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Low Zinc Levels at Clinical Admission Associates with Poor Outcomes in COVID-19

20 Pages Posted: 26 Oct 2020

See all articles by Marina Vogel-González

Marina Vogel-González

Universitat Pompeu Fabra - Laboratory of Molecular Physiology

Marc Talló-Parra

Universitat Pompeu Fabra - Molecular Virology Group

Víctor Herrera-Fernández

Universitat Pompeu Fabra - Laboratory of Molecular Physiology

Gemma Pérez-Vilaró

Universitat Pompeu Fabra - Molecular Virology Group

Miguel Chillón

Autonomous University of Barcelona - Department of Biochemistry and Molecular Biology

Xavier Nogués

Autonomous University of Barcelona - Department of Internal Medicine

Silvia Gómez-Zorrilla

Autonomous University of Barcelona - Department of Infectious Diseases

Inmaculada López-Montesinos

Autonomous University of Barcelona - Department of Infectious Diseases

Judit Villar

Autonomous University of Barcelona - Department of Infectious Diseases

Luisa Sorlí-Redó

Autonomous University of Barcelona - Department of Infectious Diseases

Juan Pablo Horcajada

Autonomous University of Barcelona - Department of Infectious Diseases

Natalia García-Giralt

Autonomous University of Barcelona - Department of Internal Medicine

Julio Pascual

Autonomous University of Barcelona - Department of Nephrology

Juana Díez

Universitat Pompeu Fabra - Molecular Virology Group

Rubén Vicente

Universitat Pompeu Fabra - Laboratory of Molecular Physiology

Robert Güerri-Fernández

Autonomous University of Barcelona - Department of Internal Medicine

More...

Abstract

Background: Biomarkers to predict Coronavirus disease-19 (COVID-19) outcome early at infection are urgently needed to improve prognosis and treatment.  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 more severe COVID-19 outcomes. We hypothesize that serum zinc content (SZC) influences COVID-19 disease progression and thus might represent a useful biomarker.

Methods: We run a retrospective observational 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 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-CoV2 infected cells.

Interpretation: SZC is a novel biomarker to predict 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.

Funding: This work was supported by the Spanish Ministry of Science and Innovation through grants PID2019-106755RB-I00/AEI/10.13039/501100011033 to RV and PID2019-106959RB-I00/AEI /10.13039/501100011033 to JD, an institutional “Maria de Maeztu” Programme for Units of Excellence in R&D (CEX2018-000792-M) to RV and JD and by the 2017 SGR 909 grant from the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement of the Generalitat de Catalunya to JD. RGF received support and funding from Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES) [Grant number CB16/10/00245], FEDER funds and the FIS Project from Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación [Grant number (PI19/00019)]

Declaration of Interests: The authors declare that no competing interests exist.

Ethics Approval Statement: The Institutional Ethics Committee of Hospital del Mar of Barcelona approved the study and due to the nature of the retrospective data review, and waived the need for informed consent from individual patients (CEIm 2020/9352).

Keywords: SARS-CoV-2, serum Zinc, clinical outcomes

Suggested Citation

Vogel-González, Marina and Talló-Parra, Marc and Herrera-Fernández, Víctor and Pérez-Vilaró, Gemma and Chillón, Miguel and Nogués, Xavier and Gómez-Zorrilla, Silvia and López-Montesinos, Inmaculada and Villar, Judit and Sorlí-Redó, Luisa and Horcajada, Juan Pablo and García-Giralt, Natalia and Pascual, Julio and Díez, Juana and Vicente, Rubén and Güerri-Fernández, Robert, Low Zinc Levels at Clinical Admission Associates with Poor Outcomes in COVID-19. Available at SSRN: https://ssrn.com/abstract=3696880 or http://dx.doi.org/10.2139/ssrn.3696880

Marina Vogel-González

Universitat Pompeu Fabra - Laboratory of Molecular Physiology ( email )

Spain

Marc Talló-Parra

Universitat Pompeu Fabra - Molecular Virology Group ( email )

Ramon Trias Fargas, 25-27
Barcelona, E-08005
Spain

Víctor Herrera-Fernández

Universitat Pompeu Fabra - Laboratory of Molecular Physiology ( email )

Spain

Gemma Pérez-Vilaró

Universitat Pompeu Fabra - Molecular Virology Group ( email )

Ramon Trias Fargas, 25-27
Barcelona, E-08005
Spain

Miguel Chillón

Autonomous University of Barcelona - Department of Biochemistry and Molecular Biology ( email )

Plaça Cívica
Cerdañola del Valles
Barcelona, Barcelona 08193
Spain

Xavier Nogués

Autonomous University of Barcelona - Department of Internal Medicine

Spain

Silvia Gómez-Zorrilla

Autonomous University of Barcelona - Department of Infectious Diseases ( email )

Plaça Cívica
Cerdañola del Valles
Barcelona, Barcelona 08193
Spain

Inmaculada López-Montesinos

Autonomous University of Barcelona - Department of Infectious Diseases ( email )

Plaça Cívica
Cerdañola del Valles
Barcelona, Barcelona 08193
Spain

Judit Villar

Autonomous University of Barcelona - Department of Infectious Diseases ( email )

Plaça Cívica
Cerdañola del Valles
Barcelona, Barcelona 08193
Spain

Luisa Sorlí-Redó

Autonomous University of Barcelona - Department of Infectious Diseases ( email )

Plaça Cívica
Cerdañola del Valles
Barcelona, Barcelona 08193
Spain

Juan Pablo Horcajada

Autonomous University of Barcelona - Department of Infectious Diseases ( email )

Plaça Cívica
Cerdañola del Valles
Barcelona, Barcelona 08193
Spain

Natalia García-Giralt

Autonomous University of Barcelona - Department of Internal Medicine ( email )

Spain

Julio Pascual

Autonomous University of Barcelona - Department of Nephrology

Barcelona
Spain

Juana Díez

Universitat Pompeu Fabra - Molecular Virology Group ( email )

Ramon Trias Fargas, 25-27
Barcelona, E-08005
Spain

Rubén Vicente

Universitat Pompeu Fabra - Laboratory of Molecular Physiology ( email )

Spain

Robert Güerri-Fernández (Contact Author)

Autonomous University of Barcelona - Department of Internal Medicine ( email )

Spain

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