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

Background: Zinc is an essential micronutrient that impacts host–pathogen interplay at infection. Zinc balances immune responses, and also has a proven direct antiviral action against some viruses. Importantly, zinc deficiency (ZD) is a common condition in elderly and individuals with chronic diseases, two groups with an increased risk for severe severe coronavirus disease 2019 (COVID-19) outcomes. We hypothesize that serum zinc content (SZC) influences COVID-19 disease progression, and thus might represent a useful biomarker. Methods: We ran an observational cohort study with 249 COVID-19 patients admitted in Hospital del Mar. We have studied COVID-19 severity and progression attending to SZC at admission. In parallel, we have studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) replication in the Vero E6 cell line modifying zinc concentrations. Findings: Our study demonstrates a correlation between serum zinc levels and COVID-19 outcome. Serum zinc levels lower than 50 µg/dL at admission correlated with worse clinical presentation, longer time to reach stability, and higher mortality. Our in vitro results indicate that low zinc levels favor viral expansion in SARS-CoV-2 infected cells. Interpretation: Low SZC is a risk factor that determines COVID-19 outcome. We encourage performing randomized clinical trials to study zinc supplementation as potential prophylaxis and treatment with people at risk of zinc deficiency.

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Low zinc levels at clinical admission associates with poor outcomes in COVID-19

10.1101/2020.10.07.20208645 ◽

2020 ◽

Author(s):

Marina Vogel-González ◽

Marc Talló-Parra ◽

Víctor Herrera-Fernández ◽

Gemma Pérez-Vilaró ◽

Miguel Chillón ◽

...

Keyword(s):

Zinc Deficiency ◽

Randomized Clinical Trials ◽

Serum Zinc ◽

Zinc Content ◽

Zinc Concentrations ◽

Infected Cells ◽

Poor Outcomes ◽

Zinc Levels ◽

Serum Zinc Levels

AbstractBackgroundBiomarkers 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.MethodsWe 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.FindingsOur 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.InterpretationSZC 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.FundingSpanish Ministry of Science and Innovation, “Maria de Maeztu” Programme for Units of Excellence in R&D and Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement of the Generalitat de Catalunya. Instituto Carlos III Fondos de Investigaciones Sanitarias (FIS), CIBER on Frailty and Healthy Ageing and FEDER funds

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The Effect of Biscuits Made From Pumpkin Seeds Flour on Serum Zinc Levels and Weight in Malnutrition Wistar Rats

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4402 ◽

2020 ◽

Vol 8 (A) ◽

pp. 428-433

Author(s):

Aminuddin Syam ◽

Fitrah Khaerani Burhan ◽

Veni Hadju ◽

C. Citrakesumasari ◽

Andi Muhammad Akhmar

Keyword(s):

Body Weight ◽

Wistar Rats ◽

Serum Zinc ◽

Zinc Content ◽

Control Group ◽

Test Results ◽

Pumpkin Seed ◽

Seed Flour ◽

Zinc Levels ◽

Serum Zinc Levels

BACKGROUND: Serum zinc levels are found to be low in children of protein energy malnutrition globally. Pumpkin seed flour has a high zinc content of 6.88 mg/100 g, has been formulated biscuits made from pumpkin seed flour with a zinc content of 1.52 mg/100 g. AIM: This study aims to determine the effect of giving biscuits made from pumpkin seed flour to serum zinc levels and body weight in malnutrition Wistar rats. METHODS: This research is a true experiment with pre-post-test with control group design. Subjects were 28 male Wistar strain rats induced by fasting malnutrition for 3 days and then given biscuits with a zinc dose of 0.027 mg; 0.054 mg; and 0.081 mg/BW/day and in the control group without biscuits for 2 weeks. Serum zinc levels were examined using the atomic absorption spectrophotometry method. Data were analyzed using paired t-test and one-way ANOVA test. RESULTS: Paired t-test results on serum zinc levels obtained p > 0.05 and on body weight obtained p < 0.05. One-way ANOVA test results on serum zinc levels after the intervention obtained p > 0.05 and at body weight obtained p < 0.05 followed by post hoc least significant difference test found that there were significant differences between the control group and the P1 group, a dose of 0.027 mg (p = 0.015) and P2 groups, doses of 0.054 mg (p = 0.012). Greater weight gain was found in the P1 group with an increase of 38.85%. CONCLUSION: The provision of biscuits made from pumpkin seed flour has an effect on increasing body weight of malnutrition Wistar rats and has no effect on serum zinc levels, so further research is expected to use different doses.

