Abstract
Aim To explore the potential relationship between NLR and micronutrient deficiency in patients with severe COVID-19 infection. Methods Sixteen patients were categorized into the mild group (mild COVID-19) and severe group (severe COVID-19) based on the guideline of the management of COVID-19. The lactate dehydrogenase (LDH); superoxide dismutase (SOD), the inflammatory markers (neutrophil lymphocyte ratio (NLR)), erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), selenium (Se), iron (Fe), zinc (Zn), nickel (Ni), copper (Cu), chromium (Cr), cadmium (Cd), arsenic (As), and manganese (Mn) were measured in the blood. Results Compared to the mild group, the NLR (P < 0.05) and the level of Se (P < 0.01), Fe (P < 0.05), and Zn (P < 0.05) were significantly decreased in the severe group. The level of Se, Fe, and Zn was significantly correlated to NLR levels. Furthermore, close positive correlation was found between NLR and severity of COVID-19. Conclusion The micronutrient deficiency in the blood is associated with NLR in the severity of COVID-19 patients.
Highlights
It has been more than two years since the outbreak of COVID-19 in Wuhan, China
Previous studies have suggested a positive correlation between the number of neutrophils and the severity of COVID-19; the more the neutrophils are, the worse the prognosis is [5, 6]. e lymphocyte is another type of leukocyte that plays a decisive role in maintaining immune homeostasis and defenses against external infections in the human body
We found that the severity of COVID-19 was positively correlated with neutrophil count and negatively correlated with lymphocytes, as confirmed by another previous study
Summary
It has been more than two years since the outbreak of COVID-19 in Wuhan, China. Despite effective measures such as wearing masks and social distancing, the cumulative number of confirmed cases and deaths worldwide continued to increase, reaching 242 million and 4.92 million, respectively, by 21 November 2021. NLR is considered as an inflammatory marker and has been found to increase in a variety of conditions such as diabetes mellitus [7], thyroiditis [8], malignancy [9], irritable bowel disease [10], other thyroid conditions [11] and ulcerative colitis [12] It has been associated with COVID-19 infection, and many studies have shown that neutrophillymphocyte ratio (NLR) is a strong clinical indicator of COVID-19 severity [13]. Micronutrients, such as selenium and iron, are essential to keeping immune system homeostasis. E aim of this study was to explore the potential relationship between NLR and micronutrient deficiency in critically ill patients
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