Li Yunhui, Luo Weihe, Liang Bin
Clinical Laboratory, PLA North Military Command Region General Hospital, Shenyang, China.
Department of Medical Engineering, PLA North Military Command Region General Hospital, Shenyang, China.
Front Nutr. 2022 Aug 12;9:982032. doi: 10.3389/fnut.2022.982032. eCollection 2022.
Trace elements are a group of essential metals or metalloids, which are necessary for life, and present in minute amounts. Despite substantial researches highlighting the importance of trace elements in Coronavirus disease 2019 (COVID-19) diseases, a thorough evaluation of the levels of circulating trace elements is lacking. Therefore, we conducted a systematic review and meta-analysis to evaluate the trace element status (Zn, Fe, Cu, Mg, and Se) in COVID-19 disease. We also assessed the relationship between circulating trace elements and COVID-19 disease severity and survival status during follow-up. We searched comprehensively MEDLINE, Web of Science, CNKI, and WangFang databases without language restriction, between November 1, 2019 and April 1, 2022. The search identified 1,566 preliminary references. A total of 49 studies met the eligibility criteria and were included in the review, and 42 studies were included in the final meta-analysis. Meta-analysis showed that COVID-19 patients had significantly lower circulating Zn (SMD: -0.83, 95% CI: -1.19 to -0.46, < 0.001), Fe (SMD: -1.56, 95% CI: -2.90 to -0.21, = 0.023), and Se (SMD: -0.75, 95% CI: -0.94 to -0.56, < 0.001) levels than healthy controls, and circulating Zn (SMD: -0.47, 95% CI: -0.75 to -0.18, = 0.002), Fe (SMD: -0.45, 95% CI: -0.79 to -0.12, = 0.008), and Se (SMD: -0.27, 95% CI: -0.49 to -0.04, = 0.020) levels were associated with the presence of severity status in COVID-19 patients. Moreover, circulating Fe levels in non-survivors were significantly lower than survivors in COVID-19 (SMD: -0.28, 95% CI: -0.44 to -0.12, = 0.001). However, there was no significant difference in Cu and Mg levels between COVID-19 patients and controls, severity and non-severity status, and survivors and non-survivors (all > 0.05). Taken together, COVID-19 patients displayed lower circulating levels of Zn, Fe, and Se, and their levels were associated with severity status. Moreover, circulating Fe levels may provide part of the explanation for the unfavorable survival status. Therefore, we presumed optimistically that supplements of trace elements might provide an adjutant treatment in the early stages of COVID-19.
[https://www.crd.york.ac.uk/prospero], identifier [CRD42022348599].
微量元素是一组必需的金属或类金属，对生命至关重要且含量微小。尽管大量研究强调了微量元素在2019冠状病毒病（COVID-19）中的重要性，但仍缺乏对循环微量元素水平的全面评估。因此，我们进行了一项系统评价和荟萃分析，以评估COVID-19患者的微量元素状况（锌、铁、铜、镁和硒）。我们还评估了循环微量元素与COVID-19疾病严重程度以及随访期间生存状况之间的关系。我们于2019年11月1日至2022年4月1日在无语言限制的情况下全面检索了MEDLINE、科学网、中国知网和万方数据库。检索共识别出1566篇初步参考文献。共有49项研究符合纳入标准并被纳入该评价，42项研究被纳入最终的荟萃分析。荟萃分析表明，COVID-19患者的循环锌（标准化均值差：-0.83，95%置信区间：-1.19至-0.46，P<0.001）、铁（标准化均值差：-1.56，95%置信区间：-2.90至-0.21，P = 0.023）和硒（标准化均值差：-0.75，95%置信区间：-0.94至-0.56，P<0.001）水平显著低于健康对照，且循环锌（标准化均值差：-0.47，95%置信区间：-0.75至-0.18，P = 0.002）、铁（标准化均值差：-0.45，95%置信区间：-0.79至-0.12，P = 0.008）和硒（标准化均值差：-0.27，95%置信区间：-0.49至-0.04，P = 0.020）水平与COVID-19患者的严重程度状况相关。此外，COVID-19非幸存者的循环铁水平显著低于幸存者（标准化均值差：-0.28，95%置信区间：-0.44至-0.12，P = 0.001）。然而，COVID-19患者与对照之间、严重与非严重状况之间以及幸存者与非幸存者之间的铜和镁水平无显著差异（均P>0.05）。综上所述，COVID-19患者的循环锌、铁和硒水平较低，且这些水平与严重程度状况相关。此外，循环铁水平可能为不良生存状况提供部分解释。因此，我们乐观地推测，补充微量元素可能在COVID-19的早期阶段提供辅助治疗。
