Trace Element Status Research Articles

Physicochemical properties of water in an intensive agricultural region in Bangladesh: a preliminary study for water quality and health risk assessment

ABSTRACT There are many reservoirs, ponds and Korotoa River in the capital of ancient Pundranagar, Bangladesh, which is an intensive agricultural region. Since different industries are operated for the preparation of different agricultural instruments and agrochemicals are extensively applied to the agricultural soils which mix with the river and pond water and these water bodies may be contaminated with trace elements. In this study, levels of nine trace elements (Cr, As, Cu, Ni, Zn, Cd, Fe, Mn and Pb) and physicochemical properties in surface water from one river and five ponds were measured and compared with water quality guidelines. In addition, health risks, pollution status and possible sources of trace elements were assessed. The mean concentrations of As, Cd, Pb, Cr, Ni, Cu, Fe, Mn and Zn in pond water were 0.059, 0.033, 0.067, 0.136, 0.133, 0.280, 0.733, 0.127 and 0.266 mg/L and river water were 0.055, 0.037, 0.054, 0.104, 0.120, 0.230, 0.702, 0.125 and 0.200 mg/L, respectively. Except Cu and Zn, the mean concentrations of trace elements were above the water quality permissible standards indicating water from these sources is not safe for human use. The WQI values suggested that the water quality is excellent to poor water quality class. Health risk indices indicated that As in water via ingestion exposure pathway may pose both non-carcinogenic and carcinogenic health risks to the residents where the non-carcinogenic risk to the residents is raised from ingestion of As, Cd, Cr and Pb from water.

Pollution status and risk assessment of trace elements in Portuguese water, soils, sediments, and associated biota: a trend analysis from the 80s to 2021.

Pollution of water bodies and sediments/soils by trace elements remains a global threat and a serious environmental hazard to biodiversity and human's health. Globalization and industrialization resulted in the increase and availability of these substances in the environment posing unpredictable adverse effects to living organisms. To determine pollution status and risk contamination by trace elements, data available in the literature of the last 40 years on trace elements occurrence in three environmental matrices (water bodies, sediments/soils, and biota) from Continental Portugal were collected (about 90 studies). Data were compared to water and sediment quality guidelines to assess potential ecological risks. Most environmentally relevant hazardous elements include Zn, Cu, Cd, Pb, and As. Various studies found trace elements at levels higher than those considered safe by environmental guidelines. In surface waters, Al, Zn, Se, and Ag were found above aquatic life limits in about 60% of the reviewed papers, while Cu, Zn, and As exceed those values in more than 60% of mining waters. Hg and Cd in sediments from mining areas exceeded aquatic life limits and potential ecological risk showed extremely high risk for most of the elements. The data compiled in this review is very heterogenous, varying in terms of sampling schemes, trace elements analysed, and spatiotemporal settings. This heterogenicity leads to data differences that make meaningful comparisons difficult. Nevertheless, the compilation of scattered environmental spatial and temporal trace elements data, of either natural sources or human activity as well as the ultimate effect on biological systems, is of the upmost importance to broaden its knowledge, risk assessment, and implementation of mitigation measures.

Serum micronutrient levels in critically ill patients receiving continuous renal replacement therapy: A prospective, observational study.

Acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT) may deplete micronutrient levels. Patients are also at risk for micronutrient depletion due to underlying illness(s), poor nutrient intake prior to intensive care unit (ICU) admission and/or increased requirements. We determined vitamin and trace element status before, during and after CRRT in critically ill patients. This prospective observational study performed in mixed medical and surgical ICU patients. Serial serum vitamin B6 and vitamin C concentrations were measured by HPLC and folic acid by ECLIA. Serum chromium, copper, selenium, and zinc were measured using ICP-MS. Serum ceruloplasmin was measured by the Erel method. Fifty adult ICU patients with AKI were recruited. The median APACHE II score on ICU admission was high at 24.0 (6.0-33.0). The median days on CRRT was 2.0 (2.0-4.0) days. At baseline (within 10-15 minutes of CRRT initiation), serum vitamin C, selenium and zinc were below normal. Serum vitamin B6 levels at 72 hours on CRRT were significantly lower than at 24 hours (p = 0.011). Serum vitamin C values fell significantly at 24 and 72 hours during CRRT (p = 0.030 and p = 0.001), respectively, and remained low 24 and 48 hours after CRRT was stopped (p = 0.021). At baseline and during CRRT, 96% of participants had at least two or more micronutrient levels below the normal range. Serum vitamin C, selenium and zinc concentrations were below the normal range at baseline. CRRT was associated with a significant further decrease in levels of vitamin C, selenium and zinc.

