血清微量营养素水平与 COVID-19 患者疾病严重程度的关系。
The association between serum levels of micronutrients and the severity of disease in patients with COVID-19.
机构信息
Anesthesiology and Intensive Care Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Nutrition. 2021 Nov-Dec;91-92:111400. doi: 10.1016/j.nut.2021.111400. Epub 2021 Jun 24.
OBJECTIVES
This study aimed to compare the serum level of micronutrients with normal amounts, and assess their association with the severity of disease and inflammatory cytokines in patients with coronavirus disease 2019 (COVID-19).
METHODS
The present cross-sectional study included 60 patients admitted to the intensive care unit with COVID-19. We recorded data on demographic characteristics, anthropometric information, and medical history. Serum levels of inflammatory markers (erythrocyte sedimentation rate, C-reactive protein, interferon-gamma, tumor necrosis factor-alpha, interleukin-6), vitamins (A, B, B, C, D, E), and minerals (magnesium, zinc, iron) were measured. A radiologist assessed the severity of lung involvement according to patient computed tomography scans. The severity of illness was evaluated with the Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, oxygen saturation, and body temperature. Independent associations among the serum levels of micronutrients with the severity of COVID-19 were measured.
RESULTS
Median patient age was 53.50 years (interquartile range, 12.75 years). Except for vitamin A and zinc, serum levels of other micronutrients were lower than the minimum normal. Patients with APACHE score ≥25 had a higher body mass index (P = 0.044), body temperature (P = 0.003), erythrocyte sedimentation rate (P = 0.008), C-reactive protein (P = 0.003), and lower oxygen saturation (P = 0.005), serum levels of vitamin D (P = < 0.001), and zinc (P = < 0.001) compared with patients with APACHE score <25. We found that lower serum levels of vitamin D, magnesium, and zinc were significantly and independently associated with higher APACHE scores (P = 0.001, 0.028, and < 0.001, respectively) and higher lung involvement (P = 0.002, 0.045, and < 0.001, respectively).
CONCLUSIONS
Lower serum levels of vitamin D, zinc, and magnesium were involved in severe COVID-19.
目的
本研究旨在比较微量元素的血清水平与正常值，并评估其与 2019 年冠状病毒病（COVID-19）患者疾病严重程度和炎症细胞因子的关系。
方法
本横断面研究纳入了 60 名因 COVID-19 入住重症监护病房的患者。我们记录了人口统计学特征、人体测量学信息和病史数据。测量了炎症标志物（红细胞沉降率、C 反应蛋白、干扰素-γ、肿瘤坏死因子-α、白细胞介素-6）、维生素（A、B、B、C、D、E）和矿物质（镁、锌、铁）的血清水平。一名放射科医生根据患者的计算机断层扫描评估肺部受累的严重程度。采用急性生理学和慢性健康评估（APACHE）评分、氧饱和度和体温来评估疾病严重程度。测量了微量元素血清水平与 COVID-19 严重程度之间的独立关联。
结果
中位患者年龄为 53.50 岁（四分位距，12.75 岁）。除维生素 A 和锌外，其他微量元素的血清水平均低于正常值下限。APACHE 评分≥25 的患者具有更高的体重指数（P=0.044）、体温（P=0.003）、红细胞沉降率（P=0.008）、C 反应蛋白（P=0.003）和更低的氧饱和度（P=0.005），血清维生素 D（P<0.001）和锌（P<0.001）水平也更低，而 APACHE 评分<25 的患者则更低。我们发现，维生素 D、镁和锌的血清水平较低与较高的 APACHE 评分（P=0.001、0.028 和<0.001）和更高的肺部受累程度（P=0.002、0.045 和<0.001）显著相关。
结论
维生素 D、锌和镁的血清水平较低与严重的 COVID-19 有关。
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