Role of Metals on SARS-CoV-2 Infection: a Review of Recent Epidemiological Studies

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Role of Metals on SARS-CoV-2 Infection: a Review of Recent Epidemiological Studies

Khan et al., 2023 | Curr Environ Health Rep | Systematic Review

Citation

Khan Khalid M, Zimpfer Mariah J, ... Parvez Faruque. Role of Metals on SARS-CoV-2 Infection: a Review of Recent Epidemiological Studies. Curr Environ Health Rep. 2023-Dec;10(4):353-368. doi:10.1007/s40572-023-00409-4

Abstract

PURPOSE OF REVIEW: Metals and metalloids are known for their nutritional as well as toxic effects in humans. In the context of the SARS-CoV-2 pandemic, understanding the role of metals on COVID-19 infection is becoming important due to their role in infectious diseases. During the past 2 years, a significant number of studies have examined the impact of metals and metalloids on COVID-19 morbidity and mortality. We conducted a systematic review of peer-reviewed manuscripts on the association of metals and metalloids with SARS-CoV-2 infection and COVID-19 severity published since the onset of the pandemic. RECENT FINDINGS: We searched for epidemiological studies available through the PubMed database published from January 2020 to December 2022. Of 92 studies identified, 20 met our inclusion criteria. These articles investigated the association of zinc (Zn), iron (Fe), selenium (Se), manganese (Mn), cadmium (Cd), arsenic (As), copper (Cu), magnesium (Mg), chromium (Cr), and/or lead (Pb) levels on SARS-CoV-2 infection and/or COVID-19 severity. Of the ten metals and metalloids of interest that reported either positive, negative, or no associations, Zn yielded the highest number of articles (n = 13), followed by epidemiological studies on Se (n = 7) and Fe (n = 5). Elevated serum Zn and Se were associated with reduced COVID-19 severity and mortality. Similarly, higher levels of serum Fe were associated with lower levels of cellular damage and symptoms of SARS-CoV-2 infection and with faster recovery from COVID-19. On the other hand, higher serum and urinary Cu and serum Mg levels were associated with higher COVID-19 severity and mortality. Along with the positive or negative effects, some studies reported no impact of metals on SARS-CoV-2 infection. This systematic review suggests that metals, particularly Zn, Fe, and Se, may help reduce the severity of COVID-19, while Cu and Mg may aggravate it. Our review suggests that future pandemic mitigation strategies may evaluate the role of Zn, Se, and Fe as potential therapeutic interventions.

Key Findings

We searched for epidemiological studies available through the PubMed database published from January 2020 to December 2022. Of 92 studies identified, 20 met our inclusion criteria. These articles investigated the association of zinc (Zn), iron (Fe), selenium (Se), manganese (Mn), cadmium (Cd), arsenic (As), copper (Cu), magnesium (Mg), chromium (Cr), and/or lead (Pb) levels on SARS-CoV-2 infection and/or COVID-19 severity. Of the ten metals and metalloids of interest that reported either positiv

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 13
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • COVID-19
  • SARS-CoV-2
  • Metals
  • Zinc
  • Cadmium
  • Selenium
  • Metalloids
  • Epidemiologic Studies
  • Metals, Heavy

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article, Research Support, N.I.H., Extramural
  • Vertical: selenium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09