Document Type : Original Article

Authors

1 Department of Surgery, School of Medicine, Emdad Trauma Hospital, Sabzevar University of Medical Sciences, Sabzevar, Iran

2 Department of Internal Medicine, School of Medicine, Vasei Hospital, Sabzevar University of Medical Sciences, Sabzevar, Iran

3 Department of Occupational Medicine, Division of Sleep Medicine, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Some studies indicate that selenium is essential in the host’s response to viral infections. This study aimed to investigate the effect of selenium administration on clinical outcomes in hospitalized patients with COVID-19.
Methods: This clinical trial was conducted in Sabzevar in 2020–2021 (registration code: IRCT20160706028815N5) on hospitalized patients with COVID-19. Demographic data, clinical symptoms, and CT scan findings were recorded. The participants were randomly divided into two groups. The control group received standard care based on the latest national treatment protocols for COVID-19. The intervention group received selenium in addition to routine treatment. Clinical outcomes were compared between the two groups using SPSS statistics software. A significance level of 0.05 was considered.
Results: Fifty-four patients were randomly assigned to the intervention (n = 29) and control (n = 25) groups. Twenty-nine men (53.7%) and 25 women (46.3%) were included in the study. The mean and SD of age and body mass index of participants were 58.3 ± 16.8 and 25.8 ± 3.3, respectively. The groups were similar in terms of gender, addiction, smoking, commodities, symptoms, amount of pulmonary parenchyma involvement in the lung CT scan, age, and body mass index. The duration of admission was significantly shorter in the intervention group (p = 0.03). There was no significant difference in terms of ICU admission, mechanical ventilation, and 30- and 90-day mortality rates.
Conclusion: The present study showed that the administration of selenium can reduce the duration of the disease. Other clinical outcomes did not show significant differences between the two groups.
 

