Low serum zinc level: The relationship with severe pneumonia and survival in critically ill children

Saleh, Nagwan Y.; Fotoh, Wafaa Moustafa M. Abo El

doi:10.1111/ijcp.13211

Cited by 28 publications

(40 citation statements)

References 38 publications

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“…Zinc supplementation is also effective in decreasing oxidative stress [ 245 , 246 ], in shortening the duration of cold symptoms in adults [ 247 ], and was found to have a direct antiviral effect on RSV [ 248 ], Dengue virus [ 249 ], and coronaviruses [ 250 ]. Lastly, some authors suggested that a combination of chloroquine with zinc might enhance chloroquine’s toxicity on viruses [ 249 , 250 , 251 , 252 ]. Te Velthius et al [ 249 ] reported that the combination of Zn2+ and zinc-ionophores like pyrithione can increase the intracellular Zn2+ concentration, and thus inhibits the replication of SARS-coronavirus (SARS-CoV) and equine arteritis virus in cell culture.…”

Section: Zincmentioning

confidence: 99%

“…In a 2018 study, serum zinc levels were found to be significantly lower among pneumonia pediatric patients admitted to PICU compared with patients admitted to other wards; there was a statistically significant decrease in zinc level in critically ill children complicated by sepsis, mechanically ventilated and fatal cases [ 252 ]. Some studies reported similar duration of hospital stay, time to symptoms resolution, and risk of treatment failure in the intervention and in the control group [ 254 , 255 , 256 , 258 , 259 , 262 , 264 , 265 ], while others described partially positive results.…”

Section: Zincmentioning

confidence: 99%

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The Role of Micronutrients in Support of the Immune Response against Viral Infections

et al. 2020

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Viral infections are a leading cause of morbidity and mortality worldwide, and the importance of public health practices including handwashing and vaccinations in reducing their spread is well established. Furthermore, it is well known that proper nutrition can help support optimal immune function, reducing the impact of infections. Several vitamins and trace elements play an important role in supporting the cells of the immune system, thus increasing the resistance to infections. Other nutrients, such as omega-3 fatty acids, help sustain optimal function of the immune system. The main aim of this manuscript is to discuss of the potential role of micronutrients supplementation in supporting immunity, particularly against respiratory virus infections. Literature analysis showed that in vitro and observational studies, and clinical trials, highlight the important role of vitamins A, C, and D, omega-3 fatty acids, and zinc in modulating the immune response. Supplementation with vitamins, omega 3 fatty acids and zinc appears to be a safe and low-cost way to support optimal function of the immune system, with the potential to reduce the risk and consequences of infection, including viral respiratory infections. Supplementation should be in addition to a healthy diet and fall within recommended upper safety limits set by scientific expert bodies. Therefore, implementing an optimal nutrition, with micronutrients and omega-3 fatty acids supplementation, might be a cost-effective, underestimated strategy to help reduce the burden of infectious diseases worldwide, including coronavirus disease 2019 (COVID-19).

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Section: Zincmentioning

confidence: 99%

Section: Zincmentioning

confidence: 99%

The Role of Micronutrients in Support of the Immune Response against Viral Infections

et al. 2020

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“…There are some previous studies that investigated the relationship between levels of serum Cu and Zn and prognosis in sepsis or septic shock and demonstrated that the higher mortality was correlated with higher serum Cu and lower serum Zn (29,43), but this correlation was not be found in the research of Ayoglu et al in Turkey (26). In contrast, although the 28-day mortality was not signi cant difference between non-SIMD and SILVSD groups, compared with survivors with septic shock, we discovered that the increased levels of whole blood Cu and the reduced levels of whole blood Zn existed in non-survivors with septic shock, which is consistent with previous studies (29,43). After analysis of the correlations between whole blood Cu and Zn and APACHE-II score and SOFA score by Pearson line correlation, we found whole blood Cu was positively correlated with APACHE-II score and SOFA score and whole blood Zn was negatively correlated with APACHE-II score and SOFA score.…”

Section: Discussionmentioning

confidence: 94%

“…Meanwhile, trace elements including copper (Cu) and zinc (Zn) play signi cant roles in anti-oxidant defence system as they can scavenge oxygen free radicals and prevent oxidative damage. Studies in human patients and animal models shown that lower level of serum Zn was associated with severe pneumonia and sepsis and could increase sensitivity for infection and sepsis (18,19). As for serum Cu, it was reported that people with high levels of serum Cu were liable to suffer from myocardial infarction(MI), hypertension, cancer, chronic obstructive pulmonary disease(COPD) and infection (20,21).…”

Section: Introductionmentioning

confidence: 99%

The Correlation Between Whole Blood Copper and Zinc Levels and Sepsis-Induced Left Ventricular Systolic Dysfunction (SILVSD) in Patients with Septic Shock: A Single-Center Prospective Observational Study

