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Tomasa-Irriguible TM, Monfà R, Miranda-Jiménez C, Morros R, Robert N, Bordejé-Laguna L, Vidal S, Torán-Monserrat P, Barriocanal AM. Preventive Intake of a Multiple Micronutrient Supplement during Mild, Acute SARS-CoV-2 Infection to Reduce the Post-Acute COVID-19 Condition: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial. Nutrients 2024; 16:1631. [PMID: 38892564 PMCID: PMC11174626 DOI: 10.3390/nu16111631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Patients hospitalized with COVID-19 have low levels of vitamins and trace elements. This could lead to a post-acute COVID-19 condition (PCC) that can worsen a patient's quality of life. We aimed to study the baseline micronutrient status of patients and assess whether a multiple micronutrient supplement (MMS) taken for 2 weeks at the first sign of COVID-19 symptoms would be able to reduce the incidence of PCC. This double-blind, placebo-controlled, randomized clinical trial was conducted in adult outpatients with acute COVID-19, recruited between 2021 and 2023 in Spain. Of the 285 patients assessed for eligibility, 267 were randomized and 246 were included in the intent-to-treat population. The mean age was 46.8 years, and 68% were female. Overall, 54.6% had micronutrient deficiencies in the acute phase of COVID-19 at baseline, and 26.2% had PCC after 180 days of follow-up (D180). The most frequently recorded PCC symptoms were neurological (14.1%), with 24% patients scoring worse in the cognitive tests compared to their baseline status. The rate of PCC at D180 was similar between the placebo (25.0%) and intervention (27.7%) groups, without significant differences (p = 0.785). Age over 50 years was the most relevant risk factor for developing PCC, followed by female sex. The most important protective factor against PCC was SARS-CoV-2 vaccination. In this population of predominantly middle-aged, white women with acute COVID-19 not requiring hospital admission, MMS intake for 14 days at symptom onset did not prevent PCC nor improve their micronutrient status at D180.
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Affiliation(s)
| | - Ramon Monfà
- Jordi Gol University Research Institute in Primary Care (IDIAP Jordi Gol), 08007 Barcelona, Spain; (R.M.); (C.M.-J.)
| | - Cristina Miranda-Jiménez
- Jordi Gol University Research Institute in Primary Care (IDIAP Jordi Gol), 08007 Barcelona, Spain; (R.M.); (C.M.-J.)
| | - Rosa Morros
- Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona (UAB), 08193 Bellaterra, Spain;
| | - Neus Robert
- Emergency Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain;
| | - Luisa Bordejé-Laguna
- Intensive Care Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain;
| | - Sandra Vidal
- Germans Trias i Pujol Research Institute (IGTP), 08916 Badalona, Spain; (S.V.); (A.M.B.)
| | - Pere Torán-Monserrat
- North Metropolitan Research Support Unit, Jordi Gol University Research Institute in Primary Care (NM-IDIAP Jordi Gol), 08303 Mataró, Spain;
| | - Ana Maria Barriocanal
- Germans Trias i Pujol Research Institute (IGTP), 08916 Badalona, Spain; (S.V.); (A.M.B.)
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2
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Rozemeijer S, Hamer HM, Heijboer AC, de Jonge R, Jimenez CR, Juffermans NP, Dujardin RWG, Girbes ARJ, de Man AME. Micronutrient Status of Critically Ill Patients with COVID-19 Pneumonia. Nutrients 2024; 16:385. [PMID: 38337670 PMCID: PMC10856879 DOI: 10.3390/nu16030385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Micronutrient deficiencies can develop in critically ill patients, arising from factors such as decreased intake, increased losses, drug interactions, and hypermetabolism. These deficiencies may compromise important immune functions, with potential implications for patient outcomes. Alternatively, micronutrient blood levels may become low due to inflammation-driven redistribution rather than consumption. This explorative pilot study investigates blood micronutrient concentrations during the first three weeks of ICU stay in critically ill COVID-19 patients and evaluates the impact of additional micronutrient administration. Moreover, associations between inflammation, disease severity, and micronutrient status were explored. We measured weekly concentrations of vitamins A, B6, D, and E; iron; zinc; copper; selenium; and CRP as a marker of inflammation state and the SOFA score indicating disease severity in 20 critically ill COVID-19 patients during three weeks of ICU stay. Half of the patients received additional (intravenous) micronutrient administration. Data were analyzed with linear mixed models and Pearson's correlation coefficient. High deficiency rates of vitamins A, B6, and D; zinc; and selenium (50-100%) were found at ICU admission, along with low iron status. After three weeks, vitamins B6 and D deficiencies persisted, and iron status remained low. Plasma levels of vitamins A and E, zinc, and selenium improved. No significant differences in micronutrient levels were found between patient groups. Negative correlations were identified between the CRP level and levels of vitamins A and E, iron, transferrin, zinc, and selenium. SOFA scores negatively correlated with vitamin D and selenium levels. Our findings reveal high micronutrient deficiency rates at ICU admission. Additional micronutrient administration did not enhance levels or expedite their increase. Spontaneous increases in vitamins A and E, zinc, and selenium levels were associated with inflammation resolution, suggesting that observed low levels may be attributed, at least in part, to redistribution rather than true deficiencies.
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Affiliation(s)
- Sander Rozemeijer
- Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science (ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam Medical Data Science (AMDS), Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (A.R.J.G.); (A.M.E.d.M.)
- Department of Anesthesiology, Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
| | - Henrike M. Hamer
- Department of Laboratory Medicine, Laboratory Specialized Techniques and Research, Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands;
| | - Annemieke C. Heijboer
- Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands;
| | - Robert de Jonge
- Department of Laboratory Medicine, Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands;
| | - Connie R. Jimenez
- OncoProteomics Laboratory, Department Laboratory Medical Oncology, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands;
| | - Nicole P. Juffermans
- Department of Intensive Care and Laboratory of Translational Intensive Care, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands;
| | - Romein W. G. Dujardin
- Department of Anesthesiology, Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
| | - Armand R. J. Girbes
- Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science (ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam Medical Data Science (AMDS), Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (A.R.J.G.); (A.M.E.d.M.)
| | - Angélique M. E. de Man
- Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science (ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam Medical Data Science (AMDS), Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (A.R.J.G.); (A.M.E.d.M.)
