Division of Intensive Care, Geneva University Hospitals, the Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland.
Forensic Toxicology and Chemistry Unit, CURML, Lausanne University Hospital, Geneva University Hospitals, 1205 Geneva, Switzerland.
Nutrients. 2023 Jul 26;15(15):3308. doi: 10.3390/nu15153308.
The primary objective of this study was to compare the plasma levels of copper, selenium, and zinc between critically ill COVID-19 patients and less severe COVID-19 patients. The secondary objective was to investigate the association of these trace element levels with adverse outcomes, including the duration of mechanical ventilation, occurrence of septic shock, and mortality in critically ill COVID-19 patients. All COVID-19 patients admitted to the ICU of the Geneva University Hospitals between 9 March 2020 and 19 May 2020 were included in the study. Plasma levels of copper, selenium and zinc were measured on admission to the ICU and compared with levels measured in COVID-19 patients hospitalized on the ward and in non-hospitalized COVID-19 patients. To analyze the association of trace elements with clinical outcomes, multivariate linear and logistic regressions were performed. Patients in the ICU had significantly lower levels of selenium and zinc and higher levels of copper compared to COVID-19 patients hospitalized on the ward and in non-hospitalized COVID-19 patients. In ICU patients, lower zinc levels tended to be associated with more septic shock and increased mortality compared to those with higher zinc levels ( = 0.07 for both). Having lower copper or selenium levels was associated with a longer time under mechanical ventilation ( = 0.01 and 0.04, respectively). These associations remained significant in multivariate analyses ( = 0.03 for copper and = 0.04 for selenium). These data support the need for interventional studies to assess the potential benefit of zinc, copper and selenium supplementation in severe COVID-19 patients.
本研究的主要目的是比较危重症 COVID-19 患者与轻症 COVID-19 患者的血浆铜、硒和锌水平。次要目的是探讨这些微量元素水平与不良结局的关系，包括危重症 COVID-19 患者机械通气时间、脓毒性休克发生和死亡率。所有于 2020 年 3 月 9 日至 5 月 19 日期间入住日内瓦大学医院 ICU 的 COVID-19 患者均纳入本研究。于入住 ICU 时测量血浆铜、硒和锌水平，并与住院病房 COVID-19 患者和未住院 COVID-19 患者的水平进行比较。为分析微量元素与临床结局的关系，进行了多元线性和逻辑回归分析。与住院病房 COVID-19 患者和未住院 COVID-19 患者相比，ICU 患者的硒和锌水平较低，铜水平较高。与锌水平较高的患者相比，锌水平较低的 ICU 患者更易发生脓毒性休克和死亡率增加（两者均为 = 0.07）。与铜或硒水平较低的患者相比，铜或硒水平较低的患者接受机械通气的时间更长（分别为 = 0.01 和 0.04）。这些关联在多元分析中仍然显著（铜为 = 0.03，硒为 = 0.04）。这些数据支持需要进行干预性研究，以评估锌、铜和硒补充在严重 COVID-19 患者中的潜在益处。
