Low zinc levels at admission associates with poor clinical outcomes in SARS-CoV-2 infection

Vogel-González, Marina; Talló Parra, Marc, 1992-; Herrera-Fernández, Víctor; Pérez Vilaró, Gemma, 1985-; Chillón, Miguel; Nogués Solán, Xavier; Gómez-Zorrilla, Silvia; López Montesinos, Inmaculada; Arnau-Barrés, Isabel; Sorli Redó, M. Luisa; Horcajada Gallego, Juan Pablo; García-Giralt, Natalia; Pascual Santos, Julio; Díez Antón, Juana, 1962-; Vicente García, Rubén, 1978-; Güerri Fernández, Roberto

doi:http://dx.doi.org/10.3390/nu13020562

Low zinc levels at admission associates with poor clinical outcomes in SARS-CoV-2 infection

Citation

Vogel-González M, Talló-Parra M, Herrera-Fernández V, Pérez-Vilaró G, Chillón M, Nogués X et al. Low zinc levels at admission associates with poor clinical outcomes in SARS-CoV-2 infection. Nutrients. 2021 Feb 9;13(2):562. DOI: 10.3390/nu13020562

Abstract

Background: Zinc is an essential micronutrient that impacts host-pathogen interplay at infection. Zinc balances immune responses, and also has a proven direct antiviral action against some viruses. Importantly, zinc deficiency (ZD) is a common condition in elderly and individuals with chronic diseases, two groups with an increased risk for severe severe coronavirus disease 2019 (COVID-19) outcomes. We hypothesize that serum zinc content (SZC) influences COVID-19 disease progression, and thus might represent a useful biomarker. Methods: We ran an observational cohort study with 249 COVID-19 patients admitted in Hospital del Mar. We have studied COVID-19 severity and progression attending to SZC at admission. In parallel, we have studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) replication in the Vero E6 cell line modifying zinc concentrations. Findings: Our study demonstrates a correlation between serum zinc levels and COVID-19 outcome. Serum zinc levels lower than 50 µg/dL at admission correlated with worse clinical presentation, longer time to reach stability, and higher mortality. Our in vitro results indicate that low zinc levels favor viral expansion in SARS-CoV-2 infected cells. Interpretation: Low SZC is a risk factor that determines COVID-19 outcome. We encourage performing randomized clinical trials to study zinc supplementation as potential prophylaxis and treatment with people at risk of zinc deficiency.