ArticleNutrients2022
Free Zinc as a Predictive Marker for COVID-19 Mortality Risk.
Article in Nutrients, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- The Association Between Antioxidants and COVID-19 Outcomes: a Systematic Review on Observational Studies.Biological trace element research · 2023Pooled it
- Selenium serum levels in patients with SARS-CoV-2 infection: a systematic review and meta-analysis.Journal of nutritional science · 2023Pooled it
- Circulating trace elements status in COVID-19 disease: A meta-analysis.Frontiers in nutrition · 2022Pooled it
- A Unique Patient Stratification Method Combined with a Machine Learning Approach Identifies Novel Genetic Susceptibility and Protective Factors for Severe COVID-19 in a Hungarian Population.International journal of molecular sciences · 2026Article
- Total and Free Zinc Dynamics as Biomarkers for Neurological Impairment in Traumatic Spinal Cord Injury.Nutrients · 2025Article
- 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
- Postprandial Micronutrient Variability and Bioavailability: An Interventional Meal Study in Young vs. Old Participants.Nutrients · 2024Article
- Selenium, Zinc, and Copper Status of Vegetarians and Vegans in Comparison to Omnivores in the Nutritional Evaluation (NuEva) Study.Nutrients · 2023Article
- Evolution of Status of Trace Elements and Metallothioneins in Patients with COVID-19: Relationship with Clinical, Biochemical, and Inflammatory Parameters.Metabolites · 2023Article
- A fluorometric assay to determine labile copper(II) ions in serum.Scientific reports · 2023Article
- Electrospun nanofibers for medical face mask with protection capabilities against viruses: State of the art and perspective for industrial scale-up.Applied materials today · 2023Review
- Nutritional deficiencies that may predispose to long COVID.Inflammopharmacology · 2023Review
- Biomarkers of Micronutrients and Phytonutrients and Their Application in Epidemiological Studies.Nutrients · 2023Review
- Review of Medical Studies on COVID-19 During the Pandemic Period.The Eurasian journal of medicine · 2022Article
- Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe.Frontiers in immunology · 2022Observational
- Serum Free Zinc Is Associated With Vaccination Response to SARS-CoV-2.Frontiers in immunology · 2022Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
Free zinc is considered to be the exchangeable and biological active form of zinc in serum, and is discussed to be a suitable biomarker for alterations in body zinc homeostasis and related diseases. Given that coronavirus disease 2019 (COVID-19) is characterized by a marked decrease in total serum zinc, and clinical data indicate that zinc status impacts the susceptibility and severity of the infection, we hypothesized that free zinc in serum might be altered in response to SARS-CoV-2 infection and may reflect disease severity. To test this hypothesis, free zinc concentrations in serum samples of survivors and nonsurvivors of COVID-19 were analyzed by fluorometric microassay. Similar to the reported total serum zinc deficit measured by total reflection X-ray fluorescence, free serum zinc in COVID-19 patients was considerably lower than that in control subjects, and surviving patients displayed significantly higher levels of free zinc than those of nonsurvivors (mean ± SD; 0.4 ± 0.2 nM vs. 0.2 ± 0.1 nM; p = 0.0004). In contrast to recovering total zinc concentrations (r = 0.706, p < 0.001) or the declining copper−zinc ratio (r = −0.646; p < 0.001), free zinc concentrations remained unaltered with time in COVID-19 nonsurvivors. Free serum zinc concentrations were particularly low in male as compared to female patients (mean ± SD; 0.4 ± 0.2 nM vs. 0.2 ± 0.1 nM; p = 0.0003). This is of particular interest, as the male sex is described as a risk factor for severe COVID-19. Overall, results indicate that depressed free serum zinc levels are associated with increased risk of death in COVID-19, suggesting that free zinc may serve as a novel prognostic marker for the severity and course of COVID-19.
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