Association of plasma zinc levels with anti-SARS-CoV-2 IgG and IgA seropositivity in the general population: A case-control study

Antoine Equey; Mette M Berger; Semira Gonseth-Nusslé; Marc Augsburger; Serge Rezzi; Andrew C C Hodgson; Sandrine Estoppey; Giuseppe Pantaleo; Céline Pellaton; Maïwenn Perrais; Sébastien Lenglet; Valentin Rousson; Valérie D'Acremont; Murielle Bochud

doi:10.1016/j.clnu.2023.04.007

Association of plasma zinc levels with anti-SARS-CoV-2 IgG and IgA seropositivity in the general population: A case-control study

Clin Nutr. 2023 Jun;42(6):972-986. doi: 10.1016/j.clnu.2023.04.007. Epub 2023 Apr 18.

Affiliations

¹ Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de La Corniche 10, 1010, Lausanne, Switzerland.
² Service of Adult Intensive Care, Lausanne University Hospital (CHUV), Lausanne, Switzerland. Electronic address: mette.berger@unil.ch.
³ Forensic Toxicology and Chemistry Unit, University Centre of Legal Medicine, Lausanne-Geneva, Lausanne University Hospital and University of Lausanne - Geneva University Hospital and University of Geneva, Lausanne-Geneva, Switzerland.
⁴ Swiss Nutrition and Health Foundation, Épalinges, Switzerland.
⁵ Service of Immunology and Allergy, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Abstract

Introduction: Some micronutrients have key roles in immune defence, including mucosal defence mechanisms and immunoglobulin production. Altered micronutrient status has been linked with COVID-19 infection and disease severity. We assessed the associations of selected circulating micronutrients with anti-SARS-CoV-2 IgG and IgA seropositivity in the Swiss community using early pandemic data.

Methods: Case-control study comparing the first PCR-confirmed COVID-19 symptomatic cases in the Vaud Canton (May to June 2020, n = 199) and controls (random population sample, n = 447), seronegative for IgG and IgA. The replication analysis included seropositive (n = 134) and seronegative (n = 152) close contacts from confirmed COVID-19 cases. Anti-SARS-CoV-2 IgG and IgA levels against the native trimeric spike protein were measured using the Luminex immunoassay. We measured plasma Zn, Se and Cu concentrations by ICP-MS, and 25-hydroxy-vitamin D₃ (25(OH)D₃) with LC-MS/MS and explored associations using multiple logistic regression.

Results: The 932 participants (54.1% women) were aged 48.6 ± 20.2 years (±SD), BMI 25.0 ± 4.7 kg/m² with median C-Reactive Protein 1 mg/l. In logistic regressions, log₂(Zn) plasma levels were negatively associated with IgG seropositivity (OR [95% CI]: 0.196 [0.0831; 0.465], P < 0.001; replication analyses: 0.294 [0.0893; 0.968], P < 0.05). Results were similar for IgA. We found no association of Cu, Se, and 25(OH)D₃ with anti-SARS-CoV-2 IgG or IgA seropositivity.

Conclusion: Low plasma Zn levels were associated with higher anti-SARS-CoV-2 IgG and IgA seropositivity in a Swiss population when the initial viral variant was circulating, and no vaccination available. These results suggest that adequate Zn status may play an important role in protecting the general population against SARS-CoV-2 infection.

Registry: CORONA IMMUNITAS:: ISRCTN18181860.

Keywords: Copper; Deficiency; Immunity; Micronutrients; Public health; Vitamin D.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Viral
COVID-19* / epidemiology
Case-Control Studies
Chromatography, Liquid
Female
Humans
Immunoglobulin A
Immunoglobulin G
Male
Micronutrients
SARS-CoV-2
Tandem Mass Spectrometry
Zinc

Substances

Antibodies, Viral
Immunoglobulin G
Micronutrients
Zinc
Immunoglobulin A

Associated data

ISRCTN/ISRCTN18181860