Low Levels of Zinc Associated With Poor Outcomes in COVID-19

Zinc is an essential trace element and mineral which is required for our body to carry out all fundamental and biological functions. One of the important functions of zinc is to maintain a healthy immune system for both adaptive and innate immunity. Zinc Deficiency (ZD) or low absorption of zinc or defective absorption of zinc can lead to an imbalance of the immune system. In adaptive immunity, zinc affects Tcell production and cytokine production.

Incase of innate immunity, zinc has an anti-inflammatory role. Conversely, Zinc Deficiency is associated with higher levels of Interleukin -1 Beta, Tumour Necrosis Factor (TNF), and altered activity of monocytes, neutrophils, and Natural Killer cells (NK) which causes increases susceptibility to infections. Zinc supplementation significantly reduced the duration of Respiratory Tract infection caused by rhinovirus and coronavirus by improving the immune system.

An observational study was carried out to check the zinc status in hospitalized COVID19 patients. The aim was to focus on the Serum Zinc Content (SZC) in COVID19 patients. A cell culture-based study was also carried out which showed that zinc supplementation can block coronavirus multiplication in Viro infected cells. The study included 249 adults admitted to the COVID unit between 9 th March to April 1 st 2020. The average age of the participants of 65 years (ranging between 54-75 years). Fever, cough, and dyspnoea were the important symptoms of these patients admitted to the hospital. The COVID-positive patients admitted to the hospital had characteristic inflammation associated with these respiratory symptoms.

The study demonstrates the correlation between the serum Zinc levels and COVID 19 outcome. Zinc levels lower than 50 micrograms /dl correlated with worse clinical presentation. longer recovery rate and higher mortality. These results suggest that serum Zinc levels impact COVID19 morbidity and mortality. The higher level of inflammatory markers such as IL- factor, TNF- factor, and CRP were present with lower Zinc values and COVID-19 severity.

Zinc supplementation decreases the incidence of infection in the elderly age group and improves cytokine balance and oxidative stress markers. Thus, supplementing the SZC- COVID patients with Zinc which helps in balancing the immune system and the cytokine storm proved beneficial based on the studies. During the beginning of the pandemic, CQ was prescribed as the first line of treatment. The Zinc supplementation with CQ showed a reduction in mortality. Zinc supplementation was useful to maintain the zinc homeostasis helped to reduce the COVID19 severity.

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