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  1. Li H, Liu SM, Yu XH, Tang SL, Tang CK. Coronavirus disease 2019 (COVID-19): current status and future perspectives. Int J Antimicrob Agents. 2020;55(5):105951. doi: 10.1016/j. ijantimicag.2020.105951
  2. Schultze JL, Aschenbrenner AC. COVID-19 and the human innate immune system. Cell. 2021;184(7):1671-92. doi: 10.1016/j.cell.2021.02.029
  3. Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: a review. Clin Immunol. 2020;215:108427. doi: 10.1016/j.clim.2020.108427
  1. AbdAllah M, Ez Elarab H, Raslan E, Saber L, Daoud E, Saber M. Role of micronutrients in the management of coronavirus disease 2019. New Microbes New Infect. 2020;38:100782. doi: 10.1016/j.nmni.2020.100782
  2. Liu Q, Zhao X, Ma J, Mu Y, Wang Y, Yang S, et al. Selenium (Se) plays a key role in the biological effects of some viruses: implications for COVID-19. Environ Res. 2021;196:110984. doi: 10.1016/j.envres.2021.110984
  3. Guillin OM, Vindry C, Ohlmann T, Chavatte L. Selenium, selenoproteins and viral infection. Nutrients. 2019;11(9):2101. doi: 10.3390/nu11092101
  4. Kuwano K, Kawashima T, Arai S. Antiviral effect of TNF-alpha and IFN-gamma secreted from a CD8 + influenza virus-specific CTL clone. Viral Immunol. 1993;6(1):1-11. doi: 10.1089/vim.1993.6.1
  5. Loscalzo J. Keshan disease, selenium deficiency, and the selenoproteome. N Engl J Med. 2014;370(18):1756-60. doi: 10.1056/NEJMcibr1402199
  6. Steinbrenner H, Al-Quraishy S, Dkhil MA, Wunderlich F, Sies H. Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 2015;6(1):73-82. doi: 10.3945/ an.114.007575
  7. Yu L, Sun L, Nan Y, Zhu LY. Protection from H1N1 influenza virus infections in mice by supplementation with selenium: a comparison with selenium-deficient mice. Biol Trace Elem Res. 2011;141(1-3):254-61. doi: 10.1007/s12011-010-8726-x
  8. Nelson HK, Shi Q, Van Dael P, Schiffrin EJ, Blum S, Barclay D, et al. Host nutritional selenium status as a driving force for influenza virus mutations. FASEB J. 2001;15(10):1727-38.
  9. Kieliszek M, Lipinski B. Selenium supplementation in the prevention of coronavirus infections (COVID-19). Med Hypotheses. 2020;143:109878. doi: 10.1016/j. mehy.2020.109878
  10. Bermano G, Méplan C, Mercer DK, Hesketh JE. Selenium and viral infection: are there lessons for COVID-19? Br J Nutr. 2021;125(6):618-27. doi: 10.1017/s0007114520003128
  11. Beck MA, Shi Q, Morris VC, Levander OA. Rapid genomic evolution of a non-virulent coxsackievirus B3 in selenium-deficient mice results in selection of identical virulent isolates. Nat Med. 1995;1(5):433-6. doi: 10.1038/nm0595-433
  12. Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, Baden L, Cheng VC, et al. Infectious diseases society of America guidelines on the treatment and management of patients with COVID-19. Clin Infect Dis. 2024;78(7):e83-102. doi: 10.1093/cid/ciaa478
  13. Alshammari MK, Fatima W, Alraya RA, Khuzaim Alzahrani A, Kamal M, Alshammari RS, et al. Selenium and COVID-19: a spotlight on the clinical trials, inventive compositions, and patent literature. J Infect Public Health. 2022;15(11):1225-33. doi: 10.1016/j.jiph.2022.09.011
  14. Zhang HY, Zhang AR, Lu QB, Zhang XA, Zhang ZJ, Guan XG, et al. Association between fatality rate of COVID-19 and selenium deficiency in China. BMC Infect Dis. 2021;21(1):452. doi: 10.1186/s12879-021-06167-8
  15. Razeghi Jahromi S, Moradi Tabriz H, Togha M, Ariyanfar S, Ghorbani Z, Naeeni S, et al. The correlation between serum selenium, zinc, and COVID-19 severity: an observational study. BMC Infect Dis. 2021;21(1):899. doi: 10.1186/s12879- 021-06617-3
  16. Sobczyk MK, Gaunt TR. The effect of circulating zinc, selenium, copper and vitamin K1 on COVID-19 outcomes: a Mendelian randomization study. Nutrients. 2022;14(2):233. doi: 10.3390/nu14020233
  17. Balboni E, Zagnoli F, Filippini T, Fairweather-Tait SJ, Vinceti M. Zinc and selenium supplementation in COVID-19 prevention and treatment: a systematic review of the experimental studies. J Trace Elem Med Biol. 2022;71:126956. doi: 10.1016/j. jtemb.2022.126956
  18. Filippini T, Fairweather-Tait S, Vinceti M. Selenium and immune function: a systematic review and meta-analysis of experimental human studies. Am J Clin Nutr. 2023;117(1):93- 110. doi: 10.1016/j.ajcnut.2022.11.007
  19. Shakoor H, Feehan J, Al Dhaheri AS, Ali HI, Platat C, Ismail LC, et al. Immune-boosting role of vitamins D, C, E, zinc, selenium and omega-3 fatty acids: could they help against COVID-19? Maturitas. 2021;143:1-9. doi: 10.1016/j. maturitas.2020.08.003
  20. Alexander J, Tinkov A, Strand TA, Alehagen U, Skalny A, Aaseth J. Early nutritional interventions with zinc, selenium and vitamin D for raising anti-viral resistance against progressive COVID-19. Nutrients. 2020;12(8):2358. doi: 10.3390/nu12082358
  21. Golin A, Tinkov AA, Aschner M, Farina M, da Rocha JB. Relationship between selenium status, selenoproteins and COVID-19 and other inflammatory diseases: a critical review. J Trace Elem Med Biol. 2023;75:127099. doi: 10.1016/j. jtemb.2022.127099
  22. Fakhrolmobasheri M, Mazaheri-Tehrani S, Kieliszek M, Zeinalian M, Abbasi M, Karimi F, et al. COVID-19 and selenium deficiency: a systematic review. Biol Trace Elem Res. 2022;200(9):3945-56. doi: 10.1007/s12011-021-02997-4
  23. Younesian O, Khodabakhshi B, Abdolahi N, Norouzi A, Behnampour N, Hosseinzadeh S, et al. Decreased serum selenium levels of COVID-19 patients in comparison with healthy individuals. Biol Trace Elem Res. 2022;200(4):1562-7. doi: 10.1007/s12011-021-02797-w
  24. Rayman MP, Taylor EW, Zhang J. The relevance of selenium to viral disease with special reference to SARS-CoV-2 and COVID-19. Proc Nutr Soc. 2023;82(1):1-12. doi: 10.1017/ s0029665122002646