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3
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Carvalho MCDC, Araujo JKCP, da Silva AGCL, da Silva NS, de Araújo NK, Luchessi AD, Ribeiro KDDS, Silbiger VN. Retinol Levels and Severity of Patients with COVID-19. Nutrients 2023; 15:4642. [PMID: 37960295 PMCID: PMC10650184 DOI: 10.3390/nu15214642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 11/15/2023] Open
Abstract
The new coronavirus infection represents a serious threat to global health and economies. In this sense, it is paramount to know the nutritional factors that may be related to the prognosis of the disease. Evidence shows that vitamin A may play an important preventive and therapeutic role in supporting respiratory infections as in COVID-19. The aim of our study was to evaluate the association of vitamin A (retinol) status with the prognosis of the disease. A case-control study from a cohort study was conducted in Brazil between May and October 2020. The study population was chosen by convenience, consisting of participants diagnosed with COVID-19. Recruitment was carried out using different approaches, including through dissemination on social media and in four hospitals in the city of Natal/RN, Brazil, recruiting participants from the COVID-19 ward and hospitalized participants who tested positive for the disease. The participants were allocated into two groups according to severity, with a group of mild (n = 88) or critical (n = 106) patients and compared to a control group (selected before the pandemic, n = 46). The extraction of retinol serum was performed and analyzed using the high-performance liquid chromatography method (HPLC). The retinol level was calculated in mmol/L, and levels below 0.7 μmol/L (20 µg/dL) were considered to be a vitamin A deficiency. Our findings suggest that the participants with mild and critical COVID-19 had lower retinol levels compared to the healthy controls (p = 0.03). In addition, milder cases of COVID-19 were associated with increased symptoms and prolonged symptoms after 90 days since the beginning of infection. However, the survival analysis showed no association with higher cases of death among participants with vitamin A deficiency (p = 0.509). More studies are needed to understand how nutritional status, including vitamin A levels, can influence prognosis and is a risk factor for the development of long COVID syndrome.
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Affiliation(s)
- Maria Clara da Cruz Carvalho
- Graduate Program in Pharmaceutical Science, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil
| | | | | | - Nayara Sousa da Silva
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil;
| | - Nathalia Kelly de Araújo
- Graduate Program of Chemistry, Chemistry Institute, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Andre Ducati Luchessi
- Graduate Program in Pharmaceutical Science, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil;
- Graduate Program of Chemistry, Chemistry Institute, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Karla Danielly da Silva Ribeiro
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil
- Graduate Program in Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil
| | - Vivian Nogueira Silbiger
- Undergraduate Program of Nutrition, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil; (J.K.C.P.A.); (V.N.S.)
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil;
- Graduate Program of Chemistry, Chemistry Institute, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
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Hosseinpour A, Daneshzad E, Dezfouli RA, Zamani S, Qorbani M. The Association Between Antioxidants and COVID-19 Outcomes: a Systematic Review on Observational Studies. Biol Trace Elem Res 2023; 201:5098-5114. [PMID: 36840911 PMCID: PMC9959932 DOI: 10.1007/s12011-023-03588-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 01/30/2023] [Indexed: 02/26/2023]
Abstract
It is proven that the blood concentration of antioxidants can impress the severity of viral infections, including COVID-19. However, the lack of a comprehensive study accumulating existing data regarding COVID-19 can be perceived. Therefore, this systematic review is aimed to report the association between the blood concentration of several antioxidants and the overall health condition of COVID-19 patients. We summarized the available data surrounding the serum antioxidant level in COVID-19 patients and COVID-19 outcomes. A systematic search was performed in PubMed, Scopus, Web of Science, and Cochrane, and studies that evaluated the association between antioxidants and COVID-19 outcomes were included. Of 4101 articles that were viewed in the database search, 38 articles were included after the title, abstract, and full-text review. Twenty-nine studies indicated that lower serum antioxidants are associated with worse outcomes, and one study reported no association between serum zinc (Zn) level and COVID-19 outcomes. In most cases, antioxidant deficiency was associated with high inflammatory factors, high mortality, acute kidney injury, thrombosis, intensive care unit (ICU) admission, acute respiratory distress syndrome, cardiac injury, and the need for mechanical ventilation (MV), and there was no significant association between serum antioxidants level and ICU or hospital length of stay (LOS). It seems that higher levels of antioxidants in COVID-19 patients may be beneficial to prevent disease progression. However, clinical trials are needed to confirm this conclusion.
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Affiliation(s)
- Ali Hosseinpour
- Research Students Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| | - Ramin Abdi Dezfouli
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shokoofeh Zamani
- Department of Internal Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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5
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Briassoulis G, Briassoulis P, Ilia S, Miliaraki M, Briassouli E. The Anti-Oxidative, Anti-Inflammatory, Anti-Apoptotic, and Anti-Necroptotic Role of Zinc in COVID-19 and Sepsis. Antioxidants (Basel) 2023; 12:1942. [PMID: 38001795 PMCID: PMC10669546 DOI: 10.3390/antiox12111942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/26/2023] Open
Abstract
Zinc is a structural component of proteins, functions as a catalytic co-factor in DNA synthesis and transcription of hundreds of enzymes, and has a regulatory role in protein-DNA interactions of zinc-finger proteins. For many years, zinc has been acknowledged for its anti-oxidative and anti-inflammatory functions. Furthermore, zinc is a potent inhibitor of caspases-3, -7, and -8, modulating the caspase-controlled apoptosis and necroptosis. In recent years, the immunomodulatory role of zinc in sepsis and COVID-19 has been investigated. Both sepsis and COVID-19 are related to various regulated cell death (RCD) pathways, including apoptosis and necroptosis. Lack of zinc may have a negative effect on many immune functions, such as oxidative burst, cytokine production, chemotaxis, degranulation, phagocytosis, and RCD. While plasma zinc concentrations decline swiftly during both sepsis and COVID-19, this reduction is primarily attributed to a redistribution process associated with the inflammatory response. In this response, hepatic metallothionein production increases in reaction to cytokine release, which is linked to inflammation, and this protein effectively captures and stores zinc in the liver. Multiple regulatory mechanisms come into play, influencing the uptake of zinc, the binding of zinc to blood albumin and red blood cells, as well as the buffering and modulation of cytosolic zinc levels. Decreased zinc levels are associated with increasing severity of organ dysfunction, prolonged hospital stay and increased mortality in septic and COVID-19 patients. Results of recent studies focusing on these topics are summarized and discussed in this narrative review. Existing evidence currently does not support pharmacological zinc supplementation in patients with sepsis or COVID-19. Complementation and repletion should follow current guidelines for micronutrients in critically ill patients. Further research investigating the pharmacological mechanism of zinc in programmed cell death caused by invasive infections and its therapeutic potential in sepsis and COVID-19 could be worthwhile.