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Dysgeusia Due to Zinc Deficiency After Pancreaticoduodenectomy Requiring Continuous Intravenous Zinc Supplementation: a Case Report and Literature Review

10.21203/rs.3.rs-957498/v1 ◽

2021 ◽

Author(s):

Hironobu Hata ◽

Yojiro Ota ◽

Katsuhiko Uesaka ◽

Yutaka Yamazaki ◽

Tsubasa Murata ◽

...

Keyword(s):

Zinc Deficiency ◽

Oral Surgery ◽

Oral Care ◽

Serum Zinc ◽

Zinc Level ◽

Normal Serum ◽

Acrodermatitis Enteropathica ◽

Proximal Jejunum ◽

Zinc Levels ◽

Serum Zinc Levels

Abstract Background: Zinc is mainly absorbed in the duodenum and proximal jejunum, which are removed during pancreaticoduodenectomy (PD). Little is known about the adverse oral events and skin disorders caused by zinc deficiency after PD. Herein, we reviewed studies regarding the development of zinc deficiency after PD and presented the case of a patient with zinc deficiency after PD, who required home intravenous zinc replacement.Case presentation: A 73-year-old woman with glossitis, taste disorder, and acrodermatitis enteropathica-like eruption on her fingers presented to the Division of Dentistry and Oral Surgery 69 days after PD. Her serum zinc level markedly decreased to 30 μg/dL. Oral zinc administration was inadequate to treat hypozincemia after PD; therefore, multi-trace elements were injected intravenously under readmission. Her serum zinc levels recovered, and the lesions gradually improved. Furthermore, a central venous port was implanted to maintain normal serum zinc levels, and she continued self-injecting zinc at home.Conclusion: Zinc deficiency after PD rarely occurs. The clinical oncologist community, including dentists responsible for the oral care of cancer patients, should be aware of dysgeusia associated with zinc deficiency after cancer surgery, as well as that induced by chemotherapy or head and neck radiation therapy.

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Zinc Intake, Zinc Serum Levels, and Intelligence in School Children in Rural Areas

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5869 ◽

2021 ◽

Vol 9 (E) ◽

pp. 394-397

Author(s):

Rostika Flora ◽

Nur Alam Fajar ◽

Fatmalina Febri ◽

Indah Yuliana ◽

Yuliarti Yuliarti ◽

...

Keyword(s):

Zinc Deficiency ◽

School Children ◽

Significant Relationship ◽

Rural Areas ◽

Serum Zinc ◽

Zinc Intake ◽

Serum Zn ◽

Zinc Levels ◽

Serum Zinc Levels ◽

Low Serum

BACKGROUND: Children in rural areas are susceptible to zinc deficiency. Zinc deficiency in children can affect cognitive function in children. Zinc plays a role in cellular function and critical brain growth processes, including cell replication, DNA and RNA synthesis, and the release of neurotransmitters. AIM: This study aimed to analyze the condition of zinc deficiency and its relationship with the level of intelligence in children in rural areas. METHODS: The study design was cross-sectional, with a sample of 44 elementary school children aged 9–12 years taken randomly. Blood was drawn to measure serum Zn-levels, and serum Zn-levels were measured using Colorimetric Assay Kit (E-BC-K137). Zinc intake data were obtained from the food recall form, which was carried out 3 × 24 h. The level of intelligence is measured by the Culture Fair Intelligence Test method. The sample characteristics data obtained through a questionnaire. Furthermore, the data were analyzed using the Chi-square test. RESULTS: About 84.2% of children with insufficient zinc intake had low serum Zn-levels. There was a significant relationship between zinc intake and serum zinc levels (p = 0.026; PR = 4.293). Children with low serum zinc levels of 96.5% have intelligence levels below average. There was a significant relationship between serum zinc levels and intelligence level as well (p = 0.001; PR = 24,500). CONCLUSION: Zinc deficiency in children is characterized by low serum Zn-levels. Low serum Zn-level is caused by low zinc intake, thus children with low serum Zn-levels are at risk of having intelligence level below average. Therefore, health education about the importance of zinc intake in children should be given to parents, so that the incidence of zinc deficiency in children can be reduced.

