Low Zinc Levels at Admission Associates with Poor Clinical Outcomes in SARS-CoV-2 Infection.

BACKGROUND: Zinc is an essential micronutrient that impacts host-pathogen interplay at infection. Zinc balances immune responses, and also has a proven direct antiviral action against some viruses. Importantly, zinc deficiency (ZD) is a common condition in elderly and individuals with chronic diseases, two groups with an increased risk for severe severe coronavirus disease 2019 (COVID-19) outcomes. We hypothesize that serum zinc content (SZC) influences COVID-19 disease progression, and thus might represent a useful biomarker. METHODS: We ran an observational cohort study with 249 COVID-19 patients admitted in Hospital del Mar. We have studied COVID-19 severity and progression attending to SZC at admission. In parallel, we have studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) replication in the Vero E6 cell line modifying zinc concentrations. FINDINGS: Our study demonstrates a correlation between serum zinc levels and COVID-19 outcome. Serum zinc levels lower than 50 µg/dL at admission correlated with worse clinical presentation, longer time to reach stability, and higher mortality. Our in vitro results indicate that low zinc levels favor viral expansion in SARS-CoV-2 infected cells. INTERPRETATION: Low SZC is a risk factor that determines COVID-19 outcome. We encourage performing randomized clinical trials to study zinc supplementation as potential prophylaxis and treatment with people at risk of zinc deficiency.

Feohifomicosis subcutánea causada por Phaeoacremonium parasiticum / Subcutaneous phaeohyphomycosis caused by Phaeoacremonium parasiticum

Antecedentes. De la literatura publicada se desprende que las infecciones producidas por hongos dematiáceos afectan con mayor frecuencia a pacientes inmunodeprimidos, y que estas infecciones se manifiestan desde formas subcutáneas hasta formas diseminadas que pueden comprometer la vida del paciente. En muchos casos la infección se relaciona con la inoculación del microorganismo por distintos mecanismos traumáticos, lo que determina que la evolución de la infección muchas veces sea lenta. Caso clínico. Se describen dos casos clínicos de feohifomicosis causados por Phaeoacremonium parasiticum, con un paciente oncológico con lesiones subcutáneas que afectaban a la mano y antebrazo izquierdos, y otro paciente que presentaba abscesos subcutáneos en la pierna izquierda. Conclusiones. Estos casos confirman la presencia de este hongo en España y demuestran la complejidad en el tratamiento. Fue necesario el uso combinado de anfotericina B (complejo lipídico) y de posaconazol, junto con varias resecciones quirúrgicas, para poder conseguir superar la infección que presentaba uno de los pacientes (AU)

Background. From the available literature, it is demonstrated that dematiaceous fungal infections mostly affect immunosuppressed patients. These infections can occur in different forms, from subcutaneous infection to disseminated forms that may compromise the life of the patient. In many cases the infection is related to the inoculation of the microorganism by diverse traumatic mechanisms, which determines the course of the infection to be slower in some cases. Case report. We describe two cases of phaeohyphomycosis caused by Phaeoacremonium parasiticum: A cancer patient with subcutaneous lesions affecting the left hand and forearm, and a patient who presented with subcutaneous abscesses in the left leg. Conclusions. These cases confirm the presence of this type of fungus in Spain. In the second case a combination of amphotericin B lipid complex and posaconazole, together with several surgical resections, were necessary in order to overcome the infection (AU)

[Subcutaneous phaeohyphomycosis caused by Phaeoacremonium parasiticum]. / Feohifomicosis subcutánea causada por Phaeoacremonium parasiticum.

BACKGROUND: From the available literature, it is demonstrated that dematiaceous fungal infections mostly affect immunosuppressed patients. These infections can occur in different forms, from subcutaneous infection to disseminated forms that may compromise the life of the patient. In many cases the infection is related to the inoculation of the microorganism by diverse traumatic mechanisms, which determines the course of the infection to be slower in some cases. CASE REPORT: We describe two cases of phaeohyphomycosis caused by Phaeoacremonium parasiticum: A cancer patient with subcutaneous lesions affecting the left hand and forearm, and a patient who presented with subcutaneous abscesses in the left leg. CONCLUSIONS: These cases confirm the presence of this type of fungus in Spain. In the second case a combination of amphotericin B lipid complex and posaconazole, together with several surgical resections, were necessary in order to overcome the infection.