Abstract
Introduction: The objective of the study was to evaluate the effect of serum zinc (Zn), copper (Cu), and selenium (Se) levels on outcomes of patients with Coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU).
Methods: This cross-sectional study was conducted on COVID-19 patients. Serum concentrations of Zn, Cu, and Se on admission, on the 5th, and 10th days in the ICU were measured in all subjects, and their association with patients’ outcomes were evaluated. The area under curve (AUC) of the receiver operating characteristic (ROC) curve and adjusted binary logistic regression analysis were used to explore the association between Zn, Cu, and Se levels on mortality as the primary outcome.
Results: Seventy patients, including 33 (47.1%) men and 37 (52.9%) women, were enrolled. Lower serum levels of Zn (85.93±14.20 vs. 92.55±8.25, P=0.017) and Se (97.29±11.74 vs.104.74±9.17, P=0.004) were observed in the non-survivors group compared to survivors of COVID-19. In adjusted analysis, higher Zn levels were associated with lower odds of mortality on 5th (OR:0.909, 95%CI:0.839-0.985, P=0.020) and 10th (OR:0.911, 95%CI:0.85-0.975, P=0.007) day of ICU and increased with higher levels of Cu on 5th day of ICU (OR:2.852, 95%CI:1.487-7.666, P=0.034).
Conclusion: This study suggests a fair predictive value of Zn and a poor predictive value of Se and Cu, as well as a fair predictive value of their cumulative effect on mortality. However, these micronutrients did not predict the need for mechanical ventilation and ICU Length of stay. Except for the combination of serum Se, Zn, and Cu on the 5th day of ICU, which had fair predictive value for mechanical ventilation.