Circulating trace elements status in COVID-19 disease: A meta-analysis

Trace elements are a group of essential metals or metalloids, which are necessary for life, and present in minute amounts. Despite substantial researches highlighting the importance of trace elements in Coronavirus disease 2019 (COVID-19) diseases, a thorough evaluation of the levels of circulating...

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Main Authors: Yunhui Li, Weihe Luo, Bin Liang
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-08-01
Series:Frontiers in Nutrition
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2022.982032/full
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author Yunhui Li
Weihe Luo
Bin Liang
author_facet Yunhui Li
Weihe Luo
Bin Liang
author_sort Yunhui Li
collection DOAJ
description Trace elements are a group of essential metals or metalloids, which are necessary for life, and present in minute amounts. Despite substantial researches highlighting the importance of trace elements in Coronavirus disease 2019 (COVID-19) diseases, a thorough evaluation of the levels of circulating trace elements is lacking. Therefore, we conducted a systematic review and meta-analysis to evaluate the trace element status (Zn, Fe, Cu, Mg, and Se) in COVID-19 disease. We also assessed the relationship between circulating trace elements and COVID-19 disease severity and survival status during follow-up. We searched comprehensively MEDLINE, Web of Science, CNKI, and WangFang databases without language restriction, between November 1, 2019 and April 1, 2022. The search identified 1,566 preliminary references. A total of 49 studies met the eligibility criteria and were included in the review, and 42 studies were included in the final meta-analysis. Meta-analysis showed that COVID-19 patients had significantly lower circulating Zn (SMD: −0.83, 95% CI: −1.19 to −0.46, P < 0.001), Fe (SMD: −1.56, 95% CI: −2.90 to −0.21, P = 0.023), and Se (SMD: −0.75, 95% CI: −0.94 to −0.56, P < 0.001) levels than healthy controls, and circulating Zn (SMD: −0.47, 95% CI: −0.75 to −0.18, P = 0.002), Fe (SMD: −0.45, 95% CI: −0.79 to −0.12, P = 0.008), and Se (SMD: −0.27, 95% CI: −0.49 to −0.04, P = 0.020) levels were associated with the presence of severity status in COVID-19 patients. Moreover, circulating Fe levels in non-survivors were significantly lower than survivors in COVID-19 (SMD: −0.28, 95% CI: −0.44 to −0.12, P = 0.001). However, there was no significant difference in Cu and Mg levels between COVID-19 patients and controls, severity and non-severity status, and survivors and non-survivors (all P > 0.05). Taken together, COVID-19 patients displayed lower circulating levels of Zn, Fe, and Se, and their levels were associated with severity status. Moreover, circulating Fe levels may provide part of the explanation for the unfavorable survival status. Therefore, we presumed optimistically that supplements of trace elements might provide an adjutant treatment in the early stages of COVID-19.Systematic review registration[https://www.crd.york.ac.uk/prospero], identifier [CRD42022348599].
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spelling doaj.art-03f6b245e2e44c459663f277eec3a8d42022-12-22T02:51:13ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-08-01910.3389/fnut.2022.982032982032Circulating trace elements status in COVID-19 disease: A meta-analysisYunhui Li0Weihe Luo1Bin Liang2Clinical Laboratory, PLA North Military Command Region General Hospital, Shenyang, ChinaDepartment of Medical Engineering, PLA North Military Command Region General Hospital, Shenyang, ChinaDepartment of Bioinformatics, Key Laboratory of Cell Biology, Ministry of Public Health, and Key Laboratory of Medical Cell Biology, Ministry of Education, School of Life Sciences, China Medical University, Shenyang, ChinaTrace elements are a group of essential metals or metalloids, which are necessary for life, and present in minute amounts. Despite substantial researches highlighting the importance of trace elements in Coronavirus disease 2019 (COVID-19) diseases, a thorough evaluation of the levels of circulating trace elements is lacking. Therefore, we conducted a systematic review and meta-analysis to evaluate the trace element status (Zn, Fe, Cu, Mg, and Se) in COVID-19 disease. We also assessed the relationship between circulating trace elements and COVID-19 disease severity and survival status during follow-up. We searched comprehensively MEDLINE, Web of Science, CNKI, and WangFang databases without language restriction, between November 1, 2019 and April 1, 2022. The search identified 1,566 preliminary references. A total of 49 studies met the eligibility criteria and were included in the review, and 42 studies were included in the final meta-analysis. Meta-analysis showed that COVID-19 patients had significantly lower circulating Zn (SMD: −0.83, 95% CI: −1.19 to −0.46, P < 0.001), Fe (SMD: −1.56, 95% CI: −2.90 to −0.21, P = 0.023), and Se (SMD: −0.75, 95% CI: −0.94 to −0.56, P < 0.001) levels than healthy controls, and circulating Zn (SMD: −0.47, 95% CI: −0.75 to −0.18, P = 0.002), Fe (SMD: −0.45, 95% CI: −0.79 to −0.12, P = 0.008), and Se (SMD: −0.27, 95% CI: −0.49 to −0.04, P = 0.020) levels were associated with the presence of severity status in COVID-19 patients. Moreover, circulating Fe levels in non-survivors were significantly lower than survivors in COVID-19 (SMD: −0.28, 95% CI: −0.44 to −0.12, P = 0.001). However, there was no significant difference in Cu and Mg levels between COVID-19 patients and controls, severity and non-severity status, and survivors and non-survivors (all P > 0.05). Taken together, COVID-19 patients displayed lower circulating levels of Zn, Fe, and Se, and their levels were associated with severity status. Moreover, circulating Fe levels may provide part of the explanation for the unfavorable survival status. Therefore, we presumed optimistically that supplements of trace elements might provide an adjutant treatment in the early stages of COVID-19.Systematic review registration[https://www.crd.york.ac.uk/prospero], identifier [CRD42022348599].https://www.frontiersin.org/articles/10.3389/fnut.2022.982032/fullSARS-CoV-2COVID-19trace elementserumprognosismeta-analysis
spellingShingle Yunhui Li
Weihe Luo
Bin Liang
Circulating trace elements status in COVID-19 disease: A meta-analysis
Frontiers in Nutrition
SARS-CoV-2
COVID-19
trace element
serum
prognosis
meta-analysis
title Circulating trace elements status in COVID-19 disease: A meta-analysis
title_full Circulating trace elements status in COVID-19 disease: A meta-analysis
title_fullStr Circulating trace elements status in COVID-19 disease: A meta-analysis
title_full_unstemmed Circulating trace elements status in COVID-19 disease: A meta-analysis
title_short Circulating trace elements status in COVID-19 disease: A meta-analysis
title_sort circulating trace elements status in covid 19 disease a meta analysis
topic SARS-CoV-2
COVID-19
trace element
serum
prognosis
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fnut.2022.982032/full
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AT weiheluo circulatingtraceelementsstatusincovid19diseaseametaanalysis
AT binliang circulatingtraceelementsstatusincovid19diseaseametaanalysis