Matsumoto Naomi, Yokokawa Hirohide, Mori Hirotake, Hiki Makoto, Tabe Yoko, Takahashi Kazuhisa, Naito Toshio
Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
Department of Emergency and Disaster Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
Int J Gen Med. 2024 Oct 16;17:4745-4753. doi: 10.2147/IJGM.S476578. eCollection 2024.
It has been reported that zinc deficiency is related to severe inflammatory conditions especially those of respiratory diseases. However, studies that have examined the association between the serum zinc concentration and the severity of coronavirus disease 2019 (COVID-19) are still limited. The aim of this study was to assess that association in Japanese inpatients with COVID-19.
This cross-sectional study, conducted from April 2020 to August 2021, included 467 eligible adult inpatients with COVID-19 whose serum zinc concentration was measured. Serum zinc concentration categories were defined as deficiency (< 60 μg/dL), marginal deficiency (≥ 60 to < 80 μg/dL), and normal (≥ 80 μg/dL). Multivariate logistic regression was used to assess the association between serum zinc deficiency and severe COVID-19. Serum zinc concentration levels were compared between mild and other severities of COVID-19 by Dunnett's method. The P for trend was estimated using the Jonckheere-Terpstra test.
The proportions of subjects with serum zinc deficiency (< 60 μg/dL) and marginal zinc deficiency (≥ 60 to < 80 μg/dL) were 39.5% and 54.3% in women, and 36.4% and 57.0% in men, respectively. Serum zinc deficiency was significantly associated with severe COVID-19 compared to marginal deficiency and normal (odds ratio = 3.60, 95% confidence interval = 1.60-8.13, P < 0.01) after adjusting for confounders. An increase in severity of COVID-19 was inversely related to increases in serum zinc concentration levels (P < 0.01 for trend). Each serum zinc concentration of moderate and severe cases was also significantly lower compared with mild cases (P < 0.01).
The severity of COVID-19 was significantly related to serum zinc concentration levels. These results suggest the importance of considering the serum zinc concentration when treating patients with COVID-19.
据报道，锌缺乏与严重炎症状态有关，尤其是呼吸系统疾病。然而，研究血清锌浓度与2019冠状病毒病（COVID-19）严重程度之间关联的研究仍然有限。本研究的目的是评估日本COVID-19住院患者中的这种关联。
这项横断面研究于2020年4月至2021年8月进行，纳入了467名符合条件的成年COVID-19住院患者，他们的血清锌浓度被测量。血清锌浓度类别定义为缺乏（<60μg/dL）、边缘缺乏（≥60至<80μg/dL）和正常（≥80μg/dL）。多因素逻辑回归用于评估血清锌缺乏与严重COVID-19之间的关联。采用Dunnett法比较轻度和其他严重程度的COVID-19患者的血清锌浓度水平。使用Jonckheere-Terpstra检验估计趋势P值。
血清锌缺乏（<60μg/dL）和边缘锌缺乏（≥60至<80μg/dL）的女性比例分别为39.5%和54.3%，男性比例分别为36.4%和57.0%。在调整混杂因素后，与边缘缺乏和正常相比，血清锌缺乏与严重COVID-19显著相关（优势比=3.60，95%置信区间=1.60-8.13，P<0.01）。COVID-19严重程度的增加与血清锌浓度水平的增加呈负相关（趋势P<0.01）。中度和重度病例的每个血清锌浓度也显著低于轻度病例（P<0.01）。
COVID-19的严重程度与血清锌浓度水平显著相关。这些结果表明在治疗COVID-19患者时考虑血清锌浓度的重要性。
