Abstract: Reproductive Sciences (2022) 29:1–6 https://doi.org/10.1007/s43032-020-00400-6 REVIEW Potential Role of Zinc in the COVID-19 Disease Process and its Probable Impact on Reproduction Ramya Sethuram 1 & David Bai 1 & Husam M. Abu-Soud 1,2,3 Received: 18 August 2020 / Accepted: 16 November 2020 / Published online: 7 January 2021 # Society for Reproductive Investigation 2021 Abstract COVID-19 (coronavirus disease 2019) is the current world health crisis, producing extensive morbidity and mortality across all age groups. Given the established roles of zinc in combating oxidative damage and viral infections, zinc is being trialed as a treatment modality against COVID-19. Zinc also has confirmed roles in both male and female reproduction. The possible depletion of zinc with the oxidative events of COVID-19 is especially relevant to the fertility of affected couples. This review aims to present the pathophysiology of COVID-19, especially in relation to reproductive function; the role of zinc in the COVID19 disease process; and how zinc depletion in concert with cytokine storm and reactive oxygen species production could affect reproduction. It also highlights research areas to better the understanding of COVID-19 and its impact on fertility and potential ways to mitigate the impact. Keywords Coronavirus . Covid-19 . Reactive oxygen species . Zinc . Infertility Abbreviations COVID-19 Coronavirus disease-19 ROS Reactive oxygen species MPO Myeloperoxidase H2O2 Hydrogen peroxide Zinc Deficiency and COVID-19 The association between zinc deficiency and worse outcomes of respiratory viral infections has been established [1]. Hence, zinc is being trialed as a nutritional supplement that is being used either as a stand-alone intervention or in conjunction with other nutrients for the prophylaxis and the treatment of the coronavirus disease 2019 (COVID-19) infection [2]. The * Husam M. Abu-Soud habusoud@med.wayne.edu 1 Department of Obstetrics and Gynecology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, 275 E. Hancock, Detroit, MI 48201, USA 2 Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, USA 3 Department of Microbiology, Immunology and Biochemistry, Wayne State University School of Medicine, Detroit, MI 48201, USA well-documented roles of zinc in preventing cell damage and its anti-viral properties are helpful in explaining the potential role of zinc in COVID-19 management [3]. Furthermore, there is a degree of overlap between the symptomatology of COVID-19 and that of zinc deficiency. Like the multiorgan damage and dysfunction characteristic of severe COVID-19 progression, zinc deficiency has farreaching impacts, affecting the nervous, cardiovascular, thymic, immune, and endocrine systems [4]. Acute effects of zinc deficiency include hair loss, diarrhea, delayed sexual maturation, impotence, hypogonadism in males, and skin lesions [5]. Also, zinc deficiency has been associated with a higher risk of atherosclerosis, diabetes, rheumatoid arthritis, neurodegenerative disease, and obesity secondary to unrestrained chronic inflammation [6–8]. These pathologies, in turn, have been correlated with increased risk for COVID-19 related complications. To a certain degree, patients with these conditions are also likely to have fertility-related and pregnancy-associated complications. Pregnant women infected with COVID-19 have been documented to have poorer..