Journal Article

The association between serum levels of micronutrients and the severity of disease in patients with COVID-19

Bitarafan, Sama, Salahshour, Faeze, Amoozadeh, Laya, Abdollahi, Alireza, Beigmohammadi, Mohammad Taghi, Mahmoodi ali abadi, Maedeh, Soltani, Danesh, Motallebnejad, Zoya Asl

2021

Overview

•Low serum levels of vitamins B9, B12, C, and D, as well as magnesium and iron, were seen in patients with the coronavirus disease of 2019•Lower levels of vitamin D, zinc, and magnesium can induce more severe disease•We recommend addressing the deficiency of micronutrients to prevent severe coronavirus disease of 2019 This study aimed to compare the serum level of micronutrients with normal amounts, and assess their association with the severity of disease and inflammatory cytokines in patients with coronavirus disease 2019 (COVID-19). The present cross-sectional study included 60 patients admitted to the intensive care unit with COVID-19. We recorded data on demographic characteristics, anthropometric information, and medical history. Serum levels of inflammatory markers (erythrocyte sedimentation rate, C-reactive protein, interferon-gamma, tumor necrosis factor-alpha, interleukin-6), vitamins (A, B9, B12, C, D, E), and minerals (magnesium, zinc, iron) were measured. A radiologist assessed the severity of lung involvement according to patient computed tomography scans. The severity of illness was evaluated with the Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, oxygen saturation, and body temperature. Independent associations among the serum levels of micronutrients with the severity of COVID-19 were measured. Median patient age was 53.50 years (interquartile range, 12.75 years). Except for vitamin A and zinc, serum levels of other micronutrients were lower than the minimum normal. Patients with APACHE score ≥25 had a higher body mass index (P = 0.044), body temperature (P = 0.003), erythrocyte sedimentation rate (P = 0.008), C-reactive protein (P = 0.003), and lower oxygen saturation (P = 0.005), serum levels of vitamin D (P = < 0.001), and zinc (P = < 0.001) compared with patients with APACHE score <25. We found that lower serum levels of vitamin D, magnesium, and zinc were significantly and independently associated with higher APACHE scores (P = 0.001, 0.028, and < 0.001, respectively) and higher lung involvement (P = 0.002, 0.045, and < 0.001, respectively). Lower serum levels of vitamin D, zinc, and magnesium were involved in severe COVID-19.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Antioxidants / APACHE / Applied Nutritional Investigation / Blood / blood serum / Body mass index / Body size / Body temperature / C-reactive protein / Calciferol / Chemotherapy / Computed tomography / Coronaviruses / COVID-19 / COVID-19 infection / Cross-Sectional Studies / Cytokine / Cytokines / Dietary minerals / Dietary supplements / Disease transmission / Enzymes / Erythrocyte sedimentation rate / Erythrocytes / Evaluation / Humans / Immune system / Interferon / interferon-gamma / Interleukin 6 / iron / Laboratories / Lungs / Magnesium / medical history / Micronutrients / Middle Aged / Mineral / Minerals / Mortality / Normal distribution / nutrition / Oxygen / Oxygen content / Oxygen saturation / Patients / Proteins / SARS-CoV-2 / Serum levels / tumor necrosis factor-alpha / Tumor necrosis factor-TNF / Tumor necrosis factor-α / Viral diseases / Vitamin / Vitamin A / Vitamin B12 / Vitamin D / Vitamins / Zinc / γ-Interferon