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Affiliation(s)
- George Briassoulis
- Postgraduate Program “Emergency and Intensive Care in Children, Adolescents, and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece;
| | - Panagiotis Briassoulis
- Second Department of Anesthesiology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Stavroula Ilia
- Postgraduate Program “Emergency and Intensive Care in Children, Adolescents, and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece;
- Paediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece;
| | - Marianna Miliaraki
- Paediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece;
| | - Efrossini Briassouli
- Infectious Diseases Department “MAKKA”, First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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Alsaeedi A, Welham S, Rose P. Impact of lifestyle factors on dietary vitamin B 6 intake and plasma pyridoxal 5'-phosphate level in UK adults: National Diet and Nutrition Survey Rolling Programme (NDNS) (2008-2017). Br J Nutr 2023; 130:1403-1415. [PMID: 36789783 PMCID: PMC10511679 DOI: 10.1017/s0007114523000417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023]
Abstract
Reduction in dietary vitamin B6 intake is associated with an increased relative risk of diseases such as cancer, atherosclerosis and cognitive dysfunction. The current research has assessed vitamin B6 intakes and PLP concentrations as a marker of vitamin B6 status among the UK adult (≥ 19 years) population. This study was carried out using a cross-sectional analysis of the National Diet and Nutrition Survey Rolling Programme (NDNS) (2008-2017). The impacts of lifestyle factors, including type of diet, smoking, alcohol consumption, and commonly used medications grouped by therapeutic usage, were determined, and data were analysed using IBM SPSS®. Results are expressed as medians (25th-75th percentiles), with P values ≤ 0·05 considered statistically significant. Among UK adults, the median intakes of total population of dietary vitamin B6 met the reference nutrient intake and median plasma PLP concentrations were above the cut-off of vitamin B6 deficiency; however, we found an association between reduction in vitamin B6 intake and plasma PLP concentration and age group (P < 0·001). Smokers had significantly lower plasma PLP concentrations than non-smokers (P < 0·001). Moreover, regression analysis showed some commonly used medications were associated with plasma PLP levels reduction (P < 0·05). Taken together, we report on a tendency for dietary vitamin B6 intake and plasma PLP concentrations to decrease with age and lifestyle factors such as smoking and medication usage. This information could have important implications for smokers and in the elderly population using multiple medications (polypharmacy).
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Affiliation(s)
- Asrar Alsaeedi
- Division of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, LeicestershireLE12 5RD, UK
| | - Simon Welham
- Division of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, LeicestershireLE12 5RD, UK
| | - Peter Rose
- Division of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, LeicestershireLE12 5RD, UK
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7
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Renata RBN, Arely GRA, Gabriela LMA, Esther MLM. Immunomodulatory Role of Microelements in COVID-19 Outcome: a Relationship with Nutritional Status. Biol Trace Elem Res 2023; 201:1596-1614. [PMID: 35668151 PMCID: PMC9170122 DOI: 10.1007/s12011-022-03290-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/16/2022] [Indexed: 12/17/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19). SARS-CoV-2 infection can activate innate and adaptive immune responses and result in massive inflammatory responses in the disease. A comprehensive understanding of the participation of micronutrients in the immune response to COVID-19 will allow the creation of prevention and supplementation scenarios in malnutrition states. Microelement deficiency can be decisive in the progression of diseases and their optimal levels can act as protective factors, helping to maintain homeostasis. Vitamin A, B, D, selenium, zinc, and copper, through their complementary and synergistic effects, allow the components of innate and adaptive immunity to counteract infections like those occurring in the respiratory tract.Thus, alterations in nutritional status are related to metabolic diseases, systemic inflammation, and deterioration of the immune system that alter the response against viral infections, such as COVID-19. The aim of this review is to describe the micronutrients that play an important role as immunomodulators and its relationship between malnutrition and the development of respiratory infections with an emphasis on severe and critical COVID-19. We conclude that although an unbalanced diet is not the only risk factor that predisposes to COVID-19, a correct and balanced diet, which provides the optimal amount of micronutrients and favors an adequate nutritional status, could confer beneficial effects for prevention and improvement of clinical results. The potential usefulness of micronutrient supplementation in special cases is highlighted.
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Affiliation(s)
- Roldán-Bretón Nuria Renata
- Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Dr. Humberto Torres Sanginés S/N, Centro Cívico, 21000, Mexicali, Baja California, México
| | - González-Rascón Anna Arely
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California, México
| | - Leija-Montoya Ana Gabriela
- Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Dr. Humberto Torres Sanginés S/N, Centro Cívico, 21000, Mexicali, Baja California, México
| | - Mejía-León María Esther
- Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Dr. Humberto Torres Sanginés S/N, Centro Cívico, 21000, Mexicali, Baja California, México.
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Lahaye C, Parant F, Haesebaert J, Goldet K, Bendim'red L, Henaff L, Saadatian-Elahi M, Vanhems P, Cuerq C, Gilbert T, Blond E, Bost M, Bonnefoy M. Minerals and Antioxidant Micronutrients Levels and Clinical Outcome in Older Patients Hospitalized for COVID-19 during the First Wave of the Pandemic. Nutrients 2023; 15:nu15061516. [PMID: 36986247 PMCID: PMC10056386 DOI: 10.3390/nu15061516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
Excessive inflammatory response has been implicated in severe respiratory forms of coronavirus disease 2019 (COVID-19). Trace elements such as zinc, selenium, and copper are known to modulate inflammation and immunity. This study aimed to assess the relationships between antioxidant vitamins and mineral trace elements levels as well as COVID-19 severity in older adults hospitalized. In this observational retrospective cohort study, the levels of zinc, selenium, copper, vitamin A, β-carotene, and vitamin E were measured in 94 patients within the first 15 days of hospitalization. The outcomes were in-hospital mortality secondary to COVID-19 or severe COVID-19. A logistic regression analysis was conducted to test whether the levels of vitamins and minerals were independently associated with severity. In this cohort (average age of 78 years), severe forms (46%) were associated with lower zinc (p = 0.012) and β-carotene (p < 0.001) concentrations, and in-hospital mortality (15%) was associated with lower zinc (p = 0.009), selenium (p = 0.014), vitamin A (p = 0.001), and β-carotene (p = 0.002) concentrations. In regression analysis, severe forms remained independently associated with lower zinc (aOR 2.13, p = 0.018) concentrations, and death was associated with lower vitamin A (aOR = 0.165, p = 0.021) concentrations. Low plasma concentrations of zinc and vitamin A were associated with poor prognosis in older people hospitalized with COVID-19.
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Affiliation(s)
- Clément Lahaye
- Department of Geriatric Medicine, Hôpital Gabriel Montpied, 63000 Clermont-Ferrand, France
- Unité de Nutrition Humaine, Université Clermont Auvergne, INRAE, 63000 Clermont-Ferrand, France
| | - François Parant
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Julie Haesebaert
- Public Health Unit, Department of Clinical Research and Epidemiology, Groupement Hospitalier Est, 69002 Lyon, France
- RESHAPE Research on Healthcare Performance Inserm U1290, Université Lyon 1, 69008 Lyon, France
| | - Karine Goldet
- Clinical Research Centre, Ageing, Brain, Fragility-Hôpital des Charpennes, 69100 Villeurbanne, France
| | - Lamia Bendim'red
- Clinical Research Centre, Ageing, Brain, Fragility-Hôpital des Charpennes, 69100 Villeurbanne, France
| | - Laetitia Henaff
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d'Italie, 69007 Lyon, France
| | - Mitra Saadatian-Elahi
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d'Italie, 69007 Lyon, France
| | - Philippe Vanhems
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d'Italie, 69007 Lyon, France
| | - Charlotte Cuerq
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Thomas Gilbert
- RESHAPE Research on Healthcare Performance Inserm U1290, Université Lyon 1, 69008 Lyon, France
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France
| | - Emilie Blond
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Muriel Bost
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Marc Bonnefoy
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France
- INSERM, 1060 CaRMeN 165 Chemin du Grand Revoyet, 69310 Pierre-Bénite, France
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Oral Candidiasis in Adult and Pediatric Patients with COVID-19. Biomedicines 2023; 11:biomedicines11030846. [PMID: 36979825 PMCID: PMC10045279 DOI: 10.3390/biomedicines11030846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Oral Candidiasis (OC) is an opportunistic fungal infection of the oral cavity, frequently reported under local and systemic predisposing circumstances. While the recurrence of OC HIV-infected subjects has been well described and reported, the association between oral candidiasis and the SARS-CoV-2 infection is a recent finding that still is worthy of further study. The present paper focuses on this novel association, reporting the incidence and prevalence of OC occurring during and after COVID-19 and the possible etiopathogenic mechanisms underlying the onset of OC in COVID-19 subjects. The work found that the immune inflammatory hypo reactions and immunosuppression found in children and adults with COVID-19 could favor the proliferation colonization of Candida species and the following infection. At the same time, poor oral hygiene and iatrogenic causes seem to be the main risk factors.
