Selenium Deficiency Linked to Increased Mortality Risk from COVID-19

by | Aug 18, 2020 | 2020, COVID-19, Selenium

Written by Joyce Smith, BS. This study reveals that selenium deficiency may be associated with more severe COVID-19 patients and supports a potential role for adjuvant selenium supplementation in selenium deficient populations.

seleniumSARS-CoV-2 infection, the cause of the present coronavirus disease (COVID-19) pandemic, is sometimes associated with a severely overreactive immune system and its massive cytokine and chemokine release commonly known as a “cytokine storm 1. Inflammation control with immunosuppressive corticosteroids has shown promise in severe cases of the disease, but has also increased the demand for dexamethasone, a steroid shown to decrease the severity of acute respiratory syndrome 2. The use of repurposed drugs in combination with certain micronutrients such as vitamins A, B, B12, C, D, and E and essential trace elements of zinc, iron, selenium (Se), magnesium, or copper have helped tame the immune response 3 ; however, it is presently not known whether a deficiency of vitamins or trace minerals in the body correlates with disease severity and increased risk of death. Se deficiency is an established risk factor for viral infections 4 and a higher viral mutation rate 5. Supplementation with Se has proven beneficial in the treatment of endemic cardiomyopathy 6, sepsis 7, and polytraumatic injury 8.  A current study associated Se status with improved outcomes in COVID-19 patients residing in different areas of China 9.

Researchers, hypothesizing a potential association between selenium deficiency and poor survival among Covid-19 patients, conducted an observational, cross-sectional pilot study 10 of 33 COVID-19 patients in a German hospital. Diagnosis was based on viral RNA using polymerase chain reaction (PCR). Serum samples (n = 166) from COVID-19 patients were analyzed for Se levels by measuring total Se concentration, serum SELENOP(selenoprotein) level, and activity of secreted Glutathione peroxidase 3 (GPx3).

All 33 COVID-19 patients had a Se deficiency in their blood along with low concentrations of the SE transporter SELENOP and low enzymatic activity of the secreted GPx3. The reference ranges (reflective of healthy European adults) used for normal Se status were 45.7–131.6 g/L for serum Se, and 2.56–6.63 mg/L for serum SELENOP concentration. According to these reference ranges, 44.4% of samples from COVID-19 patients were deficient in Se, and 39.6% were deficient in SELENOP.

When viewing patient samples from surviving vs. deceased COVID-19 patients, the difference in selenium deficiencies was amplified. Blood samples from deceased COVID-19 patients revealed deficiencies of 64.7% Se and 70.6% SELENOP, whereas samples from the survivors were reclassified as 39.3% Se- and 32.6% SELENOP-deficient, revealing significantly lower Se levels in the non-survivors. The research team suggests that participants may have already had low Se levels prior to disease onset that declined further with advanced disease (increasing inflammation) or with longer ICU stays under inflammatory and hypoxic conditions, which may have contributed to the low levels of selenium observed in this study. The greater Se deficiency in non-survivors of COVID-19 compared to survivors may also suggest selenium’s support in disease recovery.

Study limitations include the use of an explorative pilot study with its relatively limited number of patients and samples, and the lack of clinical data on inflammatory parameters. Although causality was not proven, the study suggests that analysis of Se status does provide diagnostic information for COVID-19 patients and supports further discussion on the benefits of adjuvant Se supplementation in severely diseased Se-deficient patients. Intervention studies are warranted to further investigate the use of selenium supplementation as a readily available, inexpensive, and safe prophylactic measure as well as a potential adjuvant treatment option for COVID-19.

Source: Moghaddam, Arash, Raban Arved Heller, Qian Sun, Julian Seelig, Asan Cherkezov, Linda Seibert, Julian Hackler et al. “Selenium deficiency is associated with mortality risk from COVID-19.” Nutrients 12, no. 7 (2020): 2098.

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution(CC BY) license (http://creativecommons.org/licenses/by/4.0/).

Click here to read the full text study.

Posted August 18, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

References:

  1. Song P, Li W, Xie J, Hou Y, You C. Cytokine storm induced by SARS-CoV-2. Clinica chimica acta; international journal of clinical chemistry. 2020;509:280-287.
  2. Villar J, Ferrando C, Martínez D, et al. Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial. The Lancet Respiratory medicine. 2020;8(3):267-276.
  3. Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients. 2020;12(4).
  4. Guillin OM, Vindry C, Ohlmann T, Chavatte L. Selenium, Selenoproteins and Viral Infection. Nutrients. 2019;11(9).
  5. Beck MA, Handy J, Levander OA. Host nutritional status: the neglected virulence factor. Trends in microbiology. 2004;12(9):417-423.
  6. Zhou H, Wang T, Li Q, Li D. Prevention of Keshan Disease by Selenium Supplementation: a Systematic Review and Meta-analysis. Biol Trace Elem Res. 2018;186(1):98-105.
  7. Mehl S, Sun Q, Görlich CL, et al. Cross-sectional analysis of trace element status in thyroid disease. Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS). 2020;58:126430.
  8. Braunstein M, Kusmenkov T, Zuck C, et al. Selenium and Selenoprotein P Deficiency Correlates With Complications and Adverse Outcome After Major Trauma. Shock (Augusta, Ga). 2020;53(1):63-70.
  9. Zhang J, Taylor EW, Bennett K, Saad R, Rayman MP. Association between regional selenium status and reported outcome of COVID-19 cases in China. Am J Clin Nutr. 2020;111(6):1297-1299.
  10. Moghaddam A, Heller RA, Sun Q, et al. Selenium Deficiency Is Associated with Mortality Risk from COVID-19. Nutrients. 2020;12(7).