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Zinc deficiency in Japanese children with idiopathic short stature

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0129 ◽

2019 ◽

Vol 32 (10) ◽

pp. 1083-1087 ◽

Cited By ~ 2

Author(s):

Kei Yoshida ◽

Tatsuhiko Urakami ◽

Remi Kuwabara ◽

Ichiro Morioka

Keyword(s):

Short Stature ◽

Zinc Deficiency ◽

Serum Insulin ◽

Serum Zinc ◽

Zinc Level ◽

Idiopathic Short Stature ◽

Japanese Children ◽

The Mean ◽

Zinc Levels ◽

Serum Zinc Levels

Abstract Background and methods We investigated the frequency of zinc deficiency in Japanese children with idiopathic short stature, and evaluated whether serum zinc levels correlated with background factors, including age and standard deviation scores (SDSs) for height and serum insulin-like growth factor (IGF)-1 levels. The study subjects consisted of 89 Japanese children. Results The mean serum zinc level was 79 ± 12 (49–108) μg/dL. Of all the children, 48.3% had a low zinc level, in the 60–80 μg/dL range, and 6.7% had zinc deficiency with a zinc level below 60 μg/dL. The majority with a low zinc level and zinc deficiency were asymptomatic other than for short stature. We found no significant correlations of serum zinc with age, or the SDSs for height and serum IGF-1 levels, in either the entire subject population or those with a zinc level below 80 μg/dL. Conclusions We found a low zinc level to be common in Japanese children with idiopathic short stature, whereas actual zinc deficiency was rare. However, other as yet unknown mechanisms not associated with the growth hormone (GH)-IGF-1 axis could be involved in growth retardation in idiopathic short stature.

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Clinical Significance of Serum Zinc Levels in Cerebral Ischemia

Stroke Research and Treatment ◽

10.4061/2010/245715 ◽

2010 ◽

Vol 2010 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Archit Bhatt ◽

Muhammad U. Farooq ◽

Sailaja Enduri ◽

Clement Pillainayagam ◽

Bharath Naravetla ◽

...

Keyword(s):

Functional Status ◽

Serum Zinc ◽

Stroke Severity ◽

Stroke Outcome ◽

Cellular Functions ◽

Zinc Concentrations ◽

Poor Functional Status ◽

Zinc Levels ◽

Serum Zinc Levels ◽

Low Serum

Background. Zinc mediates several vital physiological, enzymatic and cellular functions. The association between serum zinc and stroke outcome has not been previously evaluated.Methods. This single center retrospective study was conducted on consecutive stroke () and TIA () patients. We sought to determine whether serum zinc concentrations in patients with acute ischemic strokes were associated with stroke severity and poor functional status at discharge, respectively.Results. Overall, out of the 224 patients analyzed (mean age 67 years), 35.7% patients had low zinc levels (65 mcg/dL). Patients with stroke () were more likely to have low zinc levels (, CI , ) compared to patients with TIA (). For patients with stroke (), multivariate analysis showed that low serum zinc levels (OR 2.82, CI , ) and strokes with admission severe strokes () (OR 2.68, CI , ) were independently associated with poor functional status () at discharge from the hospital.Conclusion. Low serum zinc concentrations are associated with more severe strokes on admission and poor functional status at discharge.

