Low Levels of Few Micronutrients May Impact COVID-19 Disease Progression: An Observational Study on the First Wave
Teresa-Maria Tomasa-Irriguible1, Lara Bielsa-Berrocal1, Luisa Bordejé-Laguna1
1Intensive Care Unit, University Hospital Germans Trias i Pujol, 08916 Badalona, Spain.
Insights
Severe COVID-19 patients often exhibit low vitamin A and zinc levels, increasing ICU admission risk. Further research into micronutrient supplementation as adjunctive COVID-19 treatment is warranted.
Area of Science:
- Clinical Medicine
- Nutritional Science
- Infectious Diseases
Background:
- The SARS-CoV-2 pandemic highlighted the need to understand factors influencing COVID-19 severity.
- Micronutrient deficiencies may impact immune response and patient outcomes in severe infections.
Purpose of the Study:
- To investigate the association between plasma micronutrient levels and clinical outcomes in severe COVID-19 patients.
- To identify specific micronutrients linked to intensive care unit (ICU) admission and intubation.
Main Methods:
- An observational study included 120 severe COVID-19 patients admitted to a Spanish university hospital.
- Plasma levels of vitamins A, B6, C, D, E, and zinc were measured within 24 hours of admission.
- Statistical analysis assessed correlations between micronutrient status and outcomes like ICU admission and intubation.
Main Results:
- High prevalence of deficiencies: 74.2% low zinc, 71.7% low vitamin A, 100% low vitamin C, 74.3% low vitamin D.
- Low zinc and vitamin A levels were significantly associated with increased ICU admission (p=0.017 and p=0.004, respectively).
- Low vitamin A was independently associated with the need for orotracheal intubation (p=0.000). Age over 65 and male gender also predicted ICU admission.
Conclusions:
- Low levels of vitamin A and zinc are associated with a greater need for ICU admission and mechanical ventilation in severe COVID-19.
- Micronutrient status should be considered in the management of severe COVID-19 patients.
- Randomized clinical trials are recommended to evaluate the efficacy of micronutrient supplementation as an adjunctive therapy for COVID-19.
Abstract:
We report an observational study performed between March and May 2020 in a Spanish university hospital during the SARS-CoV-2 pandemic. The main objective was to analyse the association between the levels of micronutrients in severe COVID-19 patients and their outcome. Adult patients with a positive polymerase-chain-reaction (PCR) for SARS-CoV-2 in the nasopharyngeal swab or in tracheal aspirate culture in the case of intubation were included. Micronutrient data were obtained from plasma analysis of a standard nutritional assessment performed within the first 24 h of hospital admission. Vitamins A, B6, C and E were analysed with HPLC methods; 25-OH-vitamin D by immunoassay and zinc by colorimetric measurements. One hundred and twenty patients were included. We found that 74.2% patients had low levels of zinc (normal levels >84 µg/dL) with a mean value of 63.5 (SD 13.5); 71.7% patients had low levels of vitamin A (normal levels >0.3 mg/L) with a mean value of 0.17 (SD 0.06); 42.5% patients had low levels of vitamin B6 (normal levels >3.6 ng/mL) with a mean value of 2.2 (SD 0.9); 100% patients had low levels of vitamin C (normal levels >0.4 mg/dL) with a mean value of 0.14 (SD 0.05); 74.3% patients had low values of vitamin D (normal levels >20 ng/mL) with mean value of 11.4 (SD 4.3); but only 5.8% of patients had low levels of vitamin E (normal levels >5 mg/L) with a mean value of 3.95 (SD 0.87). The variables associated with the need for ICU admission were low levels of zinc (standard error 0.566, 95% CI 0.086 to 0.790, p = 0.017), low levels of vitamin A (standard error 0.582, 95% CI 0.061 to 0.594, p = 0.004), age over 65 (standard error 0.018, 95% CI 0.917 to 0.985, p = 0.005) and male gender (standard error 0.458, 95% CI 1.004 to 6.040, p = 0.049). The only variable that was independently associated with the need for orotracheal intubation was low levels of vitamin A (standard error 0.58, 95% CI 0.042 to 0.405, p = 0.000). Conclusions: Low levels of vitamin A and zinc are associated with a greater need for admission to the ICU and orotracheal intubation. Patients older than 65 years had higher mortality. Randomized clinical trials are needed to examine whether micronutrient supplementation could be beneficial as an adjunctive treatment in COVID-19.
More Related Videos
Related Concept Videos
01:18Factors Affecting Illness
For instance, risk factors are connected to illness,...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:29Bias in Epidemiological Studies
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:30Vitamins
01:15Bioavailability Study Design: Healthy Subjects Versus Patients