Correlation between Micronutrient plasma concentration and disease severity in COVID-19 patients

ABSTRACT

Objectives

Coronavirus Disease 2019 (COVID-19) is caused by a new strain of betacoronavirus called SARS-CoV-2, which leads to mild to severe symptoms. Micronutrients in blood serum, namely, zinc, iron, copper, and selenium, play essential roles in the human body’s various organs. This study investigates the association between micronutrient levels and the severity of symptoms in SARS-CoV-2 infected patients.

Methods

A cross-section study was conducted during June–August 2020 in Riyadh city among 80 patients with confirmed SARS-CoV-2 infection. Within 24 hours of hospital admission, patients have been divided into non-severe and severe cases, and blood samples were drawn from each patient to measure the serum levels of copper, iron “in the form of ferritin,” selenium, and zinc.

Results

In both study groups, the mean copper and selenium serum levels were within the normal range, while the mean zinc and iron serum levels were elevated. A statistically significant difference was recorded between non-severe and severe cases regarding serum levels of iron and selenium (331.24 vs. 1174.95 ng/ml and 134 vs. 162 mcg/L, respectively, P < 0.0001). On the other hand, no significant difference was detected between both studied groups regarding serum level of zinc and copper (124.57 vs. 116.37 mcq/L and 18.35 vs. 18.2 mcmol/L, respectively, P > 0.05).

Conclusions

There was a significant elevation of selenium and iron serum levels among severe cases compared to non-severe cases of COVID-19. High levels of iron and selenium could be correlated with the disease severity during infection with SARS-CoV-2.

KEYWORDS:

• COVID-19
• sars-CoV-2
• micronutrients
• immune system
• oxidative stress

Acknowledgments

Special thanks to Dr. Nagla Eltigani and Dr. Yousef Albalawi (Saudi Ministry of Health) for their support to complete this study.

Disclosure statement

The authors have no conflict of interest.

Additional information

Notes on contributors

Abdullah Alkattan

Abdullah Alkattan, Pharm.D, MSc. Pharmacology Candidate. Medical title and work: Clinical Pharmacist, Department of Research and Development, General Directorate of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia.Academic title and work: MSc. Pharmacology Candidate, Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Hofuf, Al-Ahsa, Saudi Arabia.

Khaled Alabdulkareem

Khaled Alabdulkareem, MBBS, SBFM, ABFM.Medical title and work: Consultant of Diabetes & Family Medicine, Department of Research, Assistant Deputy Ministry for Primary Healthcare, Ministry of Health, Riyadh, Saudi Arabia.Academic title and work: Assistant Professor of Diabetes and Family Medicine, Department of Family Medicine, College of Medicine, Al-Imam Mohammad Bin Saud Islamic University, Riyadh, Saudi Arabia.

Amr Kamel

Amr Kamel, MBBS, MSc. Gynecology and Obstetrics.Medical title and work: Gynecology and Obstetrics specialist, Department of Ghubairah Mobile Team, Tuberculosis Control Program, First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia.

Heba Abdelseed

Heba Abdelseed, MBBS, Community Medicine.Medical title and work: Community Medicine Specialist, Department of Ghubairah Mobile Team, Tuberculosis Control Program, First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia.

Yousef Almutairi

Yousef Almutairi, Pharm.D.Medical title and work: Clinical Pharmacist, Clinical Pharmacist, Department of Research and Development, General Directorate of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia. 

Eman Alsalameen

Eman Alsalameen, Pharm.D. Medical title and work: Pharmacist, Department of Pharmacy, King Khalid University Hospital, Medical City King Saud University, Riyadh, Saudi Arabia.