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

Figures & data

Table 1. Baseline characteristics of patients

Variables	All COVID-19 cases (N = 80)	Non-severe cases (N = 45)	Severe cases (N = 35)	P-value
Mean age (in years)	51.54	43.7	58.2	0.0001
Older than 50 years (%)	54	30	70	0.0003
Mean body mass index (kg/m^2)	30	29.2	31.3	0.19
Saudi nationality (%)	54	58.8	50	0.57
Fever (%)	67.6	47	85	0.0003
Shortness of breath (SOB) (%)	67.6	35.3	95	0.0001
Respiratory rate (breath per minute)	25	21.5	28	0.0001
Diabetes (%)	45.9	41.2	50	0.57
Hypertension (%)	64.9	47	80	0.002
ACEI/ARBs use (%)	32.4	29.4	35	0.6
Antibacterial use (%)	64.9	64.7	65	0.9
Anti-platelet or anti-coagulant use (%)	64.9	52.9	75	0.055

Table 2. Mean levels of some lab tests among patients diagnosed with severe and non-severe symptoms of COVID-19

Lab tests -mean values-	All COVID-19 cases (N = 80)	Non-severe cases (N = 45)	Severe cases (N = 35)	P-value
WBCs (cells/mm^[3])	9010	9941	8079	0.17
RBCs (million/mm^[3])	4.66	4.55	4.78	0.2
Na (mmol/L)	137.25	138	136.58	0.16
K (mmol/L)	4.3	4.4	4.2	0.15
Ca (mmol/L)	2.04	2.11	1.99	0.01
Cl (mmol/L)	100.29	103.3	97.7	0.0014

Table 3. Mean serum levels of copper, ferritin, selenium, and zinc among patients diagnosed with severe and non-severe symptoms of COVID-19

Trace elements -mean values-	Normal Values	All COVID-19 cases (N = 80)	Non-severe cases (N = 45)	Severe cases (N = 35)	P-value
Copper (mcmol/L)	10–22	18.2	18.35	18.2	0.85
Iron -in the form of ferritin- (ng/ml)	12–300	776.53	331.24	1174.95	< 0.0001
Selenium (mcg/L)	70–150	138	134	162	< 0.0001
Zinc (mcg/dl)	66–110	121.78	124.57	116.37	0.16

Figure 1. Mean serum level of copper among patients diagnosed with severe and non-severe symptoms of COVID-19. * Normal range of copper in blood serum: 10–22 mcmol/L

Figure 2. Mean serum level of zinc among patients diagnosed with severe and non-severe symptoms of COVID-19. * Normal range of zinc in blood serum: 66–110 mcg/dl

Figure 3. Mean serum level of selenium among patients diagnosed with severe and non-severe symptoms of COVID-19. * Normal range of selenium in blood serum: 70–150 mcg/L

Figure 4. Mean serum level of ferritin among patients diagnosed with severe and non-severe symptoms of COVID-19. * Normal range of ferritin in blood serum: 12–300 ng/ml

Figure 5. Ferritin metabolism and pathway in causing multi-organ inflammation and damage

Figure 6. Products generated by free iron elements and drugs (deferoxamine, deferasirox or deferiprone) inhibiting its pathways. *ROS: Reactive Oxygen Species

Figure 7. Products generated by free selenium elements and drug (deferiprone) inhibiting its pathways

Maggini S, Pierre A, Calder P, et al. Immune function and micronutrient requirements change over the life course. Nutrients. 2018 Oct 17;10(10):1531.

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