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Radpay R, Eghtesadi S. Relationship between Plasma Levels of Zinc and Magnesium with the Treatment Process and Mortality Risk in COVID-19 Patients. TANAFFOS 2023; 22:236-247. [PMID: 38628887 PMCID: PMC11016917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 01/20/2023] [Indexed: 04/19/2024]
Abstract
Background The COVID-19 pandemic is considered a major health problem all over the world which has caused extensive and worldwide mortality and morbidities along with vast economic and political impact. Limitations of our knowledge and controversies in treatment modalities make the control and management of this disease more difficult. The status of electrolytes especially Mg and Zn in plasma and its correlation with the clinical situation and criteria for recovery has been investigated in various studies. Limited data in Iran mandate the design of a trial for evaluating our critically ill patients. We designed this study to investigate the correlation between plasma levels of Mg and Zn and the outcome including patients' need for assisted/controlled ventilation, time required for weaning, length of ICU stay, and probable cause of death. Materials and Methods 413 patients with severe respiratory signs of COVID-19 disease who were admitted to the ICUs of 3 medical centers of Shahid Beheshti University of Medical Sciences were evaluated for plasma levels of Mg and Zn. Supplemental therapy was introduced when needed and was followed until discharge from ICU or death. All recorded data were analyzed by statistical methods and results were compared with similar studies. Results 20.6% and 35.1% of all participants had low serum levels of Mg and Zn, respectively. 11 patients (2.7%) died through the treatment period. 56.9% and 61.0% of participants received Mg and Zn supplements, respectively. Conclusion According to our results, serum Mg and Zn levels did not show a significant correlation with the risk of death due to severe COVID-19 disease, prolonged assisted ventilation, or duration of ICU stay. There was no significant association between Mg and Zn supplementation with the risk of death due to severe COVID-19; however, it showed an inverse relationship with the time required for assisted ventilation and the duration of ICU stay. It seems that Mg and Zn supplementation can be useful in preventing or managing some of the morbidities among COVID-19 patients.
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Affiliation(s)
- Rojan Radpay
- Master Science Student, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Shahryar Eghtesadi
- Professor at Science and Research Branch, Islamic Azad University, Tehran, Iran
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11
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Sarohan AR, Edipsoy S, Özkurt ZG, Özlü C, Demir AN, Cen O. Vitamin A Deficiency, COVID-19, and Rhino-Orbital Mucormycosis (Black Fungus): An Analytical Perspective. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1436:153-166. [PMID: 37253944 DOI: 10.1007/5584_2023_774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Mucormycosis is a rare but serious opportunistic fungal disease characterized by rhino-orbito-cerebral and pulmonary involvement. It is mainly seen in people with secondary immunosuppression, isolated vitamin A deficiency, measles, and AIDS patients. It showed a rise during the second wave of the COVID-19 epidemic in the spring of 2021 in India, especially in diabetic COVID-19 patients. Vitamin A deficiency is known to cause nutritional immunodeficiency and hence leading the way to increased opportunistic fungal, bacterial, and viral infections. In the eye, it causes keratitis, night blindness, xerophthalmia, conjunctivitis, Bitot spots, keratomalacia, and retinopathy. It also causes decreased tear secretion and deterioration of the anatomical/physiological defense barrier of the eye. The negative impact of vitamin A deficiency has been previously demonstrated in measles, AIDS, and COVID-19. We think that mucormycosis in COVID-19 might be rendered by vitamin A deficiency and that vitamin A supplementation may have preventive and therapeutic values against mucormycosis and other ocular symptoms associated with COVID-19. However, any vitamin A treatment regimen needs to be based on laboratory and clinical data and supervised by medical professionals.
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Affiliation(s)
| | - Sait Edipsoy
- Department of Ophthalmology, Medicina Plus Medical Center, İstanbul, Turkey
| | | | - Can Özlü
- Department of Hematology, Kütahya Health Science University, Evliya Çelebi Education and Research Hospital, Kütahya, Turkey
| | - Ayça Nur Demir
- Faculty of Medicine, Afyonkarahisar Health Science University, Afyon, Turkey
| | - Osman Cen
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Waubonsee College, Sugar Grove, IL, USA
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12
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Effect of Folic Acid Treatment for Patients with Traumatic Brain Injury (TBI)-Related Hospital Acquired Pneumonia (HAP): A Retrospective Cohort Study. J Clin Med 2022; 11:jcm11247403. [PMID: 36556017 PMCID: PMC9783303 DOI: 10.3390/jcm11247403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/27/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Hospital Acquired Pneumonia (HAP) is one of the most common complications and late causes of death in TBI patients. Targeted prevention and treatment of HAP are of great significance for improving the prognosis of TBI patients. In the previous clinical observation, we found that folic acid treatment for TBI patients has a good effect on preventing and treating HAP. We conducted this retrospective cohort study to demonstrate what we observed by selecting 293 TBI patients from two medical centers and analyzing their hospitalization data. The result showed that the incidence of HAP was significantly lower in TBI patients who received folic acid treatment (44.1% vs. 63.0%, p = 0.012). Multivariate logistic regression analysis showed that folic acid treatment was an independent protective factor for the occurrence of HAP in TBI patients (OR = 0.418, p = 0.031), especially in high-risk groups of HAP, such as the old (OR: 1.356 vs. 2.889), ICU (OR: 1.775 vs. 5.996) and severe TBI (OR: 0.975 vs. 5.424) patients. At the same time, cohort studies of HAP patients showed that folic acid also had a good effect on delaying the progression of HAP, such as reducing the chance of tracheotomy (26.1% vs. 50.8%, p = 0.041), and reduced the length of hospital stay (15 d vs. 19 d, p = 0.029) and ICU stay (5 d vs. 8 d, p = 0.046). Therefore, we believe that folic acid treatment in TBI patients has the potential for preventing and treating HAP, and it is worthy of further clinical research.
