Table 1.

Summary of the electrolytes and trace element roles in the COVID-19

Element	Physiologic role	Role in COVID-19
Zinc	It has a role in both innate and adaptive immune systems and also has an antiviral activity [16]	Zinc inhibits the activity of RNA-dependent RNA polymerase (RdRp) of coronavirus [18], and compound both of zinc and CQ/HCQ is useful for COVID-19 treatment [19]
Selenium	Selenium is a free radical scavenger and helps cellular immunity [24]	High selenium intake (50–100 μg/day) causes better and more immune responses [29]
Iron	Iron is needed for some reactions and cellular functions like RNA/DNA synthesis and repairs [10]	High level of iron may increase viral infections [36], although it has reported that COVID-19 patients have low serum level of iron [37]
Potassium	It is important for cell functions and the need for membrane potential [61]	Hypokalemia is a high prevalence condition (up to 62%) among COVID-19 patients [41]
Sodium	Sodium can modulate immune cell activities [62]	The sodium in the serum of patients with pneumonia infected by SARS-CoV-2 is lower than non-pneumonia patients [43]
Calcium	Calcium has a role in the activation of lymphocytes [63]	It has seen that SARS-CoV entry into some cell lines decreases when intracellular calcium decreases [49]
Magnesium	It has important roles in immune functions including immunoglobulin synthesis and immunoglobulin M (IgM) lymphocyte binding [51]	ND
Folic acid	Synthesis of purines and thymidylate that they are necessary for mitochondrial producing of ATP need folic acid [65]	Folic acid impairs the viral life cycle by creating hydrogen binds with 3CL hydrolase. In severe patients, the level of folic acid is lower [52, 64]
Copper	It is an essential trace element in body and is needed for protecting DNA from oxidative stress [53]	It has been reported that the human immune system response was weak when Cu is deficient. The level of serum copper in COVID-19 patients is unknown[59]