The role of micronutrient deficiency in the pathogenesis of COVID-19 has been reviewed in the literature; however, the data are limited and conflicting. This study investigated the association between the status of essential metals, vitamins, and antioxidant enzyme activities in COVID-19 patients and disease severity. We recruited 155 patients, who were grouped into four classes based on the Adults guideline for the Management of Coronavirus Disease 2019 at King Faisal Specialist & Research Centre (KFSH&RC): asymptomatic (N = 16), mild (N = 49), moderate (N = 68), and severe (N = 22). We measured serum levels of copper (Cu), zinc (Zn), selenium (Se), vitamin D 3 , vitamin A, vitamin E, total antioxidant capacity, and superoxide dismutase (SOD). Among the patients, 30%, 25%, 37%, and 68% were deficient in Se (\ 70.08 lg/L), Zn (\ 0.693 lg/mL), vitamin A (\ 0.343 lg/mL), and vitamin D 3 (\ 20.05 lg/L), respectively, and SOD activity was low. Among the patients, 28% had elevated Cu levels ([ 1.401 lg/mL, KFSH&RC upper reference limit). Multiple regression analysis revealed an 18% decrease in Se levels in patients with severe symptoms, which increased to 30% after adjusting the model for inflammatory markers. Regardless of inflammation, Se was independently associated with COVID-19 severity. In contrast, a 50% increase in Cu levels was associated with disease severity only after adjusting for C-reactive protein, reflecting its possible inflammatory and pro-oxidant role in COVID-19 pathogenesis. We noted an imbalance in the ratio between Cu and Zn, with * 83% of

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Background Despite the negative effects of tobacco use, Saudi Arabia is one of the leading causes of death globally. In Saudi Arabia, 17.1% of both sexes and 3.0% of females aged 15 or older smoke. One common way to consume tobacco is through a shisha (waterpipe). This study aims to measure the knowledge of the negative health effects and attitudes toward shisha use among health college students at Princess Nourah University (PNU) in Riyadh, Saudi Arabia. Method A descriptive, cross-sectional study was conducted at PNU’s health colleges, with the 525 student participants selected evenly from each college by using cluster sampling into five health colleges(College of Health and Rehabilitation Sciences, Nursing, Dentistry, Medicine and Pharmacy), data was collected by a pretested, structured questionnaire and was coded, entered and analyzed by Statistical Package for the Social Sciences (SPSS) v.20. Results 15.4% is the percentage for who had a history of smoked shisha. The percentage of current smokers was 4.19%. There was no association between the knowledge and shisha smoking practice ( P = .603). Conclusion In conclusion, the percentage of shisha smoking was high, in spite of having a high level of knowledge. Also, the knowledge toward shisha smoking and shisha practice was not associated. In contrast to a study conducted in USA which showed a slight association between the knowledge and smoking practice. (44)

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