Infected patients (101 ± 18 µg/dL) showed a lower serum concentration of zinc than potentially non-infected participants (114 ± 13 µg/dL) (p = 0.01). Patients with normal (odds ratio (OR), 0.19; p ≤ 0.001) and insufficient (OR, 0.3; p = 0.007) vitamin D status at the second to seventh days of disease had decreased OR of general symptoms compared to patients with vitamin D deficiency. This study revealed the importance of 25(OH)D measurement to predict the progression of general and pulmonary symptoms and showed that infected patients had significantly lower zinc concentrations than potentially non-infected participants.

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Section: Discussionsupporting

confidence: 92%

The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study

Golabi¹,

Adelipour

Mobarak³

et al. 2021

Nutrients

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show abstract

“…In humans, copper is involved in the structure of cytochrome C-oxidase and in oxidative stress-related steps, but high copper levels may have adverse effects during inflammation. The balance between zinc and copper is important for zinc to neutralize the adverse effects that copper can cause [24,41]. Therefore, we thought that the Zn/Cu ratio would be worth examining.…”

Section: Resultsmentioning

confidence: 99%

“…However, some people experience the disease in a mild asymptomatic phase, while others experience the disease in a severe symptomatic phase, which is another mystery of the disease that awaits scientific answers [20,21]. In our literature review, we found studies comparing urine [22] and serum trace element levels [21,23] and biochemical parameters (with another disease) [24] of COVID-19 patients with control groups. However, no study has been found showing how COVID-19 disease changes simultaneously with both biochemical parameters and serum trace element concentrations, according to the severity of the disease.…”

Section: Introductionmentioning

confidence: 95%

Evaluation of Serum Trace Element Levels and Biochemical Parameters of COVID-19 Patients According to Disease Severity

Koçak

Özgeriş

Parlak

et al. 2021

Biol Trace Elem Res

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While the COVID-19 disease progresses mildly or asymptomatically in some people, its progression is severe and symptomatic in others, and it is an issue that requires a scientific response regarding the disease. The present study includes 60 people infected with COVID-19, and the cases were divided into the following groups: asymptomatic, mild, moderate, and severe. Serum Zn, Se, and Cu levels of these groups were analyzed by ICP-MS. All measurements in the patients were compared with those of 32 healthy individuals. When the patient group is compared with the control group, the serum Zn and Se concentrations were statistically low ( p < 0.001) in the patient group. Serum Zn level decreased significantly in 4 different patient groups compared to the control group. Although the serum Se level decreased in all four patient groups compared to the control group, the change in Se level was statistically significant only in the severe and mild patient groups. This study examined serum Zn, Se concentrations, and biochemical parameters in patients with different severity of COVID-19, compared them with healthy individuals, and revealed new targets for diagnosis and treatment by revealing those data that may be important.

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“…Pregnant women with COVID-19 have been reported to display a trimester-dependent increase in serum Cu concentrations, with small deviations only in comparison to healthy control pregnancies [34]. Interestingly, serum Cu was elevated in the pregnant women with COVID-19 specifically in the first and third trimester, but not in the middle of pregnancy [34]. Whether these dynamics constitute a positive and pregnancy-supporting response is unknown at present.…”

Section: Discussionmentioning

confidence: 99%

“…Whether supplemental Se will yield positive health effects in COVID-19 remains to be studied. The data base on Zn in COVID-19 is similarly limited, and low Zn concentrations are observed in severely diseased patients [33,34]. In contrast to the declining Se status in non-surviving patients, serum Zn levels seem to recover in COVID-19 during the hospital stay, indicative of a redistribution between circulation and immune cells [29].…”

Section: Introductionmentioning

confidence: 99%

Relation of Serum Copper Status to Survival in COVID-19

et al. 2021

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The trace element copper (Cu) is part of our nutrition and essentially needed for several cuproenzymes that control redox status and support the immune system. In blood, the ferroxidase ceruloplasmin (CP) accounts for the majority of circulating Cu and serves as transport protein. Both Cu and CP behave as positive, whereas serum selenium (Se) and its transporter selenoprotein P (SELENOP) behave as negative acute phase reactants. In view that coronavirus disease (COVID-19) causes systemic inflammation, we hypothesized that biomarkers of Cu and Se status are regulated inversely, in relation to disease severity and mortality risk. Serum samples from COVID-19 patients were analysed for Cu by total reflection X-ray fluorescence and CP was quantified by a validated sandwich ELISA. The two Cu biomarkers correlated positively in serum from patients with COVID-19 (R = 0.42, p < 0.001). Surviving patients showed higher mean serum Cu and CP concentrations in comparison to non-survivors ([mean+/-SEM], Cu; 1475.9+/-22.7 vs. 1317.9+/-43.9 µg/L; p < 0.001, CP; 547.2.5 +/- 19.5 vs. 438.8+/-32.9 mg/L, p = 0.086). In contrast to expectations, total serum Cu and Se concentrations displayed a positive linear correlation in the patient samples analysed (R = 0.23, p = 0.003). Serum CP and SELENOP levels were not interrelated. Applying receiver operating characteristics (ROC) curve analysis, the combination of Cu and SELENOP with age outperformed other combinations of parameters for predicting risk of death, yielding an AUC of 95.0%. We conclude that the alterations in serum biomarkers of Cu and Se status in COVID-19 are not compatible with a simple acute phase response, and that serum Cu and SELENOP levels contribute to a good prediction of survival. Adjuvant supplementation in patients with diagnostically proven deficits in Cu or Se may positively influence disease course, as both increase in survivors and are of crucial importance for the immune response and antioxidative defence systems.

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The Relation Between Trace Element Status (Zinc, Copper, Magnesium) and Clinical Outcomes in COVID-19 Infection During Pregnancy

Cited by 61 publications

References 30 publications

The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study

The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study

Evaluation of Serum Trace Element Levels and Biochemical Parameters of COVID-19 Patients According to Disease Severity

Relation of Serum Copper Status to Survival in COVID-19

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