Assessment of Serum Trace Element Levels of Solid Waste Scavengers in Osogbo, South-Western, Nigeria

The aim of the study was to determine whether altered serum trace element status is one of the occupational hazards associated with solid waste scavenging. Having obtained informed consent, 30 male solid waste scavengers (SWS) and 30 age-matched males which served as control group were recruited for the study. Trace elements were analyzed by Atomic Absorption Spectrophotometry from serum obtained from 5mL of blood collected from each participant. Questionnaire was administered to obtain information on lifestyles; degree of contact with waste, sites of waste scavenging, types of scavenged waste and common ailments among SWS. Statistical analysis was carried out using Student’s t test, Chi square test, and Pearson’s correlation co-efficient. The level of significance was p≤0.05. While the levels of Zn (2.91±0.92 µmol/dL) and Cu (2.20±0.47 µmol/dL ) were significantly higher, the level of Fe (0.22±0.07 mg/L) was significantly lower in SWS compared to control (2.30±0.46; 1.73±0.47; 0.37±0.09) but Mn (11.00±0.20- SWS vs 9.00±0.04 nmol/L) was not significantly different in test and control groups. Frequency of health problems among SWS were backache (90%), headache (83%), joint pain (33%), and dizziness (20%). Results of the study suggest that solid waste scavenging is associated with various ailments as well as trace element alterations. The negative impacts of altered trace element metabolism on health are diverse.

Association between Serum Trace Elements Levels, Steroid Concentrations, and Reproductive Disorders in Ewes and Does.

This study aimed to investigate the association of different reproductive disorders with the status of serum trace elements and steroid hormones in ewes and goats. This study included 131 barren and 11 fertile (control) ewes and 94 barren and 9 fertile (control) goats. Animals were examined gynecologically for reproductive soundness. The animals were bled, and their serum was harvested and assayed for manganese (Mn), selenium (Se), iron (Fe), zinc (Zn), estrogen (E2), and progesterone (P4) levels. The results showed that genital affections were associated with significant changes in serum Se (P=0.001), Fe (P=0.008), and Zn (P=0.01) levels in ewes, as well as Mn (P=0.01) levels in goats. Ewes and goats with cystic ovaries had higher serum Se, Fe, and Zn levels (P=0.0001) than ewes with uterine affections, ovarian inactivity, and controls. Ovarian inactivity was linked to low Se levels in ewes and low Se and Zn levels in goats (P=0.05). Ewes and goats with estrogen-dominant reproductive disorders had higher Se (P=0.01), Fe (P=0.03), and Zn (P=0.01) compared with the control group. Se (P=0.02) and Zn (P=0.05) were lower in ewes and goats affected with P4-dominant genital disorders compared with the control group. It can be concluded that the reproductive disorders are associated with changes in the level of trace elements in blood of ewes and goats. There is a reciprocal relationship between the levels of estrogen and progesterone with those of the trace elements in serum of ewes and goats.

