Abstract

Zinc ion as an enzyme cofactor exhibits antiviral and anti-inflammatory activity during infection, but circulating zinc ion level during Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is unclear. This study aimed to evaluate serum zinc ion level in Coronavirus Disease 2019 (COVID-19) patients and healthy subjects, as well as its correlation with antibodies against SARS-CoV-2. 114 COVID-19 patients and 48 healthy subjects (38 healthy volunteers and 10 close contacts of patients with COVID-19) were included. Zinc ion concentration and levels of antibodies against SARS-CoV-2 Spike 1 + Spike 2 proteins, nucleocapsid protein, and receptor-binding domain in serum were measured. Results showed that the concentration of zinc ion in serum from COVID-19 patients [median: 6.4 nmol/mL (IQR 1.5 – 12.0 nmol/mL)] were significantly lower than that from the healthy subjects [median: 15.0 nmol/mL (IQR 11.9 – 18.8 nmol/mL)] (p < 0.001) and the difference remained significant after age stratification (p < 0.001) or when the patients were at the recovery stage (p < 0.001). Furthermore, COVID-19 patients with more severe hypozincemia showed higher levels of IgG against the receptor-binding domain of SARS-CoV-2 spike protein. Further studies to confirm the effect of zinc supplementation on improving the outcomes of COVID-19, including antibody response against SARS-CoV-2, are warranted.

Highlights

  • Therapeutic options for Coronavirus Disease 2019 (COVID-19) are currently limited

  • We included 114 COVID-19 patients that were tested positive for SARS-CoV-2 in throat swabs, based on real-time reverse transcription (RT)-polymerase chain reaction (PCR) according to a standard protocol [4]

  • Our study shows that patients with COVID-19 had a significantly lower serum zinc ion concentration than healthy individuals

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Summary

Introduction

Therapeutic options for Coronavirus Disease 2019 (COVID-19) are currently limited. Zinc as an enzyme cofactor has been shown to preserve respiratory epithelium, prevent pathogen entry and modulate the antiviral and inflammatory responses [1]. The MATH+ protocol formulated by the Frontline COVID-19 Critical Care Alliance incorporated zinc supplementation as an optional. Anecdotal evidence suggests treatment with high-dose zinc salt might improve outcomes of COVID-19 patients [3]. The role of zinc levels in modulating on the immune response against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in COVID-19 patients is so far unclear. We conducted a retrospective study to analyze the serum zinc ion concentration in 162 blood specimens collected from 114 COVID-19 patients and 48 healthy subjects and its correlation with the immune response profile

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