Observational studyNutrients2021
Low Zinc Levels at Admission Associates with Poor Clinical Outcomes in SARS-CoV-2 Infection.
Observational study in Nutrients, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05778383 (Zinc-based Nutritional Immunity to Lower Inflammation, Viral Load and COVID-19 Mortality During SARS-CoV-2 Infection.), which is not on this map. Cited by 59 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Zinc-based Nutritional Immunity to Lower Inflammation, Viral Load and COVID-19 Mortality During SARS-CoV-2 Infection.
Who cites it
59 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Role of Metals on SARS-CoV-2 Infection: a Review of Recent Epidemiological Studies.Current environmental health reports · 2023Pooled it
- The Association Between Antioxidants and COVID-19 Outcomes: a Systematic Review on Observational Studies.Biological trace element research · 2023Pooled it
- Effect and Tolerability of a Nutritional Supplement Based on a Synergistic Combination of β-Glucans and Selenium- and Zinc-EnrichedNutrients · 2021Trial
- Serum zinc level independently predicts need for inpatient intubation among patients hospitalized with COVID-19: A prospective observational study.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026Observational
- Zinc deficiency as possible link between immunosenescence and age-related diseases.Immunity & ageing : I & A · 2025Review
- Article
- Impact of zinc deficiency on mortality risk in patients with chronic obstructive pulmonary disease: a retrospective analysis.Frontiers in nutrition · 2025Article
- Zinc Deficiency Associated With an Increase in Mortality in COVID-19 Patients: A Meta-Analysis.Cureus · 2025Review
- Association of zinc deficiency and clinical symptoms, inflammatory markers, severity of COVID-19 in hospitalized children.Frontiers in nutrition · 2025Article
- Coordination chemistry suggests that independently observed benefits of metformin and ZnBiometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2024Article
- Zinc Deficiency And sTNF-RII Are Associated With Worse COVID-19 Outcomes.The Journal of nutrition · 2024Observational
- Dietary mineral intakes predict Coronavirus-disease 2019 (COVID-19) incidence and hospitalization in older adults.BMC nutrition · 2024Article
- Genomic prediction and QTL analysis for grain Zn content and yield inJournal of plant biochemistry and biotechnology · 2024Article
- Association Between Serum Zinc Concentration Levels And Severity Of Coronavirus Disease 2019 (Covid-19) In Japanese Inpatients.International journal of general medicine · 2024Article
- The nutritional roles of zinc for immune system and COVID-19 patients.Frontiers in nutrition · 2024Review
- Repurposing Polyether Ionophores as a New-Class of Anti-SARS-Cov-2 Agents as Adjunct Therapy.Current microbiology · 2023Review
- The Role of Diet and Specific Nutrients during the COVID-19 Pandemic: What Have We Learned over the Last Three Years?International journal of environmental research and public health · 2023Review
- Observational
- Symptomatic Characteristics of Hypozincemia Detected in Long COVID Patients.Journal of clinical medicine · 2023Article
- Biomarkers of Micronutrients and Phytonutrients and Their Application in Epidemiological Studies.Nutrients · 2023Review
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
backgroundZinc 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.
methodsWe 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.
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-CoV-2 infected cells.
interpretationLow 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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