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0 0.5 1 1.5 2+ Mortality 20% Improvement Relative Risk Zinc  Patel et al.  LATE TREATMENT  DB RCT Is late treatment with zinc beneficial for COVID-19? Double-blind RCT 33 patients in Australia Trial underpowered to detect differences Patel et al., J. Medical Virology, Feb 2021 Favors zinc Favors control

A pilot double-blind safety and feasibility randomized controlled trial of high-dose intravenous zinc in hospitalized COVID-19 patients

Patel et al., Journal of Medical Virology, doi:10.1002/jmv.26895
Feb 2021  
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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.
Small early terminated RCT with 33 hospitalized patients in Australia, 15 treated with zinc, showing no significant difference in clinical outcomes. Treatment increased zinc levels above the deficiency cutoff. Intravenous zinc 0.5mg/kg/day (elemental zinc concentration 0.24mg/kg/day) for up to 7 days. ACTRN12620000454976.
Although the 20% lower mortality is not statistically significant, it is consistent with the significant 29% lower mortality [10‑44%] from meta analysis of the 20 mortality results to date.
risk of death, 20.0% lower, RR 0.80, p = 1.00, treatment 2 of 15 (13.3%), control 3 of 18 (16.7%), NNT 30.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Patel et al., 25 Feb 2021, Double Blind Randomized Controlled Trial, Australia, peer-reviewed, 12 authors.
This PaperZincAll
A pilot double‐blind safety and feasibility randomized controlled trial of high‐dose intravenous zinc in hospitalized COVID‐19 patients
Oneel Patel, Vidyasagar Chinni, John El‐khoury, Marlon Perera, Ary S Neto, Christine Mcdonald, Emily See, Daryl Jones, Damien Bolton, Rinaldo Bellomo, Jason Trubiano, Joseph Ischia
Journal of Medical Virology, doi:10.1002/jmv.26895
Zinc inhibits replication of the SARS-CoV virus. We aimed to evaluate the safety, feasibility, and biological effect of administering high-dose intravenous zinc (HDIVZn) to patients with COVID-19. We performed a Phase IIa doubleblind, randomized controlled trial to compare HDIVZn to placebo in hospitalized patients with COVID-19. We administered trial treatment per day for a maximum of 7 days until either death or hospital discharge. We measured zinc concentration at baseline and during treatment and observed patients for any significant side effects. For eligible patients, we randomized and administered treatment to 33 adult participants to either HDIVZn (n = 15) or placebo (n = 18). We observed no serious adverse events throughout the study for a total of 94 HDIVZn administrations. However, three participants in the HDIVZn group reported infusion site irritation. Mean serum zinc on Day 1 in the placebo, and the HDIVZn group was 6.9 ± 1.1 and 7.7 ± 1.6 µmol/l, respectively, consistent with zinc deficiency. HDIVZn, but not placebo, increased serum zinc levels above the deficiency cutoff of 10.7 µmol/l (p < .001) on Day 6. Our study did not reach its target enrollment because stringent public health measures markedly reduced patient hospitalizations. Hospitalized COVID-19 patients demonstrated zinc deficiency. This can be corrected with HDIVZn. Such treatment appears safe, feasible, and only associated with minimal peripheral infusion site irritation. This pilot study justifies further investigation of this treatment in COVID-19 patients.
PEER REVIEW The peer review history for this article is available at https://publons. com/publon/10.1002/jmv.26895.
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Late treatment
is less effective
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