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Updated: Aug 27, 2026
A Data-Driven Approach to Quantifying Immune States in Sepsis
Published on: February 7, 2025
Early plasma zinc recovery and seven-day mortality in adults with sepsis: a prospective cohort study
Nguyen Van Tuan1, Nguyen Sy Thau1, Truong Nhat My1
1Institute for Clinical Infectious Diseases, 108 Military Central Hospital, Hanoi, Vietnam; Vietnamese German Center for Medical Research, Hanoi, Vietnam.
Objectives:
Plasma zinc concentrations are altered during critical illness. We determined whether recovery of plasma zinc from admission to day 3 is associated with early mortality in adults with sepsis.
Methods:
In this prospective single-center cohort of adults with Sepsis-3 sepsis or septic shock, plasma zinc was measured on admission and on day 3. The main exposure was day-3 zinc adjusted for admission, and the primary outcome was death by day 7 from admission. Zinc trajectories were analyzed using a repeated-measures mixed-effects model, and mortality risk was assessed with a parsimonious 5-predictor Cox model with internal validation.
Results:
The day-3 cohort included 120 patients, of whom 16 died by day 7. Admission zinc concentrations were similar in survivors and nonsurvivors, but day-3 zinc was lower in those died (56.05 vs 68.65 ug/dL; P = 0.081). The increase in zinc from admission to day 3 was smaller in nonsurvivors than in survivors (0.80 vs 15.40 ug/dL; P = 0.017). Zinc trajectories differed significantly by day-7 outcome (interaction P = 0.0022). Higher day-3 zinc was associated with lower mortality (HR per 10 ug/dL 0.77; 95% CI, 0.60-0.97; P = 0.028).
Conclusions:
Patients with sepsis who remained evaluable through day 3, failure of plasma zinc recovery was associated with higher mortality.