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Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe

INTRODUCTION: Certain trace elements are essential for life and affect immune system function, and their intake varies by region and population. Alterations in serum Se, Zn and Cu have been associated with COVID-19 mortality risk. We tested the hypothesis that a disease-specific decline occurs and c...

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Autores principales: Demircan, Kamil, Chillon, Thilo Samson, Bracken, Tommy, Bulgarelli, Ilaria, Campi, Irene, Du Laing, Gijs, Fafi-Kremer, Samira, Fugazzola, Laura, Garcia, Alejandro Abner, Heller, Raban, Hughes, David J., Ide, Louis, Klingenberg, Georg Jochen, Komarnicki, Pawel, Krasinski, Zbigniew, Lescure, Alain, Mallon, Patrick, Moghaddam, Arash, Persani, Luca, Petrovic, Mirko, Ruchala, Marek, Solis, Morgane, Vandekerckhove, Linos, Schomburg, Lutz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742896/
https://www.ncbi.nlm.nih.gov/pubmed/36518764
http://dx.doi.org/10.3389/fimmu.2022.1022673
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author Demircan, Kamil
Chillon, Thilo Samson
Bracken, Tommy
Bulgarelli, Ilaria
Campi, Irene
Du Laing, Gijs
Fafi-Kremer, Samira
Fugazzola, Laura
Garcia, Alejandro Abner
Heller, Raban
Hughes, David J.
Ide, Louis
Klingenberg, Georg Jochen
Komarnicki, Pawel
Krasinski, Zbigniew
Lescure, Alain
Mallon, Patrick
Moghaddam, Arash
Persani, Luca
Petrovic, Mirko
Ruchala, Marek
Solis, Morgane
Vandekerckhove, Linos
Schomburg, Lutz
author_facet Demircan, Kamil
Chillon, Thilo Samson
Bracken, Tommy
Bulgarelli, Ilaria
Campi, Irene
Du Laing, Gijs
Fafi-Kremer, Samira
Fugazzola, Laura
Garcia, Alejandro Abner
Heller, Raban
Hughes, David J.
Ide, Louis
Klingenberg, Georg Jochen
Komarnicki, Pawel
Krasinski, Zbigniew
Lescure, Alain
Mallon, Patrick
Moghaddam, Arash
Persani, Luca
Petrovic, Mirko
Ruchala, Marek
Solis, Morgane
Vandekerckhove, Linos
Schomburg, Lutz
author_sort Demircan, Kamil
collection PubMed
description INTRODUCTION: Certain trace elements are essential for life and affect immune system function, and their intake varies by region and population. Alterations in serum Se, Zn and Cu have been associated with COVID-19 mortality risk. We tested the hypothesis that a disease-specific decline occurs and correlates with mortality risk in different countries in Europe. METHODS: Serum samples from 551 COVID-19 patients (including 87 non-survivors) who had participated in observational studies in Europe (Belgium, France, Germany, Ireland, Italy, and Poland) were analyzed for trace elements by total reflection X-ray fluorescence. A subset (n=2069) of the European EPIC study served as reference. Analyses were performed blinded to clinical data in one analytical laboratory. RESULTS: Median levels of Se and Zn were lower than in EPIC, except for Zn in Italy. Non-survivors consistently had lower Se and Zn concentrations than survivors and displayed an elevated Cu/Zn ratio. Restricted cubic spline regression models revealed an inverse nonlinear association between Se or Zn and death, and a positive association between Cu/Zn ratio and death. With respect to patient age and sex, Se showed the highest predictive value for death (AUC=0.816), compared with Zn (0.782) or Cu (0.769). DISCUSSION: The data support the potential relevance of a decrease in serum Se and Zn for survival in COVID-19 across Europe. The observational study design cannot account for residual confounding and reverse causation, but supports the need for intervention trials in COVID-19 patients with severe Se and Zn deficiency to test the potential benefit of correcting their deficits for survival and convalescence.
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spelling pubmed-97428962022-12-13 Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe Demircan, Kamil Chillon, Thilo Samson Bracken, Tommy Bulgarelli, Ilaria Campi, Irene Du Laing, Gijs Fafi-Kremer, Samira Fugazzola, Laura Garcia, Alejandro Abner Heller, Raban Hughes, David J. Ide, Louis Klingenberg, Georg Jochen Komarnicki, Pawel Krasinski, Zbigniew Lescure, Alain Mallon, Patrick Moghaddam, Arash Persani, Luca Petrovic, Mirko Ruchala, Marek Solis, Morgane Vandekerckhove, Linos Schomburg, Lutz Front Immunol Immunology INTRODUCTION: Certain trace elements are essential for life and affect immune system function, and their intake varies by region and population. Alterations in serum Se, Zn and Cu have been associated with COVID-19 mortality risk. We tested the hypothesis that a disease-specific decline occurs and correlates with mortality risk in different countries in Europe. METHODS: Serum samples from 551 COVID-19 patients (including 87 non-survivors) who had participated in observational studies in Europe (Belgium, France, Germany, Ireland, Italy, and Poland) were analyzed for trace elements by total reflection X-ray fluorescence. A subset (n=2069) of the European EPIC study served as reference. Analyses were performed blinded to clinical data in one analytical laboratory. RESULTS: Median levels of Se and Zn were lower than in EPIC, except for Zn in Italy. Non-survivors consistently had lower Se and Zn concentrations than survivors and displayed an elevated Cu/Zn ratio. Restricted cubic spline regression models revealed an inverse nonlinear association between Se or Zn and death, and a positive association between Cu/Zn ratio and death. With respect to patient age and sex, Se showed the highest predictive value for death (AUC=0.816), compared with Zn (0.782) or Cu (0.769). DISCUSSION: The data support the potential relevance of a decrease in serum Se and Zn for survival in COVID-19 across Europe. The observational study design cannot account for residual confounding and reverse causation, but supports the need for intervention trials in COVID-19 patients with severe Se and Zn deficiency to test the potential benefit of correcting their deficits for survival and convalescence. Frontiers Media S.A. 2022-11-28 /pmc/articles/PMC9742896/ /pubmed/36518764 http://dx.doi.org/10.3389/fimmu.2022.1022673 Text en Copyright © 2022 Demircan, Chillon, Bracken, Bulgarelli, Campi, Du Laing, Fafi-Kremer, Fugazzola, Garcia, Heller, Hughes, Ide, Klingenberg, Komarnicki, Krasinski, Lescure, Mallon, Moghaddam, Persani, Petrovic, Ruchala, Solis, Vandekerckhove and Schomburg https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Demircan, Kamil
Chillon, Thilo Samson
Bracken, Tommy
Bulgarelli, Ilaria
Campi, Irene
Du Laing, Gijs
Fafi-Kremer, Samira
Fugazzola, Laura
Garcia, Alejandro Abner
Heller, Raban
Hughes, David J.
Ide, Louis
Klingenberg, Georg Jochen
Komarnicki, Pawel
Krasinski, Zbigniew
Lescure, Alain
Mallon, Patrick
Moghaddam, Arash
Persani, Luca
Petrovic, Mirko
Ruchala, Marek
Solis, Morgane
Vandekerckhove, Linos
Schomburg, Lutz
Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe
title Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe
title_full Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe
title_fullStr Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe
title_full_unstemmed Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe
title_short Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe
title_sort association of covid-19 mortality with serum selenium, zinc and copper: six observational studies across europe
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742896/
https://www.ncbi.nlm.nih.gov/pubmed/36518764
http://dx.doi.org/10.3389/fimmu.2022.1022673
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