Meng¹,

Hu²,

Zhang³

et al. 2020

Preprint

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Background: The dyshomeostasis of trace elements is associated with multiple organ dysfunction in patients with septic shock. However, it remains unclear whether the change of whole blood copper (Cu) and zinc (Zn) levels influence cardiac function in patients with septic shock. Here, we sought to explore relationship between whole blood Cu and Zn and cardiac dysfunction in septic shock. Methods: Between April 2018 and March 2020, septic shock patients with sepsis-induced left ventricular systolic dysfunction (SILVSD, left ventricular ejection fraction, LVEF ＜ 50%) and with no sepsis-induced myocardial dysfunction (non-SIMD, septic shock alone and LVEF＞ 50%) on an intensive care unit (ICU) in south China and healthy controls were prospectively enrolled. whole blood Cu and Zn levels were measured using flame atomic absorption spectrophotometry.Results: 86 patients with septic shock including 41 SILVSD and 45 non-SIMD and 25 healthy controls were studied. Whole blood Cu levels were significantly higher and Zn were significantly lower in SILVSD compared with non-SIMD and controls [Cu, (16.34±1.93) vs. (15.23±2.07) vs. (14.02±1.65) µmol/L, p = 0.009, < 0.001; Zn, (78.45±12.18) vs. (85.07±14.80) vs. (94.90±14.78) µmol/L, p = 0.029, < 0.001]. Both increased whole blood Cu and reduced Zn were associated with lower LVEF ( all p < 0.001) and higher amino-terminal pro-B-type natriuretic peptide (NT-proBNP) (Cu, p = 0.002, Zn, p = 0.001), and had predictive values for SILVSD [Cu, (AUC = 0.666; p = 0.005) ; Zn, (AUC = 0.625; p = 0.039)]. Whole blood Cu levels were increased but Zn were reduced in non-survivors compared with survivors[Cu, (17.20 ±2.25) vs. (14.99 ±1.49) µmol/L, p < 0.001; Zn, (71.17 ±11.98) vs. (87.67±11.30) µmol/L, p < 0.001],. Whole blood Cu and Zn displayed the value of predicting 28-day mortality [Cu (AUC = 0.802, p < 0.001); Zn (AUC = 0.869, p < 0.001)].Conclusions: Whole blood Cu levels were increased in SILVSD patients and positively correlated with the cardiac dysfunction while Whole blood Zn were reduced and negatively associated with the cardiac dysfunction. Moreover, both whole blood Cu and Zn could distinguish between SILVSD and non-SIMD in septic shock patients and predict 28-day mortality.Trial registration: ChiCTR1800015709. Registered 16 April 2018, http://www.chictr.org.cn/edit.aspx?pid=26746&htm=4.

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“…In addition, deficiencies in other substrates, including vitamin D and zinc (30,31), have been associated with the development of respiratory tract infections and pneumonia; however, we did not measure the serum levels of these components. Further studies are required.…”

Section: Discussionmentioning

confidence: 99%

Effects of Nutritional Treatment on the Frequency of Pneumonia in Bedridden Patients Receiving Oral Care

et al. 2020

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Objective Pneumonia develops in bedridden patients, even in those receiving oral care, and malnutrition is associated with the development of pneumonia. We examined the effects of nutritional treatment on the prevention of pneumonia. Patients and MethodsWe retrospectively examined the effects of nutritional treatment on the prevention of pneumonia by analyzing the records of bedridden patients (n=68; mean age: 68.0 years) who stayed in a hospital for 2 years or longer. Results Among the analyzed patients, pneumonia developed in 52 (76%) patients, and the mean frequency of pneumonia was 1.6 times per year during the first year of stay. In a multivariate analysis, the serum albumin level at admission in the pneumonia group was lower than that in the non-pneumonia group. The frequency of pneumonia during the second year of stay was lower than that during the first year of stay. Serum levels of albumin and total protein (TP) at one year after admission were higher than those at admission in all analyzed patients, and in all patients (n=52) and elderly (! 65 years) patients (n=31) in the pneumonia group. The proportions of patients with hypoalbuminemia (<3.5 g/dL) and hypoproteinemia (<6.5 g/dL) at one year after admission were lower than those at admission. The increases in the proportions of patients presenting a reduced frequency of pneumonia were correlated with increases in the proportions of patients presenting increased levels of albumin and/or TP. Conclusion Nutritional treatment may reduce the frequency of pneumonia by improving malnutrition in bedridden patients receiving oral care.

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Low serum zinc level: The relationship with severe pneumonia and survival in critically ill children

Abstract: Zinc has both a diagnostic and a prognostic value for children with pneumonia.

Cited by 28 publications

References 38 publications

The Role of Micronutrients in Support of the Immune Response against Viral Infections

The Role of Micronutrients in Support of the Immune Response against Viral Infections

The Correlation Between Whole Blood Copper and Zinc Levels and Sepsis-Induced Left Ventricular Systolic Dysfunction (SILVSD) in Patients with Septic Shock: A Single-Center Prospective Observational Study

Effects of Nutritional Treatment on the Frequency of Pneumonia in Bedridden Patients Receiving Oral Care

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