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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 1% Improvement Relative Risk Ventilation 34% Recovery 6% Hospitalization time 4% Zinc  Abd-Elsalam et al.  LATE TREATMENT  RCT Is late treatment with zinc beneficial for COVID-19? RCT 191 patients in Egypt (June - August 2020) Trial underpowered for serious outcomes c19early.org Abd-Elsalam et al., Biological Trace E.., Nov 2020 Favors zinc Favors control

Do Zinc Supplements Enhance the Clinical Efficacy of Hydroxychloroquine?: a Randomized, Multicenter Trial

Abd-Elsalam et al., Biological Trace Element Research, doi:10.1007/s12011-020-02512-1, NCT04447534
Nov 2020  
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Zinc for COVID-19
2nd treatment shown to reduce risk in July 2020
 
*, now known with p = 0.0000027 from 43 studies, recognized in 10 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments. c19early.org
191 patient RCT in Egypt comparing the addition of zinc to HCQ, not showing a significant difference. No information on baseline zinc values was recorded. Egypt has a low rate of zinc deficiency so supplementation may be less likely to be helpful ncbi.nlm.nih.gov, ncbi.nlm.nih.gov (B). For several issues with this trial, see osf.io. See also link.springer.com. The primary outcome was changed from viral clearance to "improvement or mortality" in the last month of the trial. The pre-specified outcome was not reported.
This study is excluded in the after exclusion results of meta analysis: multiple potential data reliability issues.
Study covers zinc and HCQ.
risk of death, 1.0% lower, RR 0.99, p = 0.99, treatment 5 of 96 (5.2%), control 5 of 95 (5.3%), NNT 1824.
risk of mechanical ventilation, 34.0% lower, RR 0.66, p = 0.54, treatment 4 of 96 (4.2%), control 6 of 95 (6.3%), NNT 47.
risk of no recovery, 5.8% lower, RR 0.94, p = 0.97, treatment 20 of 96 (20.8%), control 21 of 95 (22.1%), NNT 79.
hospitalization time, 3.6% lower, relative time 0.96, p = 0.55, treatment 96, control 95.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Abd-Elsalam et al., 29 Nov 2020, Randomized Controlled Trial, Egypt, peer-reviewed, 10 authors, study period 23 June, 2020 - 23 August, 2020, data issues, see notes, trial NCT04447534 (history).
This PaperZincAll
Do Zinc Supplements Enhance the Clinical Efficacy of Hydroxychloroquine?: a Randomized, Multicenter Trial
Sherief Abd-Elsalam, Shaimaa Soliman, Eslam Saber Esmail, Mai Khalaf, Ehab F Mostafa, Mohammed A Medhat, Ossama Ashraf Ahmed, Mohamed Samir Abd El Ghafar, Mohamed Alboraie, Sahar M Hassany
Biological Trace Element Research, doi:10.1007/s12011-020-02512-1
No specific treatment for COVID-19 infection is available up till now, and there is a great urge for effective treatment to reduce morbidity and mortality during this pandemic. We aimed to evaluate the effect of combining chloroquine/hydroxychloroquine (CQ/HCQ) and zinc in the treatment of COVID-19 patients. This was a randomized clinical trial conducted at three major University hospitals in Egypt. One hundred ninety-one patients with a confirmed diagnosis of COVID-19 infection were randomized into two groups: group I (96) patients received both HCQ and zinc, and group II (95) received HCQ only. The primary endpoints were the recovery within 28 days, the need for mechanical ventilation, and death. The two groups were matched for age and gender. They had no significant difference regarding any of the baseline laboratory parameters or clinical severity grading. Clinical recovery after 28 days was achieved by 79.2% in the zinc group and 77.9% in zinc-free treatment group, without any significant difference (p = 0.969). The need for mechanical ventilation and the overall mortality rates did not show any significant difference between the 2 groups either (p = 0.537 and 0.986, respectively). The age of the patient and the need for mechanical ventilation were the only risk factors associated with the patients' mortality by the univariate regression analysis (p = 0.001 and < 0.001, respectively). Zinc supplements did not enhance the clinical efficacy of HCQ. More randomized studies are needed to evaluate the value of adding zinc to other therapies for COVID 19. ClinicalTrials.gov Identifier: NCT04447534
Conflict of Interest The authors declare that they have no conflicts of interest.
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Late treatment
is less effective
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