Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.
Institute of Food Science and Engineering, Wuhan Polytechnic University, Wuhan, China.
FASEB J. 2021 Mar;35(3):e21392. doi: 10.1096/fj.202002346RR.
The variations and dynamics of essential and toxic metal(loid)s in patients with COVID-19 may associate with the progression and fatal outcome of the disease, which still remains to investigate. In the present study, a retrospective analysis was performed in a cohort of 306 confirmed COVID-19 patients admitted to Tongji hospital (Wuhan, China) from February 10 to March 15, 2020. Whole blood levels of essential and/or toxic metal(loid)s were analyzed, including magnesium, calcium, chromium, manganese, iron, copper, zinc, arsenic, cadmium, mercury, thallium, and lead according to the disease severity and outcome. Compared to the non-severe COVID-19 patients, severe cases showed significant higher levels of whole blood calcium, chromium, and copper, but lower levels of magnesium, manganese, iron, zinc, arsenic, thallium, and lead. These differences were further found consistently across the clinical course since the disease onset by longitudinal analysis. Among the severe patients, chromium and cadmium were higher in the deceased group compared to the recovered group, while arsenic was lower. Whole blood iron, age, and sex were determined to be independent factors associated with the disease severity, while chromium, cadmium, and the comorbidity of cardiovascular disease were determined to be independent factors associated with the mortality. These results suggest that variations of whole blood metal(loid)s may be associated with the severe illness and fatal outcome of COVID-19, which could be persistently monitored and would be helpful in the evaluation of the dynamic changes in patients with COVID-19.
在 COVID-19 患者中，必需和有毒金属（类）的变化和动态可能与疾病的进展和致命结局有关，但这仍有待研究。在本研究中，对 2020 年 2 月 10 日至 3 月 15 日期间入住中国武汉同济医院的 306 例确诊 COVID-19 患者的队列进行了回顾性分析。根据疾病严重程度和结局分析了全血中必需和/或有毒金属（类）的水平，包括镁、钙、铬、锰、铁、铜、锌、砷、镉、汞、铊和铅。与非重症 COVID-19 患者相比，重症患者的全血钙、铬和铜水平显著升高，而镁、锰、铁、锌、砷、铊和铅水平显著降低。通过纵向分析，从疾病发病开始，这些差异在整个临床过程中均一致存在。在重症患者中，与康复组相比，死亡组的铬和镉水平较高，而砷水平较低。全血铁、年龄和性别被确定为与疾病严重程度相关的独立因素，而铬、镉和心血管疾病合并症被确定为与死亡率相关的独立因素。这些结果表明，全血金属（类）的变化可能与 COVID-19 的严重疾病和致命结局有关，可进行持续监测，有助于评估 COVID-19 患者的动态变化。
