Hypozincemia and Long COVID symptoms in children

Authors

DOI:

https://doi.org/10.15574/SP.2025.5(149).1419

Keywords:

zinc, Zn, COVID-19, SARS-CoV-2, Long COVID, hypozincemia, post-COVID, chronic fatigue, children

Abstract

Zinc plays a crucial role in the functioning of the immune system, and its deficiency may influence the risk of infection and the severity of infectious diseases.

Aim - to assess the role of hypozincemia in the development of Long COVID and its symptoms in children.

Materials and methods. A prospective cohort study included 127 children with confirmed COVID-19. Serum zinc levels were measured during the acute phase of the disease, and the occurrence of Long COVID symptoms was monitored for 12 months.

Results. Zinc deficiency was detected in 25,2% of children. Long COVID symptoms were recorded in 42,5% of patients, but no statistically significant correlation was found between zinc levels and the development of Long COVID. The most common symptoms were fatigue (46,3%), neurological disorders (27,8%), gastrointestinal symptoms (14,8%), and cardiovascular manifestations (5,6%). Fatigue was observed 1,7 times more frequently, and neurological symptoms 2,2 times more frequently in children with zinc deficiency compared to those with normal zinc levels, but the differences were not statistically significant.

Conclusions. This study did not identify a significant impact of hypozincemia on the development of Long COVID and its symptoms in children. However, the findings highlight the need for further large-scale studies on the role of micronutrients in post-COVID recovery, the influence of nutritional status on post-COVID complications, and the potential benefits of zinc supplementation in COVID-19 patients.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Bioethics Committee of the mentioned institution. Informed consent was obtained from all participants.

The authors declare no conflict of interest.

References

Abdelmaksoud AA, Ghweil AA, Hassan MH et al. (2021). Olfactory disturbances as presenting manifestation among Egyptian patients with COVID-19: possible role of zinc. Biol Trace Elem Res. 199(11): 4101-4108. https://doi.org/10.1007/s12011-020-02546-5; PMid:33409924 PMCid:PMC7787876

Ali N, Fariha KA, Islam F et al. (2021). Assessment of the role of zinc in the prevention of COVID-19 infections and mortality: A retrospective study in the Asian and European population. J Med Virol. 93(7): 4326-4333. https://doi.org/10.1002/jmv.26932; PMid:33710631 PMCid:PMC8250922

Anuk AT, Polat N, Akdas S et al. (2021). The Relation Between Trace Element Status (Zinc, Copper, Magnesium) and Clinical Outcomes in COVID-19 Infection During Pregnancy. Biol Trace Elem Res. 199(10): 3608-3617. https://doi.org/10.21203/rs.3.rs-88054/v1

Boyarchuk O, Perestiuk V, Kosovska T et al. (2024). Coagulation profile in hospitalized children with COVID-19: pediatric age dependency and its impact on long COVID development. Front Immunol. 15: 1363410. https://doi.org/10.3389/fimmu.2024.1363410; PMid:38510249 PMCid:PMC10950941

Boyarchuk O, Predyk L, Yuryk I. (2021). COVID-19 in patients with juvenile idiopathic arthritis: frequency and severity. Reumatologia. 59(3): 197-199. https://doi.org/10.5114/reum.2021.107590; PMid:34538947 PMCid:PMC8436806

Boyarchuk O, Volianska L. (2023). Autoimmunity and long COVID in children. Reumatologia. 61(6): 492-501. https://doi.org/10.5114/reum/176464; PMid:38322108 PMCid:PMC10839920

Calder PC. (2025). Nutrition and immunity: lessons from coronavirus disease-2019. Proc Nutr Soc. 84(1): 8-23. https://doi.org/10.1017/S0029665123004792; PMid:37886807

Chen KY, Lin CK, Chen NH. (2023). Effects of vitamin D and zinc deficiency in acute and long COVID syndrome. J Trace Elem Med Biol. 80: 127278. https://doi.org/10.1016/j.jtemb.2023.127278; PMid:37566973

Doğan A, Dumanoğlu Doğan İ, Uyanık M et al. (2022). The Clinical Significance of Vitamin D and Zinc Levels with Respect to Immune Response in COVID-19 Positive Children. J Trop Pediatr. 68(5): fmac072. https://doi.org/10.1093/tropej/fmac072; PMid:35994727 PMCid:PMC9452162

Hung LW, Liu MY, Yu T et al. (2024). Zinc Deficiency and Post-acute Outcomes in Patients With COVID-19: A Six-Month Retrospective Cohort Analysis of 3,726 Patients. Cureus. 16(10): e71609. https://doi.org/10.7759/cureus.71609

