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Meta-Analysis
. 2021 May 10;13(5):1589.
doi: 10.3390/nu13051589.

Micronutrients Deficiency, Supplementation and Novel Coronavirus Infections-A Systematic Review and Meta-Analysis

Min Xian Wang  1   2 , Sylvia Xiao Wei Gwee  1   2 , Junxiong Pang  1   2
Affiliations
Meta-Analysis

Micronutrients Deficiency, Supplementation and Novel Coronavirus Infections-A Systematic Review and Meta-Analysis

Min Xian Wang et al. Nutrients. .

Abstract

Background: Micronutrients play roles in strengthening and maintaining immune function, but their supplementation and/or deficiency effects on respiratory tract infections are inconclusive. This review aims to systematically assess the associations between micronutrient supplementation or deficiency, with novel coronavirus incidence and disease severity.

Methods: Systematic literature searches conducted in five electronic databases identified 751 unique studies, of which 33 studies (five supplementation studies, one supplementation and deficiency study, and 27 deficiency studies) were eventually included in this review. Proportions of incidence and severity outcomes in each group, and adjusted summary statistics with their relevant 95% confidence intervaIs (CI) were extracted. Data from 19 studies were pooled in meta-analysis using the generic inverse variance method.

Findings: A total of 360,346 patients across 16 countries, with a mean age between 32 and 87.7 years, were involved across 33 studies. All studies were on COVID-19 infections. In individuals without micronutrient deficiency, there was a significant reduction on odds of COVID-19 incidence (pooled OR: 0.37, 95% CI: 0.18, 0.78), and ICU admissions or severe/critical disease onset when combined as a severity outcome (pooled OR: 0.26, 95% CI: 0.08, 0.89). Insignificant protective effects were observed on other outcome measures, namely mortality, ICU admission, progression to respiratory-related complications, severe/critical disease onset or requiring respiratory support and hospitalization rate.

Conclusion: The absence of micronutrient deficiency significantly reduced COVID-19 incidence and clinical deterioration in hospitalized patients. Usage of micronutrients as prophylaxis and complementary supplement in therapeutic management of COVID-19 patients may be a promising and cost-effective approach warranting in-depth investigation.

Keywords: COVID-19; MERS; SARS; micronutrients deficiency; micronutrients supplementation; novel coronavirus; prevention and treatment.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design, execution, interpretation, or writing of the study.

Figures

Figure 1
Figure 1
Flowchart of the screening and study selection process.
Figure 2
Figure 2
Pooled odds ratio on the incidence of COVID-19 episode when subjects are not deficient, compared to those deficient in any micronutrient singly.
Figure 3
Figure 3
Pooled odds ratio on mortality from COVID-19 episode, or during hospitalisation due to COVID-19 episode when hospitalized subjects are not deficient, compared to those deficient in any micronutrient singly.
Figure 4
Figure 4
Pooled odds ratio on ICU admission due to COVID-19 episode when hospitalized subjects are not deficient, compared to those deficient in any micronutrient singly.
Figure 5
Figure 5
Pooled odds ratio on progression to respiratory-related complications due to COVID-19 episode when hospitalized subjects are not deficient, compared to those deficient in any micronutrient singly.
Figure 6
Figure 6
Pooled odds ratio on clinical severity of COVID-19 patients (defined by clinical condition, or need for breathing support) hospitalized subjects are not deficient, compared to those deficient in any micronutrient singly.
Figure 7
Figure 7
Pooled odds ratio on clinical deterioration of COVID-19 patients (defined by severe/critical clinical condition or ICU admission) hospitalized subjects are not deficient, compared to those deficient in any micronutrient singly.
See this image and copyright information in PMC

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