Selenium Plays A Key Role In The Host During SARS-Cov-2 Infections, Assisting In Redox Homeostasis, Antioxidant Defense, And Minimizing Oxidative Stress

COVID-19 Supplements: A new study by researchers from Florida International University, Miami-USA has found that Selenium plays an important role in the human host during viral infections including those by the SARS-Cov-2 coronavirus, assisting in redox homeostasis, antioxidant defense, and minimizing oxidative stress.

 
Pathogenic infections especially viral infections have afflicted human health and despite great advancements in scientific knowledge and technologies, continue to affect our society today.

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The ongoing COVID-19 pandemic has put a spotlight on the need to review the evidence on the impact of nutritional strategies to maintain a healthy immune system, particularly in instances where there are limited therapeutic treatments.
 
Selenium, an essential trace element in humans, has a long history of lowering the occurrence and severity of viral infections. Much of the benefits derived from selenium are due to its incorporation into selenocysteine, an important component of proteins known as selenoproteins. Viral infections are associated with an increase in reactive oxygen species and may result in oxidative stress.
 
Studies suggest that selenium deficiency alters immune response and viral infection by increasing oxidative stress and the rate of mutations in the viral genome, leading to an increase in pathogenicity and damage to the host. This review examines viral infections, including the novel SARS-CoV-2, in the context of selenium, in order to inform potential nutritional strategies to maintain a healthy immune system.
 
The study findings were published in the peer reviewed International Journal of Molecular Sciences. https://www.mdpi.com/1422-0067/23/1/280
 
In April 2020, Thailand Medical News had also covered a study in which it was shown that dietary selenium could also influence the outcome of the COVID-1 disease. https://www.thailandmedical.news/news/covid-19-supplements-study-shows-dietary-selenium-influences-outcome-of-covid-19-disease
 
In August 2020, scientists from the University of Chicago had also published study involving using an existing organoselenium drug to treat COVID-19.
https://www.thailandmedical.news/news/breaking-covid-19-drugs-university-of-chicago-study-identifies-ebselen,-a-preexisting-organoselenium-drug-as-a-potential-candidate-for-covid-19-treatm
 
Typically, selenoproteins have the 21st amino acid, selenoc ysteine incorporated into their polypeptide chain. This is the primary mechanism by which selenium can help biological functions. There are at least 25 genes encoding for selenoproteins in humans, some of which are essential in development.
 
Selenoproteins are also known to play important roles in disease pathogenesis. Glutathione Peroxidase (GPX 1-4), for examples, is heavily involved in antioxidation, while Thioredoxin Reductase (TXNRD 1–3), methionine sulfoxide reductase B (MSRB)1, selenoproteins (SELENO) H, M, and W are important for redox regulation. Iodothyronine deiodinase (DIO) 1–3 is used in thyroid hormone metabolism, and SELENOP for selenium transport and storage.
 
The COVID-19 Supplements study team from the Florida International University have been reviewing research on the role that selenium could play in protecting individuals against coronavirus disease 2019 (COVID-19) for a while now.
 
The mineral selenium may act upon the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus by restoring GPX and TXNRD, which would reduce oxidative stress, reduce viral-induced cell apoptosis, protect endothelial cells and reduce blood platelet aggregation.
 
The typically heightened level of oxidative stress and inflammation typically seen in patients with severe COVID-19 are implicated in the pathogenesis of pulmonary disease. Glutathione or GSH is known to protect the epithelial barrier within the lungs.
 
It has been found that much of the inflammation in severe COVID-19 occurs when SARS-CoV-2 attempts to infect endothelial cells, which rapidly die and spread cell debris widely, triggering inflammation signals. Improvement of GSH levels could protect against this.
 
