Background

The dynamics of urinary trace elements in patients with COVID-19 still remains to be investigated.

Methods

A retrospective study was performed on a cohort of 138 confirmed COVID-19 patients for their urinary levels of essential and/or toxic metals including chromium, manganese, copper, arsenic, selenium, cadmium, mercury, thallium and lead according to the different disease severity (severe or non-severe) and outcome (recovered or deceased).

Results

Urinary concentrations of chromium, manganese, copper, selenium, cadmium, mercury and lead after creatinine adjustment were found to be higher in severe patients than the non-severe cases with COVID-19. And among the severe cases, these elements were also higher in the deceased group than the recovered group. When the weeks of the post-symptom onset were taken in account, the changes of these urinary elements were existed across the clinical course since the disease onset. These urinary elements were found to be mostly positively inter-correlated, and further positively correlated with other laboratory inflammatory parameters including serum cytokines (IL-1B, IL2R, IL6, IL8, IL10, TNFα), ferritin, and neutrophil count and white blood cell count. As a independently predictive factor, urinary creatinine-adjusted copper of ≥25.57 μg/g and ≥99.32 μg/g were associated with significantly increased risk of severe illness and fatal outcome in COVID-19, respectively.

Conclusions

These results suggest abnormities in urinary levels of the trace metals were tightly associated with the severe illness and fatal outcome of COVID-19.

中文翻译：

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COVID-19患者尿微量元素与疾病严重程度和预后的关系

背景

COVID-19患者尿微量元素的动态变化仍有待研究。

方法

根据不同疾病的严重程度，对138名确诊的COVID-19患者的尿液中必需和/或有毒金属（包括铬，锰，铜，砷，硒，镉，汞，th和铅）的尿液水平进行了一项回顾性研究（严重或不严重）和结果（恢复或死亡）。

结果

肌酐调节后，发现重症患者的尿中铬，锰，铜，硒，镉，汞和铅的浓度高于非严重程度的COVID-19。在严重的病例中，死者中的这些元素也高于康复者。考虑到症状发作后的几周，自疾病发作以来，这些尿液元素的变化在整个临床过程中都存在。发现这些尿液元素之间主要呈正相关，并与其他实验室炎症参数（包括血清细胞因子（IL-1B，IL2R，IL6，IL8，IL10，TNFα），铁蛋白，中性粒细胞计数和白细胞）呈正相关。计数。作为独立的预测因素，尿肌酐校正后的铜≥25.57μg/ g且≥99。

结论

这些结果表明，微量金属的尿水平异常与COVID-19的严重疾病和致命结果密切相关。