STATUS OF LIPID PROFILE, TRACE ELEMENTS, AND C-REACTIVE PROTEIN IN Helicobacter pylori INFECTED PREECLAMPSIA WOMEN

Status of lipid profile, trace elements and C-reactive protein (CRP) in Helicobacter pylori infected preeclampsia (PE) women were examined using patients attending Federal Medical Centre in Owerri, Nigeria. A total of 180 volunteer subjects within the ages of 18-40 years were recruited for the study. The volunteer subjects comprised of 60 PE women with H. pylori infection which served as group I, 60 PE women without H. pylori infection which as group II and 60 normotensive pregnant women (with no PE and H. pylori infection) which served as the control. Results obtained revealed varying levels of total cholesterol triglycerides, high density lipoprotein cholesterol (HDL-cholesterol), CRP, Cu and Zn observed among PE women with H. pylori infection compared to PE women without H. pylori infection and the control. Total cholesterol, triglycerides and CRP increased significantly (p<0.05) in group I subjects when compared to group II subjects and the control. Trace elements significantly (p<0.05) reduced in group I subjects against the control. The observation of the present study could be the status of PE women infected with H. pylori though there is need for further studies on this area to confirm the findings of the present study. This study has evaluated the lipid profile, trace elements and CRP status of H. pylori infected PE women.

Dominant species as biological indicators to predict the changes of trace element in different types of rangeland

Alpine meadow, typical steppe and desert are globally important rangeland ecosystems. However, the seasonal variations in concentrations of trace elements, which are important nutrients for grazing livestock, are unclear in these types of rangeland and it is difficult to prevent disorders in grazing livestock caused by trace element excesses and deficiencies. In order to identify which forage species might serve as indicators of the trace element status of livestock forage, we investigated the seasonal trends in Fe, Mn, Cu, and Zn concentrations in the plant communities and dominant species from diverse rangeland types in northwest China in relation to livestock sufficiency levels. The trace element concentrations in the plant communities changed significantly with the season, with the highest Cu, Mn and Zn concentrations and the lowest Fe and Mn concentrations detected in spring and summer, respectively. The seasonal mean temperature, seasonal precipitation, and above-ground biomass significantly negatively correlated with the seasonal variation of Fe and Mn concentrations in the plant community. However, there was almost no significant correlation between these factors and the seasonal Cu and Zn concentrations. The plant concentrations of Fe and Mn were much higher than the recommended levels for livestock in all rangeland types, but the concentrations of Cu in the alpine meadow and the Zn concentrations in all the rangelands barely met the nutritional requirements for animal growth. Based on these deficiencies, we suggest that some forage species could be used as biological indicators to predict changes in the concentrations of trace elements. A decrease in the relative biomass of Kobresia capillifolia and Kobresia humilis in alpine meadows implies a decrease in the levels of Cu in the plant community. A decrease in the relative biomass of K. humilis in alpine meadows, an increase in Stipa bungeana in typical steppes and an increase in Nitraria tangutorum and Salsola passertine in desert rangelands lead to decreased concentrations of Zn in the plant community.

Trace Element Levels and Socio-Demography of Pre-Teen Nigerians with Homozygous Sickle Cell Disorder

Objectives: Homozygous sickle cell disorder (SCD) children are known to have abnormal anthropometric parameters which mostly have been linked with altered zinc status. Alteration in trace element status which occurs from interaction between essential and non-essential elements has not been well studied in SCD. Therefore, the aim of the study is to relate concentrations of Zn, Cd, and Pb with anthropometric parameters. Moreover, it will be established if correlation (interaction) exists between zinc and these two non-essential elements.
 Methods: Twenty-seven SCD patients and 25 age and sex-matched children with hemoglobin genotype HbAA served as test and control groups respectively. Anthropometric parameters and information on demography, dietary zinc status and socio-economic status were obtained. The plasma and red cells obtained from 5 mL of blood were used to determine zinc and heavy metal (Pb, Cd) levels respectively by atomic absorption spectrophotometry. Data were analyzed using Student`s t-test, Chi- square test, and Pearson’s correlation coefficient. P< 0.05 was considered significant.
 Results: There were significant differences in the mean values of mid-upper-arm circumference, weight and BMI. On the other hand, there were no significant differences in mean values of head circumference, height and the trace elements in test and control groups. No association between trace elements and BMI as well as between dietary zinc content and socio-economic status was observed.
 Conclusion: the result of the study suggests there is no correlation between the toxic metals and zinc, and it seems that toxic metals play no role in abnormal BMI that is a common feature of SCD.