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Correlation between Serum Zinc Levels and Levodopa in Parkinson’s Disease

Nutrients ◽

10.3390/nu13114114 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4114

Author(s):

Hirofumi Matsuyama ◽

Keita Matsuura ◽

Hidehiro Ishikawa ◽

Yoshinori Hirata ◽

Natsuko Kato ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Zinc Deficiency ◽

Clinical Symptoms ◽

Psychiatric Symptoms ◽

Serum Zinc ◽

Dosing Frequency ◽

The Mean ◽

Zinc Levels ◽

Serum Zinc Levels

Long-term intake of potential zinc-chelating drugs may cause zinc deficiency. We postulated that zinc deficiency in Parkinson’s disease (PD) patients was related to the intake of drugs such as levodopa. We investigated the relationship between zinc levels and levodopa administration period, dosage, and symptoms of zinc deficiency in PD patients. We measured serum zinc levels and analyzed correlations between serum zinc levels, the levodopa oral administration period, dosage, dosing frequency, and zinc deficiency symptoms including taste disorders. Data analyses were performed using Spearman’s rank correlation coefficient. The mean serum zinc level was 60.5 ± 11.6 μg/dL. The mean administration period for levodopa was 8.0 ± 5.5 years, mean administration frequency 3.4 ± 0.9 times/d, and mean administration dose 420.6 ± 237.1 mg/d. Negative correlations between zinc levels and levodopa dosage and dosing frequency were found. Multiple regression analysis showed a significant correlation with the frequency of levodopa (β = −0.360, p = 0.007). No significant change in clinical symptoms was observed after zinc administration, but anxiety tended to improve. Our results indicated that frequent levodopa administration strongly influenced serum zinc levels which may have alleviating effects on psychiatric symptoms; therefore, preventing zinc deficiency can be important during PD treatment.

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Lower Serum Zinc Levels in Patients with Multiple Sclerosis Compared to Healthy Controls

Nutrients ◽

10.3390/nu10080967 ◽

2018 ◽

Vol 10 (8) ◽

pp. 967 ◽

Cited By ~ 10

Author(s):

Marc Pawlitzki ◽

Julia Uebelhör ◽

Catherine Sweeney-Reed ◽

Heike Stephanik ◽

Juliane Hoffmann ◽

...

Keyword(s):

Multiple Sclerosis ◽

Serum Zinc ◽

Healthy Controls ◽

Lower Serum ◽

Disability Status ◽

Zinc Concentrations ◽

Disease Subtypes ◽

Disease Modifying ◽

Zinc Levels ◽

Serum Zinc Levels

Objective: Diminished blood levels of zinc have been reported to be associated with T-cell-mediated autoimmunity, which has been implicated in multiple sclerosis (MS). We aimed to compare the distribution of serum zinc status in MS patients with that in healthy controls (HCs) and to investigate a potential correlation with clinical state, through analysis of serum zinc concentration in MS patients suffering from different disease subtypes. Methods: Serum zinc concentrations of 133 patients with relapsing (RMS) and 18 patients with the progressive form of MS (PMS), according to the McDonald criteria of 2010, were measured. Clinical status was quantified using the Expanded Disability Status Scale (EDSS). Zinc concentrations were also determined in the sera of 50 HCs, matched for age and sex at a group level. Results: MS patients showed significantly lower zinc concentrations (mean (SD)) than HCs (12.5 (2.1) µmol/L vs. 14.6 (2.3) µmol/L, p < 0.001). In contrast, we did not find any difference between RMS (12.4 (2.0) µmol/L) and PMS (13.0 (3.0) µmol/L) cases (p = 0.8). Patients receiving disease-modifying treatment showed lower mean (SD) serum zinc levels than untreated cases (12.3 (1.9) µmol/L vs. 13.5 (3.2) µmol/L, p < 0.03). Zinc levels were not related to disease duration, EDSS, annual relapse rate, or the median number of relapses. Conclusions: The data suggest that a diagnosis of MS is related to lower serum zinc concentrations than in HCs, and concentrations were lower still under disease-modifying therapy. However, zinc levels did not predict disease subtypes or disability status.