Jothimani D, Kailasam E, Danielraj S et al. (2020). COVID-19: Poor outcomes in patients with zinc deficiency. Int J Infect Dis. 100: 343-349. https://doi.org/10.1016/j.ijid.2020.09.014; PMid:32920234 PMCid:PMC7482607

Karakaya Molla G, Ünal Uzun Ö, Koç N et al. (2021). Evaluation of nutritional status in pediatric patients diagnosed with Covid-19 infection. Clin Nutr ESPEN. 44: 424-428. https://doi.org/10.1016/j.clnesp.2021.04.022; PMid:34330500 PMCid:PMC8110330

Kinash M, Boyarchuk O, Dobrovolska L. (2021). Zinc: its impact on immune function in children. Pediatria Polska - Polish Journal of Paediatrics. 96(4): 263-269. https://doi.org/10.5114/polp.2021.112401

Matsuda Y, Tokumasu K, Otsuka Y et al. (2023). Symptomatic Characteristics of Hypozincemia Detected in Long COVID Patients. J Clin Med. 12(5): 2062. https://doi.org/10.3390/jcm12052062; PMid:36902849 PMCid:PMC10004579

Noce A, Marrone G, Di Lauro M et al. (2024). Potential Anti-Inflammatory and Anti-Fatigue Effects of an Oral Food Supplement in Long COVID Patients. Pharmaceuticals (Basel). 17(4): 463. https://doi.org/10.3390/ph17040463; PMid:38675423 PMCid:PMC11053797

Nowak G, Szewczyk B, Pilc A. (2005). Zinc and depression. An update. Pharmacol Rep. 57(6): 713-718.

Pak VM, Lee J. (2022). Examining the role of micronutrients on improving long COVID sleep-related symptoms. J Clin Nurs. 10.1111/jocn.16326. Epub ahead of print. https://doi.org/10.1111/jocn.16326; PMid:36539931 PMCid:PMC9880629

Perestiuk V, Kosovska T, Dyvoniak O et al. (2025). Vitamin D status in children with COVID-19: does it affect the development of long COVID and its symptoms? Front Pediatr. 13: 1507169. https://doi.org/10.3389/fped.2025.1507169; PMid:40046855 PMCid:PMC11881026

Perestiuk V, Kosovska T, Volianska L et al. (2025). Association of zinc deficiency and clinical symptoms, inflammatory markers, severity of COVID-19 in hospitalized children. Front. Nutr. 12: 1566505. https://doi.org/10.3389/fnut.2025.1566505; PMid:40201587 PMCid:PMC11975579

Pisano M, Hilas O. (2016). Zinc and taste disturbances in older adults: a review of the literature. Consult Pharm. 31(5): 267-270. https://doi.org/10.4140/TCP.n.2016.267; PMid:27178656

Prasad AS. (2001). Recognition of zinc-deficiency syndrome. Nutrition. 17(1): 67-69. https://doi.org/10.1016/S0899-9007(00)00469-X; PMid:11165897

Prasad AS. (2013). Discovery of human zinc deficiency: its impact on human health and disease. Adv Nutr. 4(2): 176-190. https://doi.org/10.3945/an.112.003210; PMid:23493534 PMCid:PMC3649098

Schloss JV. (2023). Nutritional deficiencies that may predispose to long COVID. Inflammopharmacology. 31(2): 573-583. https://doi.org/10.1007/s10787-023-01183-3; PMid:36920723 PMCid:PMC10015545

Wessels I, Rolles B, Rink L. (2020). The Potential Impact of Zinc Supplementation on COVID-19 Pathogenesis. Front Immunol. 11: 1712. https://doi.org/10.3389/fimmu.2020.01712; PMid:32754164 PMCid:PMC7365891

World Health Organization. (2023). Post COVID-19 Condition (Long COVID). World Health Organization. URL: https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition. (Accessed July 11, 2023).

World Health Organization. (2020). Clinical Management of COVID-19: Interim Guidance, 27 May 2020. URL: https://iris.who.int/handle/10665/332196. (Accessed May 27, 2020). https://doi.org/10.15557/PiMR.2020.0004

Zahra SA, Iddawela S, Pillai K et al. (2020). Can symptoms of anosmia and dysgeusia be diagnostic for COVID-19? Brain Behav. 10(11): e01839. https://doi.org/10.1002/brb3.1839; PMid:32935915 PMCid:PMC7667367

Published

2025-09-28

Issue

Section

Original articles