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Micronutrient deficiency during pregnancy is an important problem in developing countries [1]. During pregnancy micronutrient deficiency especially zinc in all cultures and socioeconomic levels is a common issue [2]. Zinc deficiency in this period is still an unsolved concern that may cause adverse effects on pregnancy outcomes [3]. Maternal zinc deficiency in this period may cause infant complications such as preterm birth, low birth weight, influence on passive or active immunity in infants, and increased infant morbidity and mortality [2, 3].
Recommended daily allowance of Zinc for pregnant mothers is 11mg/day [4]. Pregnant mothers are more at risk for zinc deficiency since, they do not intake basic food requirements from their meals due to their diet being characterized by staple foods (cereals and legumes) with a small amount of food from animal sources or even vegetables and fruits. The best sources of zinc are seafood, red meat, poultry, and nuts which are so expensive and for some mothers inaccessible especially in middle and low-income countries [3, 5].
Among the dietary micronutrients, zinc is an essential element that plays different roles in biological processes at the cellular and molecular levels. Zinc is required for the structural and catalytic function of hundreds of key regulatory enzymes. It is an essential trace element for the appropriate functioning of the immune system. Zinc deficiency may have impaired function of the immune system and consequently increase the risk of viral, fungal, and bacterial infection [2, 6]. During pregnancy, zinc deficiency decreases the level of antibody and lymphocyte proliferation, which affect subsequent generation [6]. Therefore, it is necessary to ensure the adequacy of zinc intake during the COVID-19 pandemic. Zinc element prevents the entry of the virus with changes in the strengthening of the epithelium and cilia in the respiratory system, prevents the proliferation of the virus, strengthens the immune system, prevents oxidative activities, and reduces inflammation [7]. A previous study showed that level of zinc during pregnancy correlated with a higher immune response against infection [8]. An optimal diet can improve people’s health, and as a result, it may reduce the risks and consequences of COVID19 infection [9].
During the COVID-19 pandemic micronutrient deficiency especially zinc deficiency reported by Bahat et al. in turkey. This micronutrient deficiency may contribute to the decreased immune response to COVID-19 infection. This infection might cause adverse pregnancy outcomes such as preterm birth and increase maternal and fetal morbidity and mortality [7, 10].
The effects of covid-19 infection on pregnant women and their fetuses are unknown. Considering the protective role of zinc in controlling inflammation, oxidative stress, and fighting against viral infections, it is necessary to ensure that pregnant women take enough zinc during the corona pandemic. Taking Zinc supplementation during pregnancy is beneficial for both mothers and infants especially during pandemics to prevent infection.

Ethical Considerations
Compliance with ethical guidelines
There were no ethical considerations to be considered in this research.

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Conflict of interest
The author declared no conflict of interest.

1. Mojgan N, Sharifah Zainiyah SY, Munn Sann L, Zalilah MS. [Relationship between plasma cord blood zinc and infant birth weight in Fatemieh hospital, Hamadan, Iran (Persian)]. Malaysian J. Public Health Med. 2012; 12(1):49-56. http://mymedr.afpm.org.my/publications/43219
2. Wellinghausen N. Immunobiology of gestational zinc deficiency. Br J Nutr. 2007; 85(S2):S81-S6. [DOI:10.1079/BJN2000298]
3. WHO. Nutritional interventions update: zinc supplements during pregnancy [Internet]; 2021 [Last Updateb: Aguste 12 2021]. Available from: https://www.who.int/publications/i/item/9789240030466
4. Raymond JL, Morrow K. Krause and mahan’s food and the nutrition care process e-book. Amsterdam: Elsevier Health Sciences; 2020. https://books.google.com/books?id=da4sx4IdLlMC&printsec=
5. Mojgan N, Sharifah Zainiyah SY, Munn Sann L, Zalilah MS. Relationship between plasma cord blood zinc and infant birth weight in Fatemieh hospital, Hamadan, Iran. Malaysian J.Public Health Med. 2012; 12(1):49-56. http://mymedr.afpm.org.my/publications/43219
6. Ioana MC, Cosmin C, Madalin-Marius M, Marius C, Radu N, Oana Maria G, et al. Magnesium, and zinc supplementation during pregnancy: The additive value of micronutrients on maternal immune response after SARS-CoV-2 infection. Nutrients. 2022; 14(7):1445. [DOI:10.3390/nu14071445] [PMID] [PMCID]
7. Bahat PY, Talmac MA, Bestel A, Selcuki NF, Aydın Z, Polat İ. Micronutrients in COVID-19 positive pregnancies. Cureus. 2020; 12(9):e10609. https://www.cureus.com/articles/38857-micronutrients-in-covid-19-positive-pregnancies
8. Vygivska LA. Peculiarities of changes in indices of calcium and zinc trace elements and matrix metalloproteinase-2 in pregnant women with perinatal infections. Wiad Lek. 2019; 72:2076-81. [DOI:10.36740/WLek201911102]
9. Skrajnowska D, Brumer M, Kankowska S, Matysek M, Miazio N, Bobrowska-Korczak B. Covid 19: diet composition and health. Nutrients. 2021; 13(9):2980. [DOI:10.3390/nu13092980] [PMID] [PMCID]
10. Nazari M, SY Sharifah Zainiyah, MS Lye, MS Zalilah, Heydarzadeh M. Comparison of maternal characteristics in low birth weight and normal birth weight infants. East Mediterr Health J. 2013; 19(9):792-8. [DOI:10.26719/2013.19.9.775] [PMID]