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Open AccessArticle

Low Zinc Levels at Admission Associates with Poor Clinical Outcomes in SARS-CoV-2 Infection

1
Laboratory of Molecular Physiology, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
2
Molecular Virology Group, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
3
Department of Biochemistry and Molecular Biology and Institute of Neurosciences, Edifici H, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
4
Unitat Mixta UAB-VHIR, Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain
5
Institut Català de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
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Department of Internal Medicine, Hospital del Mar, Institut Mar d’Investigacions Mediques, 08003 Barcelona, Spain
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Department of Infectious Diseases, Hospital del Mar, Institut Mar d’Investigacions Mediques, 08003 Barcelona, Spain
8
Department of Nephrology, Hospital del Mar, Institut Mar d’Investigacions Mediques, Autonomous University of Barcelona, 08003 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Both authors contributed equally to the work.
J.D., R.V. and R.G.-F. are joint senior authors in this work.
Nutrients 2021, 13(2), 562; https://doi.org/10.3390/nu13020562
Received: 8 January 2021 / Revised: 27 January 2021 / Accepted: 30 January 2021 / Published: 9 February 2021
(This article belongs to the Section Micronutrients and Human Health)
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. View Full-Text
Keywords: SARS-CoV-2; zinc; clinical outcomes SARS-CoV-2; zinc; clinical outcomes
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MDPI and ACS Style

Vogel-González, M.; Talló-Parra, M.; Herrera-Fernández, V.; Pérez-Vilaró, G.; Chillón, M.; Nogués, X.; Gómez-Zorrilla, S.; López-Montesinos, I.; Arnau-Barrés, I.; Sorli-Redó, M.L.; Horcajada, J.P.; García-Giralt, N.; Pascual, J.; Díez, J.; Vicente, R.; Güerri-Fernández, R. Low Zinc Levels at Admission Associates with Poor Clinical Outcomes in SARS-CoV-2 Infection. Nutrients 2021, 13, 562. https://doi.org/10.3390/nu13020562

AMA Style

Vogel-González M, Talló-Parra M, Herrera-Fernández V, Pérez-Vilaró G, Chillón M, Nogués X, Gómez-Zorrilla S, López-Montesinos I, Arnau-Barrés I, Sorli-Redó ML, Horcajada JP, García-Giralt N, Pascual J, Díez J, Vicente R, Güerri-Fernández R. Low Zinc Levels at Admission Associates with Poor Clinical Outcomes in SARS-CoV-2 Infection. Nutrients. 2021; 13(2):562. https://doi.org/10.3390/nu13020562

Chicago/Turabian Style

Vogel-González, Marina; Talló-Parra, Marc; Herrera-Fernández, Víctor; Pérez-Vilaró, Gemma; Chillón, Miguel; Nogués, Xavier; Gómez-Zorrilla, Silvia; López-Montesinos, Inmaculada; Arnau-Barrés, Isabel; Sorli-Redó, Maria L.; Horcajada, Juan P.; García-Giralt, Natalia; Pascual, Julio; Díez, Juana; Vicente, Rubén; Güerri-Fernández, Robert. 2021. "Low Zinc Levels at Admission Associates with Poor Clinical Outcomes in SARS-CoV-2 Infection" Nutrients 13, no. 2: 562. https://doi.org/10.3390/nu13020562

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