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13
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Demircan K, Chillon TS, Bracken T, Bulgarelli I, Campi I, Du Laing G, Fafi-Kremer S, Fugazzola L, Garcia A, Heller R, Hughes DJ, Ide L, Klingenberg GJ, Komarnicki P, Krasinski Z, Lescure A, Mallon P, Moghaddam A, Persani L, Petrovic M, Ruchala M, Solis M, Vandekerckhove L, Schomburg L. Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe. Front Immunol 2022; 13:1022673. [PMID: 36518764 PMCID: PMC9742896 DOI: 10.3389/fimmu.2022.1022673] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/31/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Certain trace elements are essential for life and affect immune system function, and their intake varies by region and population. Alterations in serum Se, Zn and Cu have been associated with COVID-19 mortality risk. We tested the hypothesis that a disease-specific decline occurs and correlates with mortality risk in different countries in Europe. Methods Serum samples from 551 COVID-19 patients (including 87 non-survivors) who had participated in observational studies in Europe (Belgium, France, Germany, Ireland, Italy, and Poland) were analyzed for trace elements by total reflection X-ray fluorescence. A subset (n=2069) of the European EPIC study served as reference. Analyses were performed blinded to clinical data in one analytical laboratory. Results Median levels of Se and Zn were lower than in EPIC, except for Zn in Italy. Non-survivors consistently had lower Se and Zn concentrations than survivors and displayed an elevated Cu/Zn ratio. Restricted cubic spline regression models revealed an inverse nonlinear association between Se or Zn and death, and a positive association between Cu/Zn ratio and death. With respect to patient age and sex, Se showed the highest predictive value for death (AUC=0.816), compared with Zn (0.782) or Cu (0.769). Discussion The data support the potential relevance of a decrease in serum Se and Zn for survival in COVID-19 across Europe. The observational study design cannot account for residual confounding and reverse causation, but supports the need for intervention trials in COVID-19 patients with severe Se and Zn deficiency to test the potential benefit of correcting their deficits for survival and convalescence.
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Affiliation(s)
- Kamil Demircan
- Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Thilo Samson Chillon
- Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tommy Bracken
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Ilaria Bulgarelli
- Laboratorio Analisi Cliniche, Centro di Ricerche e Tecnologie Biomediche, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Irene Campi
- Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Gijs Du Laing
- Laboratory of Analytical Chemistry and Applied Ecochemistry, Faculty of Bioscience Engineering, Ghent University, Gent, Belgium
| | - Samira Fafi-Kremer
- CHU de Strasbourg, Laboratoire de Virologie, Strasbourg University, INSERM, IRM UMR-S 1109, Strasbourg, France
| | - Laura Fugazzola
- Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alejandro Abner Garcia
- Centre for Experimental Pathogen Host Research, School of Medicine, University College Dublin, Dublin, Ireland
| | - Raban Heller
- Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, and Berlin Institute of Health, Berlin, Germany,Clinic of Traumatology and Orthopaedics, Bundeswehr Hospital Berlin, Berlin, Germany,Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - David J. Hughes
- School of Biomolecular and Biomedical Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Louis Ide
- Laboratory Medicine, AZ Jan Palfijn AV, Gent, Belgium
| | - Georg Jochen Klingenberg
- Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Pawel Komarnicki
- Department of Endocrinology, Metabolism, and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Zbigniew Krasinski
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, Poznan, Poland
| | - Alain Lescure
- Architecture et Réactivité de l’ARN, CNRS, Université de Strasbourg, Strasbourg, France
| | - Patrick Mallon
- Centre for Experimental Pathogen Host Research, School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Luca Persani
- Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy,Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Mirko Petrovic
- Department of Internal Medicine and Paediatrics, Ghent University, Gent, Belgium
| | - Marek Ruchala
- Department of Endocrinology, Metabolism, and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Morgane Solis
- CHU de Strasbourg, Laboratoire de Virologie, Strasbourg University, INSERM, IRM UMR-S 1109, Strasbourg, France
| | - Linos Vandekerckhove
- Department of Internal Medicine and Paediatrics, Ghent University, Gent, Belgium
| | - Lutz Schomburg
- Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, and Berlin Institute of Health, Berlin, Germany,*Correspondence: Lutz Schomburg,
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Abstract
The fast spread of the coronavirus disease 2019 (COVID-19) epidemic and its high mortality were quickly noticed by the health community. B vitamins are essential micronutrients for the body with antioxidant, anti-inflammatory and immune-regulating properties. The present study can provide a comprehensive picture of the associations between B vitamins and COVID-19 incidence. This study was undertaken on 9189 adult participants of the Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd (TAMIZ) study aged 20 to 69 years. Data on dietary intakes were obtained using a validated FFQ. Multivariable logistic regression analysis was used to evaluate the association between B vitamins and COVID-19. Our findings indicated that participants in the fourth quartile of vitamin B5 intake compared with the first quartile had a protective effect against COVID-19 (OR: 0·53, 95 % CI 0·28, 0·99, P-trend = 0·02) after adjustment for all possible confounds in model 3. In addition, participants in the third quartile of vitamin B12 intake compared with the first quartile (OR: 0·63, 95 % CI 0·40, 0·98, P-trend = 0·11) had fewer odds of COVID-19 after full adjustments for confounders. Our findings indicated no significant relationship between dietary intake of vitamin B1, B2, B3, B9 and B-complex and COVID-19. A higher intake of vitamin B5 could reduce the odds of COVID-19 by 47 %, and a moderate intake of vitamin B12 had a protective effect on COVID-19. Although our study has promising results, stronger clinical studies are needed.
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15
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Wang F, Zhong J, Zhang R, Sun Y, Dong Y, Wang M, Sun C. Zinc and COVID-19: Immunity, Susceptibility, Severity and Intervention. Crit Rev Food Sci Nutr 2022; 64:1969-1987. [PMID: 36094452 DOI: 10.1080/10408398.2022.2119932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic and continuing emergence of viral mutants, there has been a lack of effective treatment methods. Zinc maintains immune function, with direct and indirect antiviral activities. Zinc nutritional status is a critical factor in antiviral immune responses. Importantly, COVID-19 and zinc deficiency overlap in high-risk population. Hence, the potential effect of zinc as a preventive and adjunct therapy for COVID-19 is intriguing. Here, this review summarizes the immune and antiviral function of zinc, the relationship between zinc levels, susceptibility, and severity of COVID-19, and the effect of zinc supplementation on COVID-19. Existing studies have confirmed that zinc deficiency was associated with COVID-19 susceptibility and severity. Zinc supplementation plays a potentially protective role in enhancing immunity, decreasing susceptibility, shortening illness duration, and reducing the severity of COVID-19. We recommend that zinc levels should be monitored, particularly in COVID-19 patients, and zinc as a preventive and adjunct therapy for COVID-19 should be considered for groups at risk of zinc deficiency to reduce susceptibility and disease severity.
