Clinical Nutrition: COVID-19患者早期的低锌血症与严重 COVID-19症状的风险增加有关

2022-06-20 xuyihan MedSci原创

ARDS一般指急性呼吸窘迫综合征。 急性呼吸窘迫综合征(ARDS)是由肺内原因和/或肺外原因引起的,以顽固性低氧血症为显著特征的临床综合征,因高病死率而倍受关注。

目前,对于由严重急性呼吸综合征冠状病毒2 (SARS-CoV-2) 引起的2019 年严重冠状病毒病(COVID-19) 的营养不良易感性仍不清楚。充足的锌状态可能是一个关键因素,因为锌缺乏与更高的感染易感性有关。目前尚未进行任何研究来探索在非住院 COVID-19 患者的早期阶段锌的血液水平。本项研究旨在评估COVID-19早期低锌血症的患病率、其与 COVID-19 筛查中心入院受试者严重程度的临床或生物学标准的相关性,以及其对 10 天内因呼吸系统并发症住院的预后价值。

为了完成本项研究,研究人员对于入住 COVID-19筛查中心的152名COVID-19患者和88名非COVID-19患者,进行了 COVID-19 国家早期预警评分(NEWS)和实验室分析,以确定重症 COVID-19 的风险。多变量逻辑回归分析评估低锌血症是否是 10 天内呼吸系统并发症住院的独立预测因素。次要观察标准是 NEWS 评分(≥7)、与严重 COVID-19 相关的合并症和生物标志物。

 

研究结果显示:与非COVID-19患者相比,COVID-19患者的低锌血症更常见(27.6% VS 11.4%;p= 0.003)。老年患者(≥65 岁)和医疗辅助疗养院居民发生低锌血症的风险较高(p<0.01)。低锌血症与较差的 NEWS 评分 (p<0.01) 和淋巴细胞减少(p<0.001) 相关。低锌血症与 10 天内因呼吸系统并发症住院独立相关(OR = 10.9,95% CI=2.3-51.6,p=0.002)。

本项研究证实在COVID-19的早期,低锌血症的患病率超过 20%。低锌血症是10天内呼吸系统并发症住院的独立预测因素。这可能表明早期发现和治疗锌缺乏症在COVID-19营养管理中的重要性,尤其是在老年人中这样的现象更明显。

原始出处:

JulienFromonot. Et al. Hypozincemia in the early stage of COVID-19 is associated with an increased risk of severe COVID-19. Clinical Nutrition.2022.

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