Biological Role of Trace Elements and Viral Pathologies

—The review presents summarized information on a new research avenue in biogeochemistry and geochemical ecology: relationships between the microcosm (viruses) and manifestations of animal and human pathologies. Some aspects of the biological action of selenium, zinc, copper and iodine, their influence on the manifestation and course of viral infections are considered. Attention is focused on the antioxidant, membrane-protective, boosting immunity, hormonal functions of trace elements, and on the antibacterial and antiviral properties of metallic copper and its compounds. The criteria currently applied in assessing the Se status of territories are compared with the incidence of COVID-19 and HIV in the population of the Russian Federation. In some cases, selenium deficiency in the environment is shown to be associated with a higher susceptibility to RNA viral infections. Emphasis is put on the necessity of improving the criteria for assessing the trace element status of territories and further studies in the geochemical ecology of viruses and their role in the biosphere.

Status of Common Serum Minerals and Trace Elements in COVID-19 Follow-up Cases: A Hospital-based Study from Eastern India

Introduction: Management of post Coronavirus Disease-2019 (COVID-19) complications are the new challenges nowadays. It has been observed that in post COVID-19 cases the serum levels of several electrolytes and trace elements are deranged. Aim: This study was conducted to estimate the levels of different serum minerals and trace elements in one month post COVID-19 follow-up patients and compared with normal age- sex matched controls. Materials and Methods: This hospital based cross-sectional study was conducted in the Department of Biochemistry in a tertiary care centre, over a period of six months (from January 2021 to June 2021). After fulfilling proper inclusion criteria, 223 COVID-19 follow-up patients of both genders (134 males and 89 females) were included as ‘case’ group. Age-sex matched 250 healthy volunteers were recruited as ‘control’ group. Levels of serum electrolytes (sodium and potassium) and trace elements (zinc, iron, calcium, phosphate, copper, magnesium and selenium) were estimated, analysed and compared against each other. Tables and statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 20.0. Results: In this study, the levels of serum zinc and iron were found to be higher and serum calcium, phosphate, copper, magnesium and selenium levels were reduced in post COVID-19 one month follow- up cases in comparison to controls. Female cases were in deficient state of iron, calcium, copper and magnesium but had high serum zinc and phosphate when compared to males. No abnormalities were noted in the level of electrolytes in post COVID-19 cases. Conclusion: Assessment and monitoring of levels of the mineral throughout the course of post COVID-19 follow-up is advisable for timely and appropriate measures to combat with post COVID-19 complications.

Maternal status of trace elements and risk of neural tube defects in offspring: a meta-analysis of 6121 pregnancies

Maternal status of trace elements and risk of neural tube defects in offspring: a meta-analysis of 6121 pregnancies

Влияние метаболического синдрома на изменение показателей микроэлементного статуса и системы перекисного окисления липидов у пациентов с вульгарным псориазом

Aim. To study the effect of metabolic syndrome on changes in the indicators of trace element status and lipid peroxidation system in patients with psoriasis vulgaris. Materials and methods. In the framework of this work, 80 patients were examined with a diagnosis of vulgar psoriasis (group I without metabolic syndrome, group II with metabolic syndrome). The study of the trace element status, the serum content of 25-OH hydroxycalciferol, alpha– tocopherol acetate, as well as the state of the lipid peroxidation system were carried out. Results. in patients with metabolic syndrome, were discovered: a decrease in the indicators of trace element status and vitamins, an increase in the overall oxidative capacity of the blood, an increase in the level of oxidative low-density lipoproteins, as well as a decrease in the overall antioxidant activity of the blood. Conclusion. The obtained data allows to develop recommendations for the management and treatment of patients with vulgar psoriasis by correcting the microelement status and vitamins, which will reduce the influence of metabolic syndrome on the course of the psoriatic process at an early stage.

The Impact of Trace Elements on Osteoarthritis.

