• Marina Vogel-González, Marc Talló-Parra, Víctor Herrera-Fernández, Gemma Pérez-Vilaró, Miguel Chillón, Xavier Nogués, Silvia Gómez-Zorrilla, Inmaculada López-Montesinos, Isabel Arnau-Barrés, Maria Luisa Sorli-Redó, Juan Pablo Horcajada, Natalia García-Giralt, Julio Pascual, Juana Díez, Rubén Vicente, and Robert Güerri-Fernández.
• Laboratory of Molecular Physiology, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain.
• Nutrients. 2021 Feb 9; 13 (2).

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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