• Thiago Jose Martins Gonçalves, Sandra Elisa Adami Batista Gonçalves, Andreia Guarnieri, Rodrigo Cristovão Risegato, Maysa Penteado Guimarães, Daniella Cabral de Freitas, Alvaro Razuk-Filho, JuniorPedro Batista BeneditoPBBDepartment of Nutrology and Clinical Nutrition, Sancta Maggiore Hospital, Prevent Senior Private Health Operator, São Paulo, Brazil., and Eduardo Fagundes Parrillo.
• Department of Nutrology and Clinical Nutrition, Sancta Maggiore Hospital, Prevent Senior Private Health Operator, São Paulo, Brazil.
• Nutr Clin Pract. 2021 Feb 1; 36 (1): 186-191.

BackgroundWe verify the prevalence of low zinc levels among critically ill patients infected by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the intensive care unit (ICU) who required invasive mechanical ventilation, as well as its association with severity of acute respiratory distress syndrome (ARDS).MethodsThis is an observational study composed of patients admitted to the ICU. Demographics, anthropometric data for calculating body mass index (BMI), and laboratory data were obtained at admission: blood count, ferritin, arterial blood gas, serum zinc levels, and C-reactive protein. Also, arterial oxygen tension (PaO2 ) divided by fractional inspired oxygen (FiO2 ) was calculated by the first arterial blood gas after intubation. A diagnosis of severe ARDS was determined if the PaO2 /FiO2 ratio was ≤100 mm Hg. Low zinc levels were established if zinc levels were <70 μg/dL.ResultsA total of 269 patients met inclusion criteria; 51.3% were men; median age was 74 (66-81) years; 91.1% (245 of 269) were elderly. The median BMI was 30.1 (24.7-32.1) kg/m2 , with 59.9% (161 of 269) of patients having overweight and obesity. The prevalence of low zinc levels was 79.6% (214 of 269) and severe ARDS was 56.5% (152 of 269). There was an association of low zinc levels and severe ARDS (odds ratio [OR], 14.4; 95% CI, 6.2-33.5; P < .001), even after adjusting for baseline variables (OR, 15.4; 95% CI, 6.5-36.3; P < .001).ConclusionCritically ill patients infected by SARS-CoV-2 with severe ARDS have a high prevalence of low serum zinc levels.© 2020 American Society for Parenteral and Enteral Nutrition.

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