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- Association of trace element status in COVID-19 patients with disease severityPublication . Bego, Tamer; Meseldžić, Neven; Prnjavorac, Besim; Prnjavorac, Lejla; Marjanović, Damir; Azevedo, Rui; Pinto, Edgar; Duro, Mary; Couto, Cristina; Almeida, AgostinhoCaused by the new SARS-CoV-2 coronavirus, COVID-19 (coronavirus disease 2019) evolves with clinical symptoms that vary widely in severity, from mild symptoms to critical conditions, which can even result in the patient’s death. A critical aspect related to an individual response to SARS-CoV-2 infection is the competence of the immune system, and it is well known that several trace elements are essential for an adequate immune response and have anti-inflammatory and antioxidant properties that are of particular importance in fighting infection. Thus, it is widely accepted that adequate trace element status can reduce the risk of SARS-CoV-2 infection and disease severity. In this study, we evaluated the serum levels of Cu, Zn, Se, Fe, I and Mg in pa- tients (n = 210) with clinical conditions of different severity (“mild”, “moderate”, “severe” and “exitus letalis”, i. e., patients who eventually died). The results showed significant differences between the four groups for Cu, Zn, Se and Fe, in particular a significant trend of Zn and Se serum levels to be decreased and Cu to be increased with the severity of symptoms. For Mg and I, no differences were observed, but I levels were shown to be increased in all groups.
- Serum iodine and bromine in chronic hemodialysis patients—an observational study in a cohort of portuguese patientsPublication . Novakova, Gergana; Bonev, Presian; Duro, Mary; Azevedo, Rui; Couto, Cristina; Pinto, Edgar; Almeida, AgostinhoPatients on chronic hemodialysis therapy are at high risk of disturbances in trace element status due to both the underlying disease and the hemodialysis process itself. Data on iodine and bromine levels in these patients are scarce. Using an ICP-MS analytical procedure, serum iodine and bromine levels were determined in a cohort (n = 57) of end-stage renal disease patients on chronic hemodialysis. The results were compared with those of a control group (n = 59). Results: Hemodialysis patients presented serum iodine levels within the normal range, slightly lower than in controls, but without reaching a statistically significant difference (67.6 ± 17.1 µg/L vs. 72.2 ± 14.8 µg/L; p = 0.1252). In contrast, serum bromine levels were much lower in patients (1086 ± 244 µg/L vs. 4137 ± 770 µg/L; p < 0.0001), at values only about 26% of the values observed in controls. Hemodialysis patients had normal serum iodine levels, but highly decreased serum bromine levels. The clinical significance of this finding requires further investigation, but it may be associated with sleep disturbances and fatigue that affect hemodialysis patients.
- Low serum bromine levels in chronic hemodialysis patients - is there any clinical impact?Publication . Duro, Mary; Novakova, Gergana; Bonev, Presian; Azevedo, Rui; Couto, Cristina; Pinto, Edgar; Almeida, AgostinhoPatients on chronic hemodialysis therapy are at high risk for disturbed trace element status due to both the underlying disease and the hemodialysis process itself. Data on serum bromine levels in these patients are scarce. Using an ICP-MS analytical procedure, serum bromine levels were determined in a cohort of end-stage renal disease patients on chronic hemodialysis (n=57; 68.9±14.0 years old; male/female ratio: 1.37). The results were compared with those of a control group (individuals without evidence of kidney disease according to standard clinical laboratory criteria who attended the same clinical laboratory for routine analyses: n=59; 57.4±17.9 years old; male/female ratio: 0.90). Hemodialysis patients had much lower serum bromine levels than controls: 1086±244 vs. 4137±770 µg/L; P<0.0001. Bromine (bromide in plasma) showed to be extensively removed from plasma due to the hemodialysis process. The actual impact of this bromine “deficiency” is unknown. Bromine has not generally been considered an “essential” element, however, evidence of possible essentiality has been growing. In particular, bromine has been linked to brain metabolism: it is used as a sedative to induce sleep, increases in animals during hibernation as well as in sleeping humans; and a bromine compound with REM sleep-inducing and anti-choline esterase activities (1-methylheptyl gammabromoacetoacetate) was identified in human cerebrospinal fluid. On the other hand, estimates suggest that 40-85% of hemodialysis patients have sleep disorders, mainly insomnia. Thus, the possibility has been raised that the bromine “deficiency” found in these patients may be associated with sleep the disorders that affect them. This is an interesting hypothesis that requires further clinical investigation.
- Trace Elements as Contaminants and NutrientsPublication . Couto, Cristina; Pinto, Edgar; Almeida, AgostinhoKnowledge about trace elements has evolved remarkably in recent decades, both in terms of their metabolism and their functions. Acting mainly as cofactors of enzymatic systems, several trace elements play an essential role in numerous physiological processes in the human organism, from cell metabolism to the immune response and gene expression, among others. On the other hand, it is also well known that excessive exposure to trace elements can be highly harmful and even fatal.