Assessment of Vitamin D, Vitamin B12, Retinol-binding Protein (RBP), Zinc, Selenium, Copper and Magnesium in Iranian COVID-19 Patients and Their Relationships with the Disease Linked Death

Clinical evidence on the nutritional statuses of COVID-19 patients and their associations with COVID-19 clinical outcomes are limited. To the best of the authors’ knowledge, no studies have been carried out on COVID-19 patients of Iranian population. Therefore, the aim of this study was to assess vitamin D, vitamin B12, RBP, zinc, selenium, copper and magnesium levels in patients with COVID-19. Furthermore, associations of nutrient levels with the disease-linked death were investigated.

This cross-sectional study was carried out in hospitals affiliated to Hamadan University of Medical Sciences, Hamadan, Iran, on 98 COVID-19 positive patients, March to May 2020. Demographic and clinical data of the patients were collected from their clinical records. Blood samples of 5 ml were collected from the patients, which were used for hospital routine laboratory assays as well as measuring trace elements and vitamins. Comparison of chemical biomarkers based on the patient’s treatment outcomes was carried out using Mann-Whitney U test. For data analysis, Stata Software v.14 was used.

From 98 COVID-19 positive patients, 16 (13.33%) patients died during the treatment. These patients had higher proportions of heart diseases (37.5% against 10.98%, p = 0.007). Moreover, the median of white blood cell counts was significantly higher in patients, who died during treatment (p = 0.002). For vitamin D3, vitamin B12, RBP, zinc, selenium, cupper and magnesium, 59.2, 12.24, 53.08, 30.61, 88.71, 16.33 and 26.53% of the patients had values below the reference value ranges of these elements, respectively. Comparison of chemical biomarkers based on the patient’s treatment outcomes did not show significant differences (p > 0.05).

Although results of this study did not show significant differences between the levels of the trace elements and vitamins with the outcomes in COVID-19 patients due to the small sample size of the present study, assessment of these relationships needs stronger evidence by designing large studies.