Osteoarthritis (OA) is a progressive degenerative disease characterized by cartilage degradation, synovial inflammation, subchondral sclerosis and osteophyte formation. It has a multifactorial etiology with potential contributions from heredity, endocrine function, abnormal mechanical load and nutrition. Of particular considerations are trace element status. Several trace elements, such as boron and magnesium are essential for normal development of the bone and joint in human. While cadmium correlates with the severity of OA. The present review focuses on the roles of trace elements (boron, cadmium, copper, iron, magnesium, manganese, selenium, zinc) in OA and explores the mechanisms by which they act.

Evaluation of the Effectiveness of Personalized Treatment of Trace Element and Vitamin Status in Men with Initial Stages of Androgenic Alopecia Treated with Conservative Therapy

Background. Androgenic alopecia (AGA) is the most common form of pathological hair loss with multiple micronutrient disorders involvedin its occurrence and development.
 Aimto evaluatethe effectiveness of personalized treatment of micronutrient deficiencies in patients with early stages of AGA and conservative therapy using a vasodilator drug minoxidil based on evidence-based medicine.
 Methods. A total 48 patients with stages IIV of AGA (according to the NorwoodHamilton scale) were recruited to experimental prospective clinical study evaluating the effectiveness of pharmaceutical forms of trace elements and vitamins. The primary diagnosis of micronutrient deficiency was carried out by comparing laboratory parameters of patients with AGA and 25 healthy volunteers. After that, conservative treatment with 5% topical minoxidilin AGA patients was enriched with 2-month personalized systemic supplementation of pharmaceutical forms of trace elements and vitamins. At the end of the study, the correspondence between changes in trace elements and vitamins content in the plasma and the trichogram parameters before and after conservative therapy was assessed.
 Results. The majority (96%) of the examined patients with AGA were characterized by mono- or polynutrient deficiencies. Personalized correction made it possible to restore the content of Se, Mg, Fe and vitamin E to the baseline levels and to achieve a significant increase in Zn, vitamin D and folic acid plasma content. The relationship between changes in the level of micronutrients and trichogram parameters was recorded only for Se (decrease in anagen hairs: r = 0.43; p = 0.037; decrease in hair density: r = 0.45; p = 0.028) and folic acid (an increase in anagen hairs: r = 0.41; p = 0.024); the positive effect of vitamin E on hair density was also detected.
 Conclusion. The results of the study allow to recommend a personalized treatment of folic acid and vitamin E deficiencies, with possible refusal to use the Se-containing drugs in conservative therapy of patients with the early stages of AGA.

Diet and dog characteristics affect major and trace elements in hair and blood of healthy dogs

Obtaining correct amounts of essential elements, and avoiding toxic metals are key factors in dog health. Through analyzing major and trace elements in hair and blood of 50 healthy companion dogs using ICP-MS, we study their associations with dog characteristics and diet, hypothesizing that eating the same diet long-term results in strong correlations between hair and blood element concentrations, and that dog characteristics and diet affect element status. The correlation between hair and blood was significant for Hg (R = 0.601, p = 0.000) and Pb (R = 0.384, p = 0.010). The following associations were significant (p < 0.05): Dark hair had higher Ca and Mg compared to light hair. Females had higher hair Zn, blood Mn, and blood As compared to males. Blood Mn and Se increased, while blood Pb decreased with age. Raw diet fed dogs had higher hair Zn and Se compared to dry or mixed diet fed dogs, and lower blood Mn compared to dry diet fed dogs. Dry and mixed diet fed dogs had higher blood Cd compared to raw diet fed dogs. Mixed diet fed dogs had higher hair Ca and Mg compared to raw or dry diet fed dogs, and higher hair Pb compared to dry diet fed dogs. Wild game consumption was associated with higher blood Pb, and rice consumption with higher blood As. In conclusion, hair provides an alternative for assessing Hg and Pb exposure, and major and trace elements status is affected by hair color, sex, age, and diet.

