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0 0.5 1 1.5 2+ Progression 33% Improvement Relative Risk ICU time 6% Zinc  Darban et al.  ICU PATIENTS  RCT Is very late treatment with zinc + melatonin and vitamin C beneficial for COVID-19? RCT 20 patients in Iran (April - June 2020) Trial underpowered to detect differences Darban et al., J. Cellular & Molecular.., Dec 2020 Favors zinc Favors control

Efficacy of High Dose Vitamin C, Melatonin and Zinc in Iranian Patients with Acute Respiratory Syndrome due to Coronavirus Infection: A Pilot Randomized Trial

Darban et al., Journal of Cellular & Molecular Anesthesia, doi:10.22037/jcma.v6i2.32182, IRCT20151228025732N52
Dec 2020  
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Zinc for COVID-19
2nd treatment shown to reduce risk in July 2020
*, now known with p = 0.0000013 from 44 studies, recognized in 11 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments.
Small RCT in Iran with 20 ICU patients, 10 treated with high-dose vitamin C, melatonin, and zinc, not showing significant differences.
Study covers zinc, vitamin C, and melatonin.
risk of progression, 33.3% lower, RR 0.67, p = 1.00, treatment 2 of 10 (20.0%), control 3 of 10 (30.0%), NNT 10.
ICU time, 6.0% lower, relative time 0.94, p = 0.30, treatment 10, control 10.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Darban et al., 15 Dec 2020, Randomized Controlled Trial, Iran, peer-reviewed, 8 authors, study period 7 April, 2020 - 8 June, 2020, this trial uses multiple treatments in the treatment arm (combined with melatonin and vitamin C) - results of individual treatments may vary, trial IRCT20151228025732N52.
This PaperZincAll
Efficacy of High Dose Vitamin C, Melatonin and Zinc in Iranian Patients with Acute Respiratory Syndrome due to Coronavirus Infection: A Pilot Randomized Trial
Mahboubeh Darban, Farhad Mal, Mohammad Memari, Ali Goha, Arda Kiani, Alireza Emadi, Samaneh Lavvaf, Bahador Bagheri
Background: We aimed to investigate the efficacy of high-dose vitamin C, melatonin, and zinc in patients with severe Covid-19. Materials and Methods: Twenty-one adult patients were randomized 1:1 to standard care alone or standard care plus IV vitamin C (2 g, q6hr), oral melatonin (6 mg, q6hr), and oral zinc sulfate (50 mg, q6hr) for 10 days. Patients were monitored for changes in hypoxemia and inflammatory markers. Results: Both treatment modalities were effective to improve PaO2/FiO2 and oxygen saturation. However, there were no significant differences between the 2 study groups (P>0.05). There were reductions in CRP, ESR, and LDH levels in both study groups, although were not significant. No significant difference was noted in the length of ICU stay between the 2 study groups (P=0.3). Conclusion: Our study suggests that the addition of vitamin C, melatonin, and zinc to standard care is not associated with considerable improvement in patients with severe Covid-19.
Conflicts of Interest The authors declare that they have no conflict of interest.
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Jamalimoghadamsiahkali, Zarezade, Koolaji, Seyedalinaghi, Zendehdel et al., Safety and effectiveness of high-dose vitamin C in patients with COVID-19: a randomized open-label clinical trial, Eur J Med Res
Kuhn, Meissner, Mayes, Bartels, Vitamin C in sepsis, Curr Opin Anaesthesiol
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Wongchitrat, Shukla, Sharma, Govitrapong, Reiter, Role of Melatonin on Virus-Induced Neuropathogenesis-A Concomitant Therapeutic Strategy to Understand SARS-CoV-2
Zhang, Rao, Li, Zhu, Liu et al., Pilot trial of high-dose vitamin C in critically ill COVID-19 patients, Ann Intensive Care
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Late treatment
is less effective
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