Table 2.
Characteristics of the 152 COVID-19 patients according to plasma zinc status.a
| Characteristics | COVID-19 patients with hypozincemia |
p-value | |||
|---|---|---|---|---|---|
| Yes (N = 42) | No (N = 110) | ||||
| Time between symptoms onset and COVID-19 testing (days) | 4 | (3–7) | 4 | (3–6) | 0.14 |
| Demographics | |||||
| Median age (IQR) – yr | 50 | (32–58) | 38 | (26–52) | 0.01 |
| Male – no. (%) | 16 | (38.1) | 55 | (50.0) | 0.19 |
| Median BMI (IQR) – kg/m2 | 24.0 | (22.6–26.3) | 24.4 | (22.3–28.7) | 0.30 |
| BMI < 18.5 kg/m2 – no. (%) | 3 | (7.9) | 3 | (2.8) | 0.18 |
| Presenting symptoms – no. (%) | |||||
| Fever | 25 | (59.5) | 31 | (28.2) | <0.001 |
| Cough | 22 | (52.4) | 53 | (48.2) | 0.64 |
| Anosmia and/or ageusia | 20 | (47.6) | 60 | (54.5) | 0.44 |
| Headache | 18 | (42.9) | 58 | (52.7) | 0.28 |
| Myalgia | 18 | (42.9) | 44 | (40.0) | 0.75 |
| Rhinitis | 17 | (40.5) | 44 | (40.0) | 0.96 |
| Fatigue | 11 | (26.2) | 36 | (32.7) | 0.44 |
| Shortness of breath | 10 | (23.8) | 28 | (25.5) | 0.83 |
| Diarrhea | 7 | (16.7) | 20 | (18.2) | 0.83 |
| Comorbidities for severe COVID-19 – no. (%) | |||||
| Age ≥ 65 yr | 9 | (21.4) | 6 | (5.5) | 0.006 |
| Medically assisted nursing homes | 7 | (16.7) | 2 | (1.8) | 0.002 |
| Smoker | 8 | (19.0) | 24 | (21.8) | 0.71 |
| Obesity (BMI ≥ 30 kg/m2) | 3 | (7.9) | 21 | (19.3) | 0.10 |
| Arterial hypertension | 7 | (16.7) | 13 | (11.8) | 0.43 |
| Chronic respiratory diseases | 6 | (14.3) | 7 | (6.4) | 0.19 |
| Diabetes (type 2) | 3 | (7.1) | 7 | (6.4) | >0.99 |
| Cardiovascular diseases | 7 | (16.7) | 8 | (5.5) | 0.12 |
| Cancer | 2 | (4.8) | 2 | (1.8) | 0.31 |
| Chronic kidney diseases | 1 | (2.4) | 1 | (0.9) | 0.48 |
| Immunosuppressive treatment | 3 | (7.1) | 2 | (1.8) | 0.13 |
| Early warning score (NEWSb) – no. (%) | |||||
| Median NEWS (IQR) | 2 | (1–4) | 1 | (0–2) | <0.001 |
| 0–4 (low) | 32 | (76.2) | 107 | (97.3) | <0.001 |
| 5–6 (medium) | 6 | (14.3) | 3 | (2.7) | 0.014 |
| ≥7 (high) | 4 | (9.5) | 0 | (0.0) | 0.005 |
| Laboratory findingsc– median (IQR) | |||||
| Plasma zinc concentration, μg/dL | 59 | (56–62) | 74 | (69–81) | <0.001 |
| White blood cell count, ×109/L | 5.4 | (4.2–7.0) | 4.6 | (3.6–6.0) | 0.03 |
| Hemoglobin, g/dL | 13.5 | (12.2–14.3) | 14.3 | (13.4–15.4) | <0.001 |
| Platelet count, ×109/L | 230 | (177–269) | 220 | (190–256) | 0.92 |
| Neutrophil cell count, ×109/L | 3.1 | (2.4–4.8) | 2.3 | (1.4–3.0) | 0.003 |
| Lymphocyte count, ×109/L | 1.2 | (0.9–1.5) | 1.6 | (1.4–2.1) | <0.001 |
| Neutrophil-lymphocyte ratio (NLR) | 2.9 | (1.6–5.4) | 1.3 | (0.9–1.8) | <0.001 |
| D-Dimer level, mg/L | 0.33 | (0.27–0.96) | 0.28 | (0.27–0.38) | 0.01 |
| C-reactive protein, mg/L | 7 | (2–20) | 2 | (1–5) | <0.001 |
| Lymphocyte-to-CRP ratio (LCR) (×109/L/mg/L) | 0.15 | (0.04–1.04) | 0.76 | (0.29–1.85) | <0.001 |
| Lactate dehydrogenase, UI/L | 187 | (169–237) | 191 | (169–216) | 0.74 |
| Ferritin, μg/L | 252 | (78–382) | 182 | (62–242) | 0.04 |
| Albumin, g/dL | 4.4 | (4.2–4.6) | 4.7 | (4.5–4.9) | <0.001 |
| Alanine aminotransferase (ALAT), UI/L | 21 | (16–31) | 25 | (19–41) | 0.06 |
| Aspartate aminotransferase (ASAT), UI/L | 27 | (20–33) | 25 | (23–32) | 0.63 |
| Total bilirubin, μmol/L | 6 | (4–8) | 6 | (4–7) | 0.84 |
| Creatine kinase, UI/L | 65 | (50–90) | 84 | (56–115) | 0.09 |
| Alkaline phosphatase, UI/L | 63 | (56–78) | 63 | (51–79) | 0.53 |
| Gamma-glutamyltransferase, UI/L | 23 | (15–32) | 26 | (16–45) | 0.23 |
| Creatinine, mg/dL | 0.77 | (0.67–0.93) | 0.81 | (0.70–0.97) | 0.26 |
| Distributiond– no./total no (%) | |||||
| Anemia | 9/42 | (21.4) | 9/110 | (8.2) | 0.045 |
| Albumin < 3.5 g/dL | 3/39 | (7.7) | 0/106 | (0.0) | 0.02 |
| D-dimer > 0.5 mg/L | 15/41 | (36.6) | 19/109 | (17.4) | 0.01 |
| C-reactive protein < 20 mg/L | 29/40 | (72.5) | 104/108 | (96.3) | <0.001 |
| C-reactive protein ≥20 mg/L | 11/40 | (27.5) | 4/108 | (3.7) | <0.001 |
| Lymphopenia | 23/31 | (74.2) | 24/77 | (31.2) | <0.001 |
| Clinical course – no. (%) | |||||
| Hospitalization for respiratory complications within 10 days | 7 | (16.7) | 6 | (5.5) | 0.046 |
Significant p-values are formatted in bold.
a
Quantitative continuous variables were expressed as medians with interquartile ranges (IQRs) compared using Mann–Whitney U tests. Qualitative variables were expressed as no. (%) or no./total no (%) where total no. is the total number with available data, and compared using Chi-square test or Fisher's exact test, as appropriate.
b
NEWS: National Early Warning Score for COVID-19.
c
To convert the values for zinc to μmol/L, divide by 6.54. To convert the values for creatinine to μmol/L, multiply by 88.4.
d
Anemia was defined as hemoglobin values below 12 g/dL for women and 13 g/dL for men. Lymphopenia was defined as lymphocyte count below 1.5 × 109/L.