Analysis of the predictive factors for a critical illness of COVID-19 during treatment － relationship between serum zinc level and critical illness of COVID-19 −

Abstract

Highlights Close relationship is found between low serum zinc and severe states of COVID-19. Hypozincemia critically contributes to aggravation of COVID-19. Serum zinc level can be predictive factor for critical illness of COVID-19. We would recommend oral medication of zinc salts to patients with COVID-19. Abstract Objectives Because most severely ill patients with COVID-19 in our hospital showed zinc deficiency, we aimed to examine the relationship between the patient’s serum zinc level and severe cases of COVID-19. Methods Serum zinc <70 µg/dL was defined as the criterion for hypozincemia, and patients continuously with serum zinc <70 µg/dL were classified in the hypozincemia cohort. To evaluate whether hypozincemia could be a predictive factor for critical illness of COVID-19, we performed the multivariate analysis by employing logistic regression analysis. Results Prolonged hypozincemia was found to be a risk factor for a severe case of COVID-19. In evaluating the relationship between the serum zinc level and severity of patients with COVID-19 by multivariate logistic regression analysis, critical illness can be predicted through the sensitivity and false specificity of an ROC curve with an error rate of 10.3% and AUC of 94.2% by only two factors: serum zinc value ( P = 0.020) and LDH value ( P = 0.026). Conclusions Proper management of the prediction results in this study can contribute to the establishment and maintenance of a safe medical system, taking the arrival of the second wave and spread of COVID-19 in the future into consideration.

The relation between serum D-dimer, ferritin and vitamin D levels, and dysgeusia symptoms, in patients with coronavirus disease 2019

“…5,6,16 Recently, Yasui et al reported that decreased levels of zinc, an activator of immune cells that regulate cell-mediated immunity, could be related to Covid-19 severity. 19 Moreover, Tan et al reported elevated CRP levels and ESR at a very early stage of Covid-19. 6 They suggested that elevated CRP levels and ESR could predict the occurrence of severe disease before CT findings.…”

“…reported that decreased levels of zinc, an activator of immune cells that regulate cell-mediated immunity, could be related to Covid-19 severity. 19 Moreover, Tan et al . reported elevated CRP levels and ESR at a very early stage of Covid-19.…”

“…The outbreak of coronavirus disease 2019 (Covid- 19), which is caused by the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was announced a pandemic in March 2020 by the World Health Organization. 1 The disease mainly affects the respiratory system and spreads via aerosols released during sneezing and coughing.…”

COVID-19 pandemic: Can zinc supplementation provide an additional shield against the infection?

“…In another uncontrolled case series study with COVID-19 patients, a high dose of oral zinc salt resulted in clinical recovery, improved oxygenation, and less shortness of breath among those patients [95] . A study conducted in Japan on 62 patients with COVID-19 showed a close association between low serum zinc level and severity of the disease [5] . The investigators also found serum zinc level as a predictive factor for a critical illness of patients with COVID-19 [5] .…”

“…Zinc deficiency is associated with a higher rate of infections, degenerative diseases, oral diseases, and behavioral disorders in humans [1] , [4] . Available information suggests that zinc deficiency is associated with increased disease severity of the COVID-19 [5] . In a comprehensive metal(loid)s analysis, compared to the non‐severe COVID‐19 patients, the whole blood chromium, calcium, and copper levels were higher, while the levels of zinc, magnesium, manganese, iron, lead, arsenic, and thallium were lower in the severe patients with COVID-19 [6] .…”