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Affiliation(s)
- Fan Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Jiayi Zhong
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Rui Zhang
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Yongzhi Sun
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Yingran Dong
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Maoqing Wang
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Changhao Sun
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
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16
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In-silico screening and in-vitro assay show the antiviral effect of Indomethacin against SARS-CoV-2. Comput Biol Med 2022; 147:105788. [PMID: 35809412 PMCID: PMC9245396 DOI: 10.1016/j.compbiomed.2022.105788] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/30/2022] [Accepted: 06/26/2022] [Indexed: 11/28/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the worldwide spread of coronavirus disease 19 (COVID-19), and till now, it has caused death to more than 6.2 million people. Although various vaccines and drug candidates are being tested globally with limited to moderate success, a comprehensive therapeutic cure is yet to be achieved. In this study, we applied computational drug repurposing methods complemented with the analyses of the already existing gene expression data to find better therapeutics in treatment and recovery. Primarily, we identified the most crucial proteins of SARS-CoV-2 and host human cells responsible for viral infection and host response. An in-silico screening of the existing drugs was performed against the crucial proteins for SARS-CoV-2 infection, and a few existing drugs were shortlisted. Further, we analyzed the gene expression data of SARS-CoV-2 in human lung epithelial cells and investigated the molecules that can reverse the cellular mRNA expression profiles in the diseased state. LINCS L1000 and Comparative Toxicogenomics Database (CTD) were utilized to obtain two sets of compounds that can be used to counter SARS-CoV-2 infection from the gene expression perspective. Indomethacin, a nonsteroidal anti-inflammatory drug (NSAID), and Vitamin-A were found in two sets of compounds, and in the in-silico screening of existing drugs to treat SARS-CoV-2. Our in-silico findings on Indomethacin were further successfully validated by in-vitro testing in Vero CCL-81 cells with an IC50 of 12 μM. Along with these findings, we briefly discuss the possible roles of Indomethacin and Vitamin-A to counter the SARS-CoV-2 infection in humans.
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17
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Wimalawansa SJ. Rapidly Increasing Serum 25(OH)D Boosts the Immune System, against Infections-Sepsis and COVID-19. Nutrients 2022; 14:2997. [PMID: 35889955 PMCID: PMC9319502 DOI: 10.3390/nu14142997] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/31/2022] [Accepted: 06/16/2022] [Indexed: 12/24/2022] Open
Abstract
Vitamin D deficiency is a global public health problem, a pandemic that commonly affects the elderly and those with comorbidities such as obesity, diabetes, hypertension, respiratory disorders, recurrent infections, immune deficiency, and malignancies, as well as ethnic minorities living in temperate countries. The same groups were worst affected by COVID-19. Since vitamin D deficiency weakens the immune system, it increases the risk of infections, complications, and deaths, such as from sepsis and COVID-19. Deficiency can be remedied cost-effectively through targeted food fortification, supplementation, and/or daily safe sun exposure. Its endocrine functions are limited to mineral metabolism, musculoskeletal systems, specific cell membrane interactions, and parathyroid gland functions. Except for the rapid, endocrine, and cell membrane-based non-genomic functions, all other biological and physiological activities of vitamin D depend on the adequate intracellular synthesis of 1,25(OH)2D (calcitriol) in peripheral target cells via the genome. Calcitriol mediates autocrine (intracrine) and paracrine signalling in immune cells, which provides broader, protective immune functions crucial to overcoming infections. The synthesis of 1,25(OH)2D (calcitriol) in peripheral target cells is dependent on diffusion and endocytosis of D3 and 25(OH)D from the circulation into them, which requires maintenance of serum 25(OH)D concentration above 50 ng/mL. Therefore, in acute infections such as sepsis and respiratory infections like COVID-19, it is necessary to rapidly provide its precursors, D3 and 25(OH)D, through the circulation to generate adequate intracellular calcitriol. Immune defence is one of the crucial non-hormonal functions of vitamin D. A single oral (bolus) dose or divided upfront loading doses between 100,000 and 500,000 IU, using 50,000 IU vitamin D3 increase the serum 25(OH)D concentrations to a therapeutic level of above 50 ng/mL that lasts between two to three months. This takes three to five days to raise serum 25(OH)D. In contrast, a single oral dose of calcifediol (0.014 mg/kg body weight) can generate the needed 25(OH)D concentration within four hours. Considering both D3 and 25(OH)D enter immune cells for generating calcitriol, using the combination of D3 (medium-term) and calcifediol (immediate) is cost-effective and leads to the best clinical outcome. To maximise protection against infections, particularly to reduce COVID-19-associated complications and deaths, healthcare workers should advise patients on safe sun exposure, adequate vitamin D supplementation and balanced diets containing zinc, magnesium, and other micronutrients to support the immune system. Meanwhile, governments, the World Health Organisation, the Centers for Disease Control, and governments should consider similar recommendations to physicians and the public, change the outdated vitamin D and other micronutrient recommendations directed to their population, and organise targetted food fortification programs for the vulnerable groups. This article discusses a rational approach to maintaining a sustained serum 25(OH)D concentration above 50 ng/mL, necessary to attain a robust immune system for overcoming infections. Such would cost-effectively improve the population’s health and reduce healthcare costs. It also describes three cost-effective, straightforward protocols for achieving and sustaining therapeutic serum 25(OH)D concentrations above 50 ng/mL (>125 nmol/L) to keep the population healthy, reduce absenteeism, improve productivity, and lower healthcare costs.
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Affiliation(s)
- Sunil J Wimalawansa
- Endocrinology & Nutrition, Department of Medicine, Cardiometabolic & Endocrine Institute, North Brunswick, NJ 08873, USA
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18
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Martínez-Gómez LE, Ibarra-González I, Fernández-Lainez C, Tusie T, Moreno-Macías H, Martinez-Armenta C, Jimenez-Gutierrez GE, Vázquez-Cárdenas P, Vidal-Vázquez P, Ramírez-Hinojosa JP, Rodríguez-Zulueta AP, Vargas-Alarcón G, Rojas-Velasco G, Sánchez-Muñoz F, Posadas-Sanchez R, Martínez-Ruiz FDJ, Zayago-Angeles DM, Moreno ML, Barajas-Galicia E, Lopez-Cisneros G, Gonzalez-Fernández NC, Ortega-Peña S, Herrera-López B, Olea-Torres J, Juárez-Arias M, Rosas-Vásquez M, Cabrera-Nieto SA, Magaña JJ, Camacho-Rea MDC, Suarez-Ahedo C, Coronado-Zarco I, Valdespino-Vázquez MY, Martínez-Nava GA, Pineda C, Vela-Amieva M, López-Reyes A. Metabolic Reprogramming in SARS-CoV-2 Infection Impacts the Outcome of COVID-19 Patients. Front Immunol 2022; 13:936106. [PMID: 36341434 PMCID: PMC9634751 DOI: 10.3389/fimmu.2022.936106] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/10/2022] [Indexed: 11/25/2023] Open
Abstract
Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection triggers inflammatory clinical stages that affect the outcome of patients with coronavirus disease 2019 (COVID-19). Disease severity may be associated with a metabolic imbalance related to amino acids, lipids, and energy-generating pathways. The aim of this study was to characterize the profile of amino acids and acylcarnitines in COVID-19 patients. A multicenter, cross-sectional study was carried out. A total of 453 individuals were classified by disease severity. Levels of 11 amino acids, 31 acylcarnitines, and succinylacetone in serum samples were analyzed by electrospray ionization-triple quadrupole tandem mass spectrometry. Different clusters were observed in partial least squares discriminant analysis, with phenylalanine, alanine, citrulline, proline, and succinylacetone providing the major contribution to the variability in each cluster (variable importance in the projection >1.5). In logistic models adjusted by age, sex, type 2 diabetes mellitus, hypertension, and nutritional status, phenylalanine was associated with critical outcomes (odds ratio=5.3 (95% CI 3.16-9.2) in the severe vs. critical model, with an area under the curve of 0.84 (95% CI 0.77-0.90). In conclusion the metabolic imbalance in COVID-19 patients might affect disease progression. This work shows an association of phenylalanine with critical outcomes in COVID-19 patients, highlighting phenylalanine as a potential metabolic biomarker of disease severity.