In this study involving the observation of the effect of supplementing sodium selenite levels in patients with ARDS - often seen in severe COVID-19 cases, it was found that this reduced inflammation, improved respiratory mechanics and restored the antioxidant capability of the lungs. https://www.tandfonline.com/doi/abs/10.1080/08820139.2018.1496098
 
Study findings also showed that it was also possible that selenium status could affect the function of B and T cells in COVID-19 patients, as severe COVID-19 patients often show lower levels of lymphocytes, CD4+, CD8+, B, and NK cells compared to individuals with a milder form of the disease. https://academic.oup.com/jid/article/221/11/1762/5813618?login=true
 
https://www.liebertpub.com/doi/abs/10.1089/ars.2011.4145
 
https://academic.oup.com/jn/article/140/6/1155/4600362?login=true
 
However, unfortunately, there is little concrete data on the relationship between selenium and COVID-19.

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Interestingly, China naturally has a wide range of selenium levels in soil, and a similar range of levels in the population. It has been reported that there is a linear association between COVID-19 cure rates and selenium levels in hair, with higher selenium levels corresponding to a significant increase in cure rates. https://academic.oup.com/ajcn/article/111/6/1297/5826147?login=true
 
Importantly a similar association can be seen with fatality risk. This could be seen most in Wuhan, Suizhou and Xiaogan.
 
A past study in Wuhan revealed that severity of COVID-19 was associated with higher selenium levels in urine, possibly due to liver abnormalities resulting from the disease. https://academic.oup.com/ajcn/article/111/6/1297/5826147?login=true
 
Interestingly a South Korean study took a narrower focus on selenium and COVID-19, specifically investigating the levels of selenium in hospitalized COVID-19 patients. While they did discover that 42% of COVID-19 patients were selenium deficient, and that selenium levels decreased as severity of the disease increased, they also showed multiple other nutritional deficiencies. https://www.sciencedirect.com/science/article/pii/S1201971220306470
 
Other similar studies in India, Iran, and Russia all showed lower levels of selenium in plasma in COVID-19 patients compared to healthy patients.
https://pubmed.ncbi.nlm.nih.gov/33321395/
 
https://link.springer.com/article/10.1007/s12011-021-02797-w
 
https://www.mdpi.com/2218-1989/11/4/244
 
Another study investigating selenium levels in serum in Germany found that patients who had survived COVID-19 were less likely to have a selenium deficiency than those who died. https://pubmed.ncbi.nlm.nih.gov/32708526/
 
Also a similar study in Belgium examining individuals with COVID-19 pneumonia found both lower GSH and GPX compared with references, as well as higher markers of oxidative stress and lower antioxidant status. https://www.mdpi.com/2076-3921/10/2/257
 
At present, there is one study examining the efficiency of treatment with selenious acid infusion for moderately, severely and critically ill COVID-19 patients, and no clinical trials ongoing. Sodium selenite is available easily, mostly non-toxic in the short term, and can cross the blood-brain barrier. It also has the potential effect to oxidize thiol groups, which could prevent the virus from entering the cells. https://clinicaltrials.gov/ct2/show/NCT04869579
 
The study team of this review conclude that selenium is important in protecting the host against viruses such as SARS-CoV-2, and when individuals are deficient in selenium, important functions such as redox homeostasis, antioxidant stress, and reduction of oxidative stress are significantly impaired. The reduction in selenium levels in serum and plasma from severe COVID-19 patients likely indicates a lack of functional selenoproteins. This information could be very valuable to drug development manufacturers and COVID-19 researchers and could help develop selenium-based treatments.
 
Sodium selenite has been proposed as a preventive measure and adjuvant therapy for COVID-19 based on its potential ability to restore GPX and TXNRD activity, reduce viral-induced cell apoptosis, protect endothelial cells, and reduce blood platelet aggregation. Se nanoparticles should also be considered as a mechanism to deliver Se to target organs such as the lungs and deliver Se without risks of toxicity. Data available from other viral infections in conjunction with the current COVID-19 data provide sufficient justification for future and timely Selenium intervention studies.

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