High manganese and nickel concentrations in human hair and well water and low calcium concentration in blood serum in a pristine area with sulphide-rich bedrock

We report the trace element status of residents living in areas with naturally sulphide-rich bedrock and soil in two municipalities in Finland, Sotkamo and Kaavi. Altogether, 225 people from these sparsely populated regions participated voluntarily by providing hair and blood samples. The concentrations of calcium, zinc and copper in serum as well as selenium and cadmium in whole blood did not show correlation with those concentrations in hair samples. Calcium concentration in serum was slightly lower in the sulphide-rich areas (median value 91.4 mg/l, n = 103) than in the areas with adjacent sulphur-poor bedrock (median value 93.6 mg/l, n = 82). The concentrations of Ni and Mn in hair correlated with those in drinking water. The highest Mn and Ni concentrations in the water samples from private wells were 1620 µg/l and 51 µg/l and the highest concentrations in human hair samples 36.44 mg/kg and 12.3 mg/kg, respectively. The challenge with elevated trace element concentrations in some well waters is well documented. In northern countries (Finland, Sweden, Norway and Canada), only 10% of the population depend on private well water, and 90% have access to monitored municipal water supplies. Compared with data available from sulphide mine sites globally, the nickel and manganese concentrations in human hair samples were high in our sulphide-rich study area at Sotkamo representing the trace element status of residents under natural conditions.

Temporal-spatial variations, source apportionment, and ecological risk of trace elements in sediments of water-level-fluctuation zone in the Three Gorges Reservoir, China.

The Three Gorges Reservoir (TGR) plays a crucial role in providing electricity for mega-cities across China. However, since the impoundment was completed in 2006, attention to environmental concerns has also been intensive. In order to determine the distribution, sources, and pollution status of trace elements in the water fluctuation zone of the TGR following ten years of repeated "submergence" and "exposure", we systematically collected 16 paired surface sediment samples (n = 32) covering the entire main body of the TGR in March 2018 (following 6months of submergence) and September 2018 (after 6months of exposure), and quantitatively analyzed 13 elements (e.g., Mn, Fe, V, Cr, Ni, Cu, Zn, As, Sr, Y, Zr, Ba, and Pb) using X-ray fluorescence spectrophotometry (XRF). The results showed that, except for Sr, concentrations of trace metals following submergence were generally higher than those after exposure due to the less settling of suspended solids at the faster flow velocity during the drawdown period. Assessment using enrichment factors (EFs) and a geo-accumulation index (Igeo) both characterized a relatively serious anthropogenic pollution status of metals in the upper reaches of the TGR with respect to the middle-lower reaches. Source apportionment by positive matrix factorization (PMF) analysis indicated that agricultural activities (24.8 and 24.3%, respectively) and industrial emissions (24.5 and 22.9%, respectively) were the two major sources in these two periods, followed by natural sources, domestic sewage, and ore mining. Ecological risk assessment showed that metalloid arsenic (As) could be the main potential issue of risk to aquatic organisms and human health. A new source-specific risk assessment method (pRI) combined with PMF revealed that agricultural activities could be the major source of potential ecological risk and should be prioritized as the focus of metal/metalloid risk management in the TGR.

Trace elements in whole blood in the general population in Trøndelag County, Norway: The HUNT3 Survey