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Affiliation(s)
- Laura E. Martínez-Gómez
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Isabel Ibarra-González
- Unidad de Genética de la Nutrición, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, Mexico
| | - Cynthia Fernández-Lainez
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de México, Mexico
| | - Teresa Tusie
- Unidad de Biología Molecular y Medicina Genómica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Instituto de Investigaciones Biomédicas UNAM, Ciudad de México, Mexico
| | - Hortensia Moreno-Macías
- Unidad de Biología Molecular y Medicina Genómica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Instituto de Investigaciones Biomédicas UNAM, Ciudad de México, Mexico
- Departamento de Economía. División de Ciencias Sociales y Humanidades, Universidad Autónoma Metropolitana, Iztapalapa, Ciudad de México, Mexico
| | - Carlos Martinez-Armenta
- Posgrado en Biología Experimental, Dirección de Ciencias Biológicas y de la Salud (DCBS), Universidad Autónoma Metropolitana Iztapalapa, Ciudad de México, Mexico
| | - Guadalupe Elizabeth Jimenez-Gutierrez
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Paola Vázquez-Cárdenas
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Secretaría de Salud, Ciudad de México, Mexico
| | - Patricia Vidal-Vázquez
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Secretaría de Salud, Ciudad de México, Mexico
| | - Juan P. Ramírez-Hinojosa
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Secretaría de Salud, Ciudad de México, Mexico
| | - Ana P. Rodríguez-Zulueta
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Secretaría de Salud, Ciudad de México, Mexico
| | - Gilberto Vargas-Alarcón
- Departamentos de Biología Molecular, Inmunología, Endocrinologia y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Secretaría de Salud, Ciudad de México, Mexico
| | - Gustavo Rojas-Velasco
- Departamentos de Biología Molecular, Inmunología, Endocrinologia y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Secretaría de Salud, Ciudad de México, Mexico
| | - Fausto Sánchez-Muñoz
- Departamentos de Biología Molecular, Inmunología, Endocrinologia y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Secretaría de Salud, Ciudad de México, Mexico
| | - Rosalinda Posadas-Sanchez
- Departamentos de Biología Molecular, Inmunología, Endocrinologia y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Secretaría de Salud, Ciudad de México, Mexico
| | - Felipe de J. Martínez-Ruiz
- Nuevo Hospital General Delegación Regional Sur de la Ciudad de México, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE), Ciudad de México, Mexico
| | - Dulce M. Zayago-Angeles
- Nuevo Hospital General Delegación Regional Sur de la Ciudad de México, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE), Ciudad de México, Mexico
| | - Mariana L. Moreno
- Nuevo Hospital General Delegación Regional Sur de la Ciudad de México, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE), Ciudad de México, Mexico
| | - Edith Barajas-Galicia
- Hospital Central Norte Petróleos Mexicanos (PEMEX), Estado de México, Mexico City, Mexico
| | - Gerardo Lopez-Cisneros
- Hospital Central Norte Petróleos Mexicanos (PEMEX), Estado de México, Mexico City, Mexico
| | | | - Silvestre Ortega-Peña
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Brígida Herrera-López
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Jessel Olea-Torres
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Manuel Juárez-Arias
- Unidad de Investigación y Desarrollo en Alimentos, Tecnológico Nacional de México/Instituto Tecnológico (IT) Veracruz, Veracruz, Mexico
| | - Maritza Rosas-Vásquez
- Unidad de Investigación y Desarrollo en Alimentos, Tecnológico Nacional de México/Instituto Tecnológico (IT) Veracruz, Veracruz, Mexico
| | - Sara Aileen Cabrera-Nieto
- Posgrado en Ciencias Médicas, Facultad de Ciencias de la Salud, Universidad Anáhuac, Ciudad de México, Mexico
| | - Jonathan J. Magaña
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - María del Carmen Camacho-Rea
- Departamento de Nutrición Animal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salud, Ciudad de México, Mexico
| | - Carlos Suarez-Ahedo
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Irma Coronado-Zarco
- Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, Mexico
| | | | - Gabriela Angélica Martínez-Nava
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Carlos Pineda
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Marcela Vela-Amieva
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de México, Mexico
| | - Alberto López-Reyes
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
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19
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Režen T, Martins A, Mraz M, Zimic N, Rozman D, Moškon M. Integration of omics data to generate and analyse COVID-19 specific genome-scale metabolic models. Comput Biol Med 2022; 145:105428. [PMID: 35339845 PMCID: PMC8940269 DOI: 10.1016/j.compbiomed.2022.105428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 12/16/2022]
Abstract
COVID-19 presents a complex disease that needs to be addressed using systems medicine approaches that include genome-scale metabolic models (GEMs). Previous studies have used a single model extraction method (MEM) and/or a single transcriptomic dataset to reconstruct context-specific models, which proved to be insufficient for the broader biological contexts. We have applied four MEMs in combination with five COVID-19 datasets. Models produced by GIMME were separated by infection, while tINIT preserved the biological variability in the data and enabled the best prediction of the enrichment of metabolic subsystems. Vitamin D3 metabolism was predicted to be down-regulated in one dataset by GIMME, and in all by tINIT. Models generated by tINIT and GIMME predicted downregulation of retinol metabolism in different datasets, while downregulated cholesterol metabolism was predicted only by tINIT-generated models. Predictions are in line with the observations in COVID-19 patients. Our data indicated that GIMME and tINIT models provided the most biologically relevant results and should have a larger emphasis in further analyses. Particularly tINIT models identified the metabolic pathways that are a part of the host response and are potential antiviral targets. The code and the results of the analyses are available to download from https://github.com/CompBioLj/COVID_GEMs_and_MEMs.
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Affiliation(s)
- Tadeja Režen
- Centre for Functional Genomics and Bio-Chips, Institute for Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Miha Mraz
- Faculty of Computer and Information Science, University of Ljubljana, Ljubljana, Slovenia
| | - Nikolaj Zimic
- Faculty of Computer and Information Science, University of Ljubljana, Ljubljana, Slovenia
| | - Damjana Rozman
- Centre for Functional Genomics and Bio-Chips, Institute for Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miha Moškon
- Faculty of Computer and Information Science, University of Ljubljana, Ljubljana, Slovenia.
