Selenium Deficiency Is Associated with Mortality Risk from COVID-19

Nutrients. 2020 Jul 16;12(7):2098. doi: 10.3390/nu12072098.

Abstract

SARS-CoV-2 infections underlie the current coronavirus disease (COVID-19) pandemic and are causative for a high death toll particularly among elderly subjects and those with comorbidities. Selenium (Se) is an essential trace element of high importance for human health and particularly for a well-balanced immune response. The mortality risk from a severe disease like sepsis or polytrauma is inversely related to Se status. We hypothesized that this relation also applies to COVID-19. Serum samples (n = 166) from COVID-19 patients (n = 33) were collected consecutively and analyzed for total Se by X-ray fluorescence and selenoprotein P (SELENOP) by a validated ELISA. Both biomarkers showed the expected strong correlation (r = 0.7758, p < 0.001), pointing to an insufficient Se availability for optimal selenoprotein expression. In comparison with reference data from a European cross-sectional analysis (EPIC, n = 1915), the patients showed a pronounced deficit in total serum Se (mean ± SD, 50.8 ± 15.7 vs. 84.4 ± 23.4 µg/L) and SELENOP (3.0 ± 1.4 vs. 4.3 ± 1.0 mg/L) concentrations. A Se status below the 2.5th percentile of the reference population, i.e., [Se] < 45.7 µg/L and [SELENOP] < 2.56 mg/L, was present in 43.4% and 39.2% of COVID samples, respectively. The Se status was significantly higher in samples from surviving COVID patients as compared with non-survivors (Se; 53.3 ± 16.2 vs. 40.8 ± 8.1 µg/L, SELENOP; 3.3 ± 1.3 vs. 2.1 ± 0.9 mg/L), recovering with time in survivors while remaining low or even declining in non-survivors. We conclude that Se status analysis in COVID patients provides diagnostic information. However, causality remains unknown due to the observational nature of this study. Nevertheless, the findings strengthen the notion of a relevant role of Se for COVID convalescence and support the discussion on adjuvant Se supplementation in severely diseased and Se-deficient patients.

Keywords: COVID-19; inflammation; micronutrient; selenoprotein P; trace element.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus*
  • Biomarkers / blood
  • COVID-19
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / mortality*
  • Cross-Sectional Studies
  • Female
  • Germany / epidemiology
  • Glutathione Peroxidase / blood
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status
  • Pandemics
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / mortality*
  • Prognosis
  • SARS-CoV-2
  • Selenium / blood
  • Selenium / deficiency*
  • Selenoprotein P / blood

Substances

  • Biomarkers
  • Selenoprotein P
  • GPX3 protein, human
  • Glutathione Peroxidase
  • Selenium