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Decreasing Zinc Levels in Stunting Toddlers in Lampung Province, Indonesia

Biomedical & Pharmacology Journal ◽

10.13005/bpj/1633 ◽

2019 ◽

Vol 12 (1) ◽

pp. 239-243

Author(s):

Khairun Nisa Berawi ◽

Maya Nurul Hidayati ◽

Susianti Susianti ◽

Roro Rukmi W. Perdami ◽

Tiwuk Susantiningsih ◽

...

Keyword(s):

Univariate Analysis ◽

Serum Zinc ◽

Zinc Content ◽

Zinc Level ◽

Bivariate Analysis ◽

Cross Sectional ◽

The Mean ◽

The Difference ◽

Zinc Levels ◽

Serum Zinc Levels

Stunting is a condition of chronic malnutrition in children that causes the posture is not optimal and triggers other disorders such as deacreasing of immunity and intelligence. The level of adequacy of zinc is one of the factors that influence the incidence of stunting. Zinc is needed to activate and begin the synthesis of Growth Hormone (GH) so that children with zinc deficiency cause GH receptors to be disrupted and GH production to be resistant. This study aims to examine the decrease in zinc levels by looking at the difference in mean zinc levels in stunting and non-stunting toddlers. The research method was carried out observational analytic with a cross sectional approach used in this study. The study sample was 40 toddlers aged 24-60 months with 18 stunting toddlers and 22 non-stunting toddlers in Gunung Sugih District, Central Lampung Regency. The results of univariate analysis revealed that the average zinc level of toddlers serum was 52.60 ug / dl with the largest value of 76 ug / dl and the lowest value was 24 ug / dl. The results of bivariate analysis showed that there were significant differences in the mean zinc levels of stunting and non-stunting children (p = 0.01). The mean zinc content of stunting infants was 45.06 ± 12.21 lower than the mean zinc level of non-stunting infants 58.77 ± 12.98. There is a decrease in serum zinc levels in stunting toddlers compared to non stunting toddlers.

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Comparison of maternal serum and neonatal cord blood levels of zinc in relation to birth weight and period of gestation

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20212880 ◽

2021 ◽

Vol 8 (8) ◽

pp. 1349

Author(s):

Shabbeer Ahmed ◽

Avula Kanthi Sagar

Keyword(s):

Birth Weight ◽

Cord Blood ◽

Zinc Deficiency ◽

Serum Zinc ◽

Maternal Serum ◽

Blood Levels ◽

P Value ◽

Zinc Levels ◽

Blood Zinc ◽

Serum Zinc Levels

Background: Women are at increased risk of zinc deficiency during pregnancy because of high fetal requirements for zinc. Severe maternal zinc deficiency has been associated with poor fetal growth, spontaneous abortion and congenital malformations (i.e., anencephaly), whereas milder forms of zinc deficiency have been associated with low birth weight (LBW), intrauterine growth retardation, and preterm delivery. However, the research relating maternal zinc status and birth weight has not produced consistent results. This study has been undertaken to confirm the association between maternal serum zinc concentration and birth weight and period of gestation in setting like India.Methods: A total of 100 new-borns were included and divided into two groups, the ‘study group’ had babies with birth weight <2.5 kg and control group’ with babies >2.5 kg birth weight. Cord blood from the new-borns and serum samples of mothers were collected and the zinc levels were measured.Results: The correlation of cord blood and the maternal serum zinc levels were assessed in relation to birth weight and the gestational age. The results were compared between the two groups. The difference in values between the two groups was statistically significant, maternal serum zinc levels and birth weight (84.78±21.62 vs 66.04±18.66) (‘P’ value 0.04), cord blood zinc levels and birth weight (98.44±22.59 vs 79.78±19.54) (‘P’ value <0.001). The maternal serum and cord blood zinc was compared between the preterm and term; the results were statistically significant.Conclusions: The maternal and cord blood levels of zinc are correlated well with the birth weight and the gestational age at delivery. Supplementation of zinc during gestation might help reduce the incidence of IUGR and the risk of prematurity.

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