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20
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Voelkle M, Gregoriano C, Neyer P, Koch D, Kutz A, Bernasconi L, Conen A, Mueller B, Schuetz P. Prevalence of Micronutrient Deficiencies in Patients Hospitalized with COVID-19: An Observational Cohort Study. Nutrients 2022; 14:1862. [PMID: 35565831 PMCID: PMC9101904 DOI: 10.3390/nu14091862] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND A higher risk for severe clinical courses of coronavirus disease 2019 (COVID-19) has been linked to deficiencies of several micronutrients. We therefore studied the prevalence of deficiencies of eight different micronutrients in a cohort of hospitalized COVID-19-patients. METHODS We measured admission serum/plasma levels of vitamins A, B12, D, and E, as well as folic acid, zinc, selenium, and copper in 57 consecutively admitted adult patients with confirmed COVID-19 and analyzed prevalence of micronutrient deficiencies and correlations among micronutrient levels. Further, we studied associations of micronutrient levels with severe disease progression, a composite endpoint consisting of in-hospital mortality and/or need for intensive care unit (ICU) treatment with logistic regression. RESULTS Median age was 67.0 years (IQR 60.0, 74.2) and 60% (n = 34) were male. Overall, 79% (n = 45) of patients had at least one deficient micronutrient level and 33% (n = 19) had ≥3 deficiencies. Most prevalent deficiencies were found for selenium, vitamin D, vitamin A, and zinc (51%, 40%, 39%, and 39%, respectively). We found several correlations among micronutrients with correlation coefficients ranging from r = 0.27 to r = 0.42. The strongest associations with lower risk for severe COVID-19 disease progression (adjusted odds ratios) were found for higher levels of vitamin A (0.18, 95% CI 0.05-0.69, p = 0.01), zinc (0.73, 95% CI 0.55-0.98, p = 0.03), and folic acid (0.88, 95% CI 0.78-0.98, p = 0.02). CONCLUSIONS We found a high prevalence of micronutrient deficiencies in mostly older patients hospitalized for COVID-19, particularly regarding selenium, vitamin D, vitamin A, and zinc. Several deficiencies were associated with a higher risk for more severe COVID-19 courses. Whether supplementation of micronutrients is useful for prevention of severe clinical courses or treatment of COVID-19 warrants further research.
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Affiliation(s)
- Manyola Voelkle
- Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland; (M.V.); (C.G.); (D.K.); (A.K.); (B.M.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland;
| | - Claudia Gregoriano
- Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland; (M.V.); (C.G.); (D.K.); (A.K.); (B.M.)
| | - Peter Neyer
- Institute of Laboratory Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland; (P.N.); (L.B.)
| | - Daniel Koch
- Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland; (M.V.); (C.G.); (D.K.); (A.K.); (B.M.)
| | - Alexander Kutz
- Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland; (M.V.); (C.G.); (D.K.); (A.K.); (B.M.)
| | - Luca Bernasconi
- Institute of Laboratory Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland; (P.N.); (L.B.)
| | - Anna Conen
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland;
- Department of Infectious Diseases and Infection Prevention, Kantonsspital Aarau, 5001 Aarau, Switzerland
| | - Beat Mueller
- Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland; (M.V.); (C.G.); (D.K.); (A.K.); (B.M.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland;
| | - Philipp Schuetz
- Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland; (M.V.); (C.G.); (D.K.); (A.K.); (B.M.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland;
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21
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Obesity and Leptin Resistance in the Regulation of the Type I Interferon Early Response and the Increased Risk for Severe COVID-19. Nutrients 2022; 14:nu14071388. [PMID: 35406000 PMCID: PMC9002648 DOI: 10.3390/nu14071388] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 02/06/2023] Open
Abstract
Obesity, and obesity-associated conditions such as hypertension, chronic kidney disease, type 2 diabetes, and cardiovascular disease, are important risk factors for severe Coronavirus disease-2019 (COVID-19). The common denominator is metaflammation, a portmanteau of metabolism and inflammation, which is characterized by chronically elevated levels of leptin and pro-inflammatory cytokines. These induce the “Suppressor Of Cytokine Signaling 1 and 3” (SOCS1/3), which deactivates the leptin receptor and also other SOCS1/3 sensitive cytokine receptors in immune cells, impairing the type I and III interferon early responses. By also upregulating SOCS1/3, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 adds a significant boost to this. The ensuing consequence is a delayed but over-reactive immune response, characterized by high-grade inflammation (e.g., cytokine storm), endothelial damage, and hypercoagulation, thus leading to severe COVID-19. Superimposing an acute disturbance, such as a SARS-CoV-2 infection, on metaflammation severely tests resilience. In the long run, metaflammation causes the “typical western” conditions associated with metabolic syndrome. Severe COVID-19 and other serious infectious diseases can be added to the list of its short-term consequences. Therefore, preventive measures should include not only vaccination and the well-established actions intended to avoid infection, but also dietary and lifestyle interventions aimed at improving body composition and preventing or reversing metaflammation.
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22
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Hange N, Somagutta MR, Wadagale A, Hamdan AHY, Jain MS, Bobba SH, Batti E, Emuze B. Impact of the Coronavirus Disease on Micronutrient Search Trends and Interest in Global Population: A Worldwide Google Trend Analysis. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/11877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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Tsuchiya H. Gustatory and Saliva Secretory Dysfunctions in COVID-19 Patients with Zinc Deficiency. Life (Basel) 2022; 12:life12030353. [PMID: 35330104 PMCID: PMC8950751 DOI: 10.3390/life12030353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 12/22/2022] Open
Abstract
Given the ever-progressing studies on coronavirus disease 2019 (COVID-19), it is critical to update our knowledge about COVID-19 symptomatology and pathophysiology. In the present narrative review, oral symptoms were overviewed using the latest data and their pathogenesis was hypothetically speculated. PubMed, LitCovid, ProQuest, and Google Scholar were searched for relevant studies from 1 April 2021 with a cutoff date of 31 January 2022. The literature search indicated that gustatory dysfunction and saliva secretory dysfunction are prevalent in COVID-19 patients and both dysfunctions persist after recovery from the disease, suggesting the pathogenic mechanism common to these cooccurring symptoms. COVID-19 patients are characterized by hypozincemia, in which zinc is possibly redistributed from blood to the liver at the expense of zinc in other tissues. If COVID-19 induces intracellular zinc deficiency, the activity of zinc-metalloenzyme carbonic anhydrase localized in taste buds and salivary glands may be influenced to adversely affect gustatory and saliva secretory functions. Zinc-binding metallothioneins and zinc transporters, which cooperatively control cellular zinc homeostasis, are expressed in oral tissues participating in taste and saliva secretion. Their expression dysregulation associated with COVID-19-induced zinc deficiency may have some effect on oral functions. Zinc supplementation is expected to improve oral symptoms in COVID-19 patients.
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