Hung Lun-Wu, Liu Mei-Yuan, Yu Tsung, Hung Kuo-Chuan, Tsai Ya-Wen, Lai Chih-Cheng, Wu Jheng-Yan
Division of Cardiovascular Surgery, Department of Surgery, Chi Mei Medical Center, Tainan, TWN.
Department of Nutrition, Chi Mei Medical Center, Tainan, TWN.
Cureus. 2024 Oct 16;16(10):e71609. doi: 10.7759/cureus.71609. eCollection 2024 Oct.
Background Previous studies have suggested that zinc deficiency (ZD) may increase the risk of short-term mortality in patients with coronavirus disease 2019 (COVID-19). However, the relationship between zinc status and post-acute COVID-19 outcomes remains unclear. This study aimed to determine the association between ZD and long-term outcomes in patients with COVID-19. Methodology We conducted a retrospective cohort study using the TriNetX database, including patients aged 18 years or older diagnosed with COVID-19 between January 1, 2022, and July 31, 2023. Patients had documented serum or plasma zinc levels within three months before COVID-19 diagnosis and were not deceased or hospitalized in the first month of infection. They were categorized into ZD (zinc levels <70 μg/dL) and control (zinc levels ≥70 μg/dL) groups. After 1:1 propensity score matching for demographic and clinical variables, outcomes were assessed from 30 to 180 days post-diagnosis, including all-cause hospitalization, all-cause mortality, and four subphenotypes of post-acute COVID-19. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Results After matching, each group included 1,863 patients with balanced baseline characteristics. The ZD group had a higher incidence of all-cause hospitalization (25.3% vs. 20.3%; HR = 1.314; 95% CI = 1.148-1.505; p < 0.001) and all-cause mortality (3.8% vs. 2.2%; HR = 1.735; 95% CI = 1.180-2.551; p = 0.045) compared to the control group during the follow-up period. Among the four subphenotypes, only the cardiac and renal subphenotype showed a significantly higher risk in the ZD group (HR = 1.099; 95% CI = 1.002-1.205; p = 0.004). Conclusions ZD is associated with increased risks of long-term hospitalization, mortality, and increased risk in COVID-19 patients with cardiac and renal comorbidities. Monitoring and managing zinc levels may be important for improving long-term outcomes. Further research is warranted to explore the potential benefits of zinc supplementation in COVID-19 patients with ZD.
背景 先前的研究表明，锌缺乏（ZD）可能会增加2019冠状病毒病（COVID-19）患者短期死亡的风险。然而，锌状态与COVID-19急性感染后结局之间的关系仍不清楚。本研究旨在确定ZD与COVID-19患者长期结局之间的关联。方法 我们使用TriNetX数据库进行了一项回顾性队列研究，纳入了2022年1月1日至2023年7月31日期间确诊为COVID-19的18岁及以上患者。患者在COVID-19诊断前三个月内有血清或血浆锌水平记录，且在感染的第一个月内未死亡或住院。他们被分为ZD组（锌水平<70μg/dL）和对照组（锌水平≥70μg/dL）。在对人口统计学和临床变量进行1:1倾向评分匹配后，评估诊断后30至180天的结局，包括全因住院、全因死亡以及COVID-19急性感染后的四种亚表型。计算了95%置信区间（CI）的风险比（HR）。结果 匹配后，每组包括1863例基线特征均衡的患者。在随访期间，ZD组的全因住院发生率（25.3%对20.3%；HR = 1.314；95% CI = 1.148 - 1.505；p < 0.001）和全因死亡率（3.8%对2.2%；HR = 1.735；95% CI = 1.180 - 2.551；p = 0.045）均高于对照组。在四种亚表型中，只有心脏和肾脏亚表型在ZD组中显示出显著更高的风险（HR = 1.099；95% CI = 1.002 - 1.205；p = 0.004）。结论 ZD与COVID-19患者长期住院、死亡风险增加以及合并心脏和肾脏疾病的患者风险增加有关。监测和管理锌水平可能对改善长期结局很重要。有必要进一步研究探索锌补充剂对ZD的COVID-19患者的潜在益处。
