The association between serum levels of micronutrients and the severity of disease in patients with COVID-19

Beigmohammadi, Mohammad Taghi; Bitarafan, Sama; Abdollahi, Alireza; Amoozadeh, Laya; Salahshour, Faeze; Mahmoodi ali abadi, Maedeh; Soltani, Danesh; Motallebnejad, Zoya Asl

BACKGROUND AND AIM: To compare the serum level of micronutrients with the normal amount and assess the association among them and the severity of disease and inflammatory cytokines in patients with COVID-19. METHODS: Present cross-sectional study included 60 ICU-admitted patients with COVID-19. We recorded data on demographics, anthropometric, and medical history. Serum levels of inflammatory markers (ESR, CRP, IFN-g, TNF-a, IL-6), vitamins (A, B(9), B(12), C, D, E), and minerals (Mg, Zn, Iron) were measured. A Radiologist assessed the severity of lung involvement according to their CT scan. The severity of illness was evaluated with APACHE score, O2 saturation, and body temperature. Independent associations among the serum levels of micronutrients with the severity of the COVID-19 were measured. RESULTS: The median (IQR) of patient age was 53.50 (12.75). Except for vitamin A and Zn, serum levels of other micronutrients were lower than minimum normal. Patients with APACHE score ≥ 25 had higher BMI (p= 0.044), body temperature (0.003), ESR (0.008), CRP (0.003), and had lower O(2) saturation (0.005), serum levels of vitamin D (< 0.001) and Zn (< 0.001), compared to patients with APACHE score < 25. We found that the lower serum levels of vitamin D, Mg, and Zn were significantly and independently associated with higher APACHE scores (p= 0.001, 0.028, and < 0.001, respectively) and higher lung involvement (p= 0.002, 0.045, and < 0.001, respectively). CONCLUSIONS: Conclusions: Lower serum levels of vitamin D, Zn, and Mg were involved in severe COVID-19.