Safety and efficacy of selenium in improving the outcomes of stroke patients: a systematic review and meta-analysis with GRADE system

Background Stroke represents the second most common cause of death worldwide and a significant cause of long-term morbidity. Although the brain is incapable of regeneration, the element selenium (Se) has been found to have a role in regenerating the antioxidant systems and improving cell proliferation and viability. So, we conduct this systematic review and meta-analysis to assess its effectiveness in enhancing cell proliferation and viability. Aims Our study aims to determine the efficacy and safety of selenium in alleviating the impact of brain injury and promoting recovery in patients with stroke. Summary of review We finally included five randomized clinical trials. Our meta-analysis showed a statistically significant difference between selenium and placebo in the outcomes of interest: Glasgow Outcome Scale after 1 month (OR: 1.54, 95% CI [1.10, 2.15], P = 0.01) and respiratory infection (OR: 0.55, 95% CI [0.34, 0.88], P = 0.01). There is no statistically significant difference in Glasgow Outcome Scale after 3 months (OR: 1.36, 95% CI [0.97, 1.91], P = 0.07), mortality (OR: 0.76, 95% CI [0.45, 1.30], P = 0.31). Conclusion Selenium showed a promising contribution to minimizing the damage caused by brain injuries. Further studies, including randomized-controlled trials, must be conducted on the efficacy of selenium and its association with better neurological outcomes.