Abstract
Zinc deficiency is associated with impaired antiviral response, cytokine releasing syndrome (CRS), and acute respiratory distress syndrome. Notably, similar complications are being observed during severe SARS-CoV-2 infection. We conducted a prospective, single-center, observational study in a tertiary university hospital (CUB-Hôpital Erasme, Brussels) to address the zinc status, the association between the plasma zinc concentration, development of CRS, and the clinical outcomes in PCR-confirmed and hospitalized COVID-19 patients. One hundred and thirty-nine eligible patients were included between May 2020 and November 2020 (median age of 65 years [IQR = 54, 77]). Our cohort’s median plasma zinc concentration was 57 µg/dL (interquartile range [IQR] = 45, 67) compared to 74 µg/dL (IQR = 64, 84) in the retrospective non-COVID-19 control group (N = 1513; p < 0.001). Markedly, the absolute majority of COVID-19 patients (96%) were zinc deficient (<80 µg/dL). The median zinc concentration was lower in patients with CRS compared to those without CRS (-5 µg/dL; 95% CI = -10.5, 0.051; p = 0.048). Among the tested outcomes, zinc concentration is significantly correlated with only the length of hospital stay (rho = -0.19; p = 0.022), but not with mortality or morbidity. As such, our findings do not support the role of zinc as a robust prognostic marker among hospitalized COVID-19 patients who in our cohort presented a high prevalence of zinc deficiency. It might be more beneficial to explore the role of zinc as a biomarker for assessing the risk of developing a tissue-damaging CRS and predicting outcomes in patients diagnosed with COVID-19 at the early stage of the disease.
Keywords: COVID-19; Inflammation; SARS-CoV-2; Zinc; cHIS.
【저자키워드】 COVID-19, SARS-CoV-2, Inflammation, Zinc, cHIS., 【초록키워드】 Biomarker, Mortality, Infection, risk, outcome, Clinical outcome, Prevalence, outcomes, Cohort, morbidity, Patient, Complication, Prognostic marker, early stage, association, acute respiratory distress, hospitalized COVID-19 patient, CRS, antiviral response, retrospective, Concentration, COVID-19 patient, Hospital stay, Support, deficiency, interquartile range, Non-COVID-19, control group, hospitalized COVID-19 patients, 95% CI, PCR-confirmed, plasma zinc concentration, median age, university hospital, syndrome, single-center, cytokine releasing syndrome, severe SARS-CoV-2, robust, tested, significantly, the disease, conducted, median, majority, correlated, diagnosed with COVID-19, eligible patient, IQR, 【제목키워드】 Hyperinflammatory syndrome, hospitalized COVID-19,