BackgroundBiomonitoring of a cohort within a large health survey can provide reliable information on trace element status. The main aims of this study were 1) to determine the concentrations of 28 trace elements in whole blood samples from the general population of the Nord-Trøndelag region, Norway, and 2) to investigate how trace element concentrations vary with geographical area, lifestyle, and socio-demographic factors. MethodsWhole blood samples were collected in the third survey of the Trøndelag Health Survey (HUNT3), a large population-based study in Norway. In total, 1011 whole blood samples from individuals aged 20–91 years were analyzed using high resolution inductively coupled plasma-mass spectrometry (HR-ICP-MS). We compared trace element concentrations (As, B, Be, Br, Ca, Cd, Cr, Cs, Cu, Ga, Au, In, Fe, Pb, Hg, Tl, Mg, Mn, Mo, Ni, Rb, Sc, Se, Ag, Sr, Sn, W and Zn) between three geographical areas (coastal, fjord/town, inland/mountain) using multivariable linear regression and assessed differences in trace element concentrations with socio-demographic and lifestyle factors using general linear models. ResultsTrace element concentrations were generally comparable to levels reported in other recent studies and suggest low exposure to toxic trace elements in the region. We found geographical differences in concentrations of 19 trace elements. As, Br, Hg, and Se concentrations were higher on the coast compared to the fjord/town and inland/mountain areas, suggesting that the marine environment is an important source of exposure for these trace elements. In addition, socio-demographic and lifestyle characteristics, particularly age and sex, were associated with differences in trace element concentrations. ConclusionsWe report concentrations of 28 trace elements in the general population of a rural region with low exposure to pollution. Whole blood concentrations of trace elements varied with geographical area, the participants' lifestyle, and socio-demographic characteristics, highlighting the importance of considering these factors when evaluating trace element status in a population.

Circulatory Imbalance of Essential and Toxic Trace Elements in Pre-dialysis and Hemodialysis Patients.

The status of essential and toxic trace elements in patients with different stages of chronic kidney disease (CKD) is still unclear and not well characterized. The present study examined the circulatory levels of a wide panel of trace elements (Al, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Rb, Sr, Cd, Pb, and U) in hemodialysis patients (HD group) and pre-dialysis patients with stage 3 CKD (PD group). Comparisons were made between groups of patients and healthy individuals from the control group (CG). The levels of Al, Mn, Co, Ni, Cu, As, Se, Sr, and Pb were higher, while the levels of Cr, Zn, Rb, Cd, and U were lower in HD patients than in our CG. Higher levels of Al and Se, as well as lower levels of As, Sr, Zn, Rb, and U were significant and distinguished HD from PD. Among other analyzed elements, Co, Se, and U are the only trace elements that did not distinguish PD from CG at a statistically significant level. The HD group had lower serum U levels than the PD group, and this could be a result of hemodialysis. This study also revealed that the Cu/Zn ratio could be used as a marker for early and late detection of renal failure. Marked changes of essential and toxic trace element levels in sera indicate additional pathophysiological events in CKD, which could additionally contribute to the preexisting increased morbidity of HD patients. Measurement of trace elements in HD patients should be performed routinely.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12011-021-02940-7.

Course and Survival of COVID-19 Patients with Comorbidities in Relation to the Trace Element Status at Hospital Admission.

Selenium (Se) and zinc (Zn) are essential trace elements needed for appropriate immune system responses, cell signalling and anti-viral defence. A cross-sectional observational study was conducted at two hospitals in Ghent, Belgium, to investigate whether Se and/or Zn deficiency upon hospital admission correlates to disease severity and mortality risk in COVID-19 patients with or without co-morbidities. Trace element concentrations along with additional biomarkers were determined in serum or plasma and associated to disease severity and outcome. An insufficient Se and/or Zn status upon hospital admission was associated with a higher mortality rate and a more severe disease course in the entire study group, especially in the senior population. In comparison to healthy European adults, the patients displayed strongly depressed total Se (mean ± SD: 59.2 ± 20.6 vs. 84.4 ± 23.4 µg L−1) and SELENOP (mean ± SD: 2.2 ± 1.9 vs. 4.3 ± 1.0 mg L−1) concentrations at hospital admission. Particularly strong associations were observed for death risk of cancer, diabetes and chronic cardiac disease patients with low Se status, and of diabetes and obese patients with Zn deficiency. A composite biomarker based on serum or plasma Se, SELENOP and Zn at hospital admission proved to be a reliable tool to predict severe COVID-19 course and death, or mild disease course. We conclude that trace element assessment at hospital admission may contribute to a better stratification of patients with COVID-19 and other similar infectious diseases, support clinical care, therapeutic interventions and adjuvant supplementation needs, and may prove of particular relevance for patients with relevant comorbidities.