Trace Elements as Immunoregulators in SARS-CoV-2 and Other Viral Infections

Dharmalingam, K.; Birdi, Amandeep; Tomo, Sojit; Sreenivasulu, Karli; Charan, Jaykaran; Yadav, Dharamveer; Purohit, Purvi; Sharma, Praveen

doi:10.1007/s12291-021-00961-6

Cited by 46 publications

(50 citation statements)

References 95 publications

(88 reference statements)

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“…Further, the zinc deficiency also results in lymphoid atrophy and decreased T cell immunity. So, any imbalance of Zn also adversely affects immune functions [26]. In this study, serum zinc levels were found to be significantly decreased in the severe group when compared to mild, moderate and controls.…”

Section: Discussionmentioning

confidence: 44%

“…In vitro studies showed that SARS-CoV-2 viral spike protein interacts with ACE2 receptor, which is a zinc-dependent peptidyl dipeptide hydrolase. So, any imbalance of Zn adversely affects immune functions [26,27]. Previous studies also reported that a decrease in zinc levels supports the ACE2 to SARS-CoV-2 spike protein and an increase will inhibit the ACE2 expression resulting in reduced viral interaction [28].…”

Section: Discussionmentioning

confidence: 97%

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Comparative Analysis of Serum Zinc, Copper and Magnesium Level and Their Relations in Association with Severity and Mortality in SARS-CoV-2 Patients

PVSN

Tomo

Purohit

et al. 2022

Biol Trace Elem Res

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The deficiencies of trace elements and infectious diseases often coexist and exhibit complex interactions. Several trace elements such as zinc (Zn), copper (Cu) and magnesium (Mg) have immunomodulatory functions and thus influence the susceptibility to the course and outcome of a variety of viral infections. So, this present study was aimed to study relations of trace metals in association with severity and mortality in SARS-CoV-2 patients. A total of 150 individuals infected with COVID-19 and 50 healthy individuals were recruited. Cases were divided based on severity (mild, moderate and severe) and outcome (discharged or deceased). Serum Zn, Mg and Cu levels were analysed by direct colourimetric method. Both serum Cu and Zn levels were significantly decreased in cases when compared to those in controls ( p < 0.005 and p < 0.0001). Serum magnesium levels although not significant were found to be slightly decreased in controls. On comparing the trace elements between the deceased and discharged cases, a significant difference was found between serum copper and zinc levels, but for magnesium, both groups have similar levels. The receiver operating characteristic (ROC) curve results indicate that a serum Cu/Zn ratio along with the age of patient provides some reliable information on COVID-19 course and survival odds by yielding an AUC of 95.1% with a sensitivity of 93.8% and specificity of 89.8%. Therefore, we would like to emphasize that measuring the serum copper and zinc along with their ratio can be used as routine investigations for COVID-19 patients in proper identification and management of severe cases in upcoming new waves of COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s12011-022-03124-7.

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Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 97%

Comparative Analysis of Serum Zinc, Copper and Magnesium Level and Their Relations in Association with Severity and Mortality in SARS-CoV-2 Patients

PVSN

Tomo

Purohit

et al. 2022

Biol Trace Elem Res

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“…Furthermore, in this study, the probability of finding leukocytosis (OR 8) in patients with abnormal serum Cu was higher than those with normal Cu levels. Copper plays a crucial role in the development, maturation, and proper functioning of the immune system [94]. The maturing immune system relies on Cu and Zn [95], especially for antibody production (both Cu and Zn), function of neutrophils and monocytes (Cu) [96], and the viability, proliferation, and differentiation of cells of both the innate and adaptive immune system (Zn), as well as for the maintenance of skin and mucosal barriers (Zn) [95,96].…”

Section: Blood Analysis and Inflammatory Responsementioning

confidence: 99%

Copper and Copper/Zn Ratio in a Series of Children with Chronic Diseases: A Cross-Sectional Study

et al. 2021

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Copper is an essential micronutrient for humans. A cross-sectional and comparative study was done to assess serum Cu levels and serum copper/zinc (Cu/Zn) ratio and its association with nutritional indicators in a series of children and adolescents with chronic diseases. Anthropometric, biochemical, dietary, body composition, and bone densitometry assessments were carried out. Serum Cu and Zn were measured by atomic absorption spectrophotometry. Seventy-eight patients (55% women) participated. The mean serum Cu in the entire series and by nutritional status through body mass index (BMI) was normal. Serum Cu decreased significantly with age and was meaningfully higher in children than in adolescents. The risk of finding altered Cu levels in children and men was higher than in adolescents and women, respectively. Twenty-two per cent of patients had abnormal serum copper levels, 13 had hypercupremia, and four had hypocupremia. The Cu/Zn ratio was greater than 1.00 for 87% of the patients, which is an indicator of an inflammatory state. All patients with hypozincemia and hypocupremia had deficient Zn intake, but only 65% of the patients with hypercupremia had dietary Zn deficiency. Consequently, the Cu/Zn ratio could indicate an inflammatory state and a high risk of zinc deficiency in this specific child population.

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“…Previous studies have shown that micronutrient balance is essential for enhancing immune response and improving antiviral function [29]. Micronutrients, such as selenium and iron, have immunomodulatory functions and can influence susceptibility to various viral infections [30]. Selenium is essential for the proliferation and differentiation of immune cells [16].…”

Section: Discussionmentioning

confidence: 99%

Micronutrient Level Is Negatively Correlated with the Neutrophil-Lymphocyte Ratio in Patients with Severe COVID-19

Zhou

Zhang

Chen

et al. 2022

International Journal of Clinical Practice

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Aim. To explore the potential relationship between NLR and micronutrient deficiency in patients with severe COVID-19 infection. Methods. Sixteen patients were categorized into the mild group (mild COVID-19) and severe group (severe COVID-19) based on the guideline of the management of COVID-19. The lactate dehydrogenase (LDH); superoxide dismutase (SOD), the inflammatory markers (neutrophil lymphocyte ratio (NLR)), erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), selenium (Se), iron (Fe), zinc (Zn), nickel (Ni), copper (Cu), chromium (Cr), cadmium (Cd), arsenic (As), and manganese (Mn) were measured in the blood. Results. Compared to the mild group, the NLR ( P < 0.05 ) and the level of Se ( P < 0.01 ), Fe ( P < 0.05 ), and Zn ( P < 0.05 ) were significantly decreased in the severe group. The level of Se, Fe, and Zn was significantly correlated to NLR levels. Furthermore, close positive correlation was found between NLR and severity of COVID-19. Conclusion. The micronutrient deficiency in the blood is associated with NLR in the severity of COVID-19 patients.

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Trace Elements as Immunoregulators in SARS-CoV-2 and Other Viral Infections

Cited by 46 publications

References 95 publications

Comparative Analysis of Serum Zinc, Copper and Magnesium Level and Their Relations in Association with Severity and Mortality in SARS-CoV-2 Patients

Comparative Analysis of Serum Zinc, Copper and Magnesium Level and Their Relations in Association with Severity and Mortality in SARS-CoV-2 Patients

Copper and Copper/Zn Ratio in a Series of Children with Chronic Diseases: A Cross-Sectional Study

Micronutrient Level Is Negatively Correlated with the Neutrophil-Lymphocyte Ratio in Patients with Severe COVID-19

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