COVID-19: Poor outcomes in patients with Zinc deficiency

Jothimani, Dinesh; Kailasam, Ezhilarasan; Danielraj, Silas; Nallathambi, Balaji; Ramachandran, Hemalatha; Sekar, Padmini; Manoharan, Shruthi; Ramani, Vidyalakshmi; Narasimhan, Gomathy; Kaliamoorthy, Ilankumaran; Rela, Mohamed

Background Zinc is a trace element with potent immunoregulatory, antiviral properties and is utilized in the treatment of COVID-19. However, we do not know the clinical significance of serum Zinc level in COVID-19 patients. Aim To determine the clinical significance of serum Zinc in COVID-19 patients and to establish a correlation with disease severity. Methodology A prospective study on COVID-19 patients underwent fasting Zinc level at the time of hospitalisation. An initial comparative analysis was carried out between COVID-19 patients and healthy controls. Zinc deficiency COVID-19 patients were compared to those with normal levels. Results COVID-19 patients (n = 47) showed significantly low Zinc levels compared to healthy controls (n = 45), median 74.5 (IQR 53.4-94.6) vs 105.8 (IQR 95.65120.90) µg/dl, P < 0.001. Amongst COVID-19 positive patients, 27 (57.4%) were found Zinc deficient. These patients were found to have higher complications (P = 0.009), ARDS (18.5% vs 0%, P = 0.06), received corticosteroid therapy (P = 0.02), prolonged hospital stay (P = 0.05) and increased mortality (18.5% vs 0%, P = 0.06). The Odds ratio (OR) of developing complications in Zinc deficient COVID-19 patients was 5.54. Conclusion Our data clearly shows that significant number of COVID-19 patients are Zinc deficient. These Zinc deficient patients developed more complications with prolonged hospital stay and were associated with increased mortality.