Serious coronavirus 2 (SARS-CoV-2) infections with acute respiratory syndrome can have a variety of consequences, from asymptomatic to mild symptoms and severe pathologies such as pneumonia and acute shortness of breath, which can potentially be fatal. Therefore, it is very important that we identify the biomarkers that predict serious diseases in the early stages of infection. Finding biomarkers for predicting the results of Coronavirus Disease 2019 (COVID-19) will help improve prognosis and treatment.
A team of researchers from various universities and institutes in Spain recently published an article on the preprint server medRxiv *, in which they hypothesized that serum zinc levels have a significant influence on COVID-19 progression and therefore a useful biomarker for prediction more serious illnesses could be in the early stages of COVID-19 infection.
Role of zinc in our immune system
Zinc is a trace element in our body that plays various roles that are essential for the maintenance of various basic biological processes. Zinc acts as a signaling molecule, cofactor and structural element. One of the most important roles zinc plays in the human body is its effect on our immune system. Zinc levels affect both innate and adaptive immunity. Zinc balances our immune responses and has a direct antiviral effect against some viruses.
Zinc deficiency is caused by poor zinc intake or malabsorption of zinc. It’s common in the elderly and those with underlying medical conditions, two groups more prone to severe COVID-19. As a result, zinc deficiency creates an imbalance in the immune system that can ultimately lead to a major public health concern that affects those at risk even more.
The study shows a strong correlation between serum zinc levels and severe COVID-19
The research team conducted a retrospective observational study of 249 COVID-19 patients admitted to the Hospital del Mar. They examined the severity of COVID-19 and the progression of the disease in the enrolled patients. In parallel, they analyzed the replication of the SARS-CoV-2 virus in the Vero E6 cell line at various zinc concentrations.
The results of their study showed a correlation between the COVID-19 result and serum zinc levels. Patients with serum zinc levels less than 50 mcg / dL, which defines the cut-off point for zinc deficiency and the development of related clinical symptoms, had poorer clinical presentation at the time of admission, took longer to achieve stability, and also had higher mortality. In vitro results of the study show that lower zinc levels favor virus expansion in cells infected with SARS-CoV-2.
“These results would support that the poor clinical outcome seen in patients with low SZC is caused by the effect of ZD on both, resulting in an imbalance in the immune system and an increase in viral load by increasing the extent of the virus in the infected Cell is promoted. “
Zinc supplementation in risk groups can help reduce the severity of COVID-19
The relationship between serum zinc levels and human health is well known. Zinc deficiency remains a major nutritional problem in many countries, as poor nutrition leads to low zinc intake. Even in developed countries, zinc deficiency is common among 15 to 31% of the elderly.
According to the authors, their work aims to clinically examine serum zinc concentration in COVID-19 patients. Their analysis shows a strong correlation between low serum zinc levels and COVID-19 severity and mortality. They believe the reason for this could be a combination of an immune system imbalance and improved virus replication in zinc-deficient patients. So they are suggesting serum zinc levels as a new biomarker that can help predict COVID-19 results.
The researchers believe there is an urgent need to supplement zinc-deficient patients with zinc during intake in order to bring their zinc levels to a normal range. They also recommended prophylactic zinc supplementation in high-risk groups like the elderly to help reduce the severity of COVID-19.
The authors encourage future studies that conduct randomized clinical trials to evaluate the effects of zinc supplementation as a potential prophylaxis and also as a therapeutic approach in people at risk for zinc deficiency.
“It should also be recommended to promote zinc supplement programs that target those at risk of zinc deficiency such as the elderly in order to reduce the severity of COVID-19.”
* Important NOTE
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, guide clinical practice / health-related behavior, or be treated as established information.
- Low zinc levels on clinical admission are linked to poor results in COVID-19 Marina Vogel, Marc Tallo-Parra, Victor Herrera-Fernandez, Gemma Perez-Vilaro, Miguel Chillon, Xavier Nogues, Silvia Gomez-Zorrilla, Inmaculada Lopez-Montesinos, and Judit Villar Maria Luisa Sorli-Redo, Juan Pablo Horcajada, Natalia Garcia-Giralt, Julio Pascual, Juana Diez, Ruben Vicente, Robert Guerri-Fernandez medRxiv 2020.10.07.20208645; doi: https://doi.org/10.1101/2020.10.07.20208645, https://www.medrxiv.org/content/10.1101/2020.10.07.20208645v1