Zinc deficiency as a possible risk factor for increased susceptibility and severe progression of Corona Virus Disease 19

Abstract

The importance of zinc for human health becomes obvious during zinc deficiency. Even mild insufficiencies of zinc cause alterations in haematopoiesis and immune functions, resulting in a pro-inflammatory phenotype and a disturbed redox metabolism. Although immune system malfunction is the most obvious effect, the functions of several tissue cell types are disturbed if zinc supply is limiting. Adhesion molecules and tight junction proteins decrease while cell death increases, generating barrier dysfunction and possibly organ failure. Taken together, zinc deficiency both weakens the resistance of the human body towards pathogens and at the same time increases the danger of an overactive immune response that may cause tissue damage. The case numbers of COVID-19 are still increasing, which is causing enormous problems for health systems and economies. There is an urgent need to reduce both the number of severe cases and the resulting deaths. While therapeutic options are still under investigation,and first vaccines have been approved, cost-effective ways to reduce the likelihood of or even prevent infection, and the transition from mild symptoms to more serious detrimental disease, are highly desirable. Nutritional supplementation might be an effective option to achieve these aims. In this review, we discuss known zinc deficiency effects in the context of an infection with SARS-CoV-2 and its currently known pathogenic mechanisms and elaborate on how severe pre-existing zinc deficiency may pre-dispose patients to a severe progression of COVID-19. First published clinical data on the association of zinc homeostasis with COVID-19 and registered studies in progress are listed.

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

“…Additionally, as mentioned in a recently published review study, zinc may have beneficial effects including a decreased susceptibility to infection in the current and future pandemics [51]. In contrast to our study results, a review study revealed that a pre-existing severe zinc deficiency predisposes patients to a stronger progression of SARS-CoV-2 infections, and even a mild zinc deficiency should be corrected to prevent a more severe viral infection [5]. However, in the present study, no significant difference was observed between the serum concentration of zinc and the severity of COVID-19 disease, which may be due to insufficient sample size.…”

“…While therapeutic options are still under investigation, and some vaccines have been approved, cost-effective ways to reduce the probability of or even prevent infection and the shift from mild symptoms to more serious detrimental disease are highly worthwhile [5].…”

Allicin, the Odor of Freshly Crushed Garlic: A Review of Recent Progress in Understanding Allicin’s Effects on Cells

“…This effect is zinc dependent and allicin increases [Zn 2+ ]cyt by causing intracellular Zn 2+ release from proteins by oxidizing the Cys residues which chelate it, e.g., from SOD-1, shown to be a major target for S-thioallylation in human Jurkat cells [90]. The importance of Zn 2+ for the immune system in relation to preventing severe COVID-19 has recently been reviewed [101].…”

Strengthening the immunity of the Swiss population with micronutrients: A narrative review and call for action

“…The antiviral property of zinc has been studied extensively, including coronavirus, hepatitis C virus, and HIV infections [70,71]. Pre-existing zinc deficiency may pre-dispose patients to a severe progression of COVID-19 [72,73]. Zinc supplementation may reduce the incidence of acute lower respiratory infection [74].…”