Analgesics
Antiandrogens
Antihistamines
Azvudine
Bromhexine
Budesonide
Colchicine
Conv. Plasma
Curcumin
Famotidine
Favipiravir
Fluvoxamine
Hydroxychlor..
Ivermectin
Lifestyle
Melatonin
Metformin
Minerals
Molnupiravir
Monoclonals
Naso/orophar..
Nigella Sativa
Nitazoxanide
PPIs
Paxlovid
Quercetin
Remdesivir
Thermotherapy
Vitamins
More

Other
Feedback
Home
Top
Results
Abstract
All zinc studies
Meta analysis
 
Feedback
Home
next
study
previous
study
c19early.org COVID-19 treatment researchZincZinc (more..)
Melatonin Meta
Metformin Meta
Antihistamines Meta
Azvudine Meta Molnupiravir Meta
Bromhexine Meta
Budesonide Meta
Colchicine Meta Nigella Sativa Meta
Conv. Plasma Meta Nitazoxanide Meta
Curcumin Meta PPIs Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Quercetin Meta
Fluvoxamine Meta Remdesivir Meta
Hydroxychlor.. Meta Thermotherapy Meta
Ivermectin Meta

All Studies   Meta Analysis       

Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial

Thomas et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.0369, COVIDAtoZ, NCT04342728
Feb 2021  
  Post
  Facebook
Share
  Source   PDF   All Studies   Meta AnalysisMeta
Hospitalization -44% Improvement Relative Risk Recovery time 12% primary Zinc  COVIDAtoZ  EARLY TREATMENT  RCT Is early treatment with zinc beneficial for COVID-19? RCT 108 patients in the USA (April 2020 - February 2021) Faster recovery with zinc (not stat. sig., p=0.38) c19early.org Thomas et al., JAMA Network Open, February 2021 Favorszinc Favorscontrol 0 0.5 1 1.5 2+
Zinc for COVID-19
2nd treatment shown to reduce risk in July 2020, now with p = 0.00000032 from 46 studies, recognized in 17 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
Small 214 low-risk outpatient RCT showing non-statistically significant faster recovery with zinc and with vitamin C. Study performed in the USA where zinc deficiency is relatively uncommon. The zinc dosage is relatively low, 50mg zinc gluconate (7mg elemental zinc), one tenth of that shown to reduce the duration of colds in other studies1.
Study covers vitamin C and zinc.
risk of hospitalization, 43.7% higher, RR 1.44, p = 0.72, treatment 5 of 58 (8.6%), control 3 of 50 (6.0%).
recovery time, 11.9% lower, relative time 0.88, p = 0.38, treatment mean 5.9 (±4.9) n=58, control mean 6.7 (±4.4) n=50, mean time to a 50% reduction in symptoms, primary outcome.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Thomas et al., 12 Feb 2021, Randomized Controlled Trial, USA, peer-reviewed, 11 authors, study period 8 April, 2020 - 11 February, 2021, trial NCT04342728 (history) (COVIDAtoZ).
This PaperZincAll
Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection
MD, MBA Suma Thomas, MD, MS Divyang Patel, BSN, RN Barbara Bittel, MPH Kathy Wolski, MS Qiuqing Wang, MD, MS Anirudh Kumar, Zachary J Il’giovine, MD, MS Reena Mehra, MD Carla Mcwilliams, MD Steve E Nissen, MD, MBA Milind Y Desai
JAMA Network Open, doi:10.1001/jamanetworkopen.2021.0369
IMPORTANCE There is limited evidence regarding early treatment of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to mitigate symptom progression. OBJECTIVE To examine whether high-dose zinc and/or high-dose ascorbic acid reduce the severity or duration of symptoms compared with usual care among ambulatory patients with SARS-CoV-2 infection. DESIGN, SETTING, AND PARTICIPANTS This multicenter, single health system randomized clinical factorial open-label trial enrolled 214 adult patients with a diagnosis of SARS-CoV-2 infection confirmed with a polymerase chain reaction assay who received outpatient care in sites in Ohio and
ARTICLE INFORMATION Additional Contributions: Serpil Erzurum, MD, James Young, MD, Daniel Culver, MD, Joan Booth, RN, Nancy Obuchowski, MPH, and John Petrich, RPh (Cleveland Clinic), were members of the operational and safety monitoring board. They were not compensated for their time. We would like to thank Samantha Xu, BS (Cleveland Clinic), for help with logistics of study set-up and coordination. She was compensated for her time.
References
Carr, Vitamin C administration in the critically ill: a summary of recent meta-analyses, Crit Care, doi:10.1186/s13054-019-2538-y
Eby, Davis, Halcomb, Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study, Antimicrob Agents Chemother, doi:10.1128/AAC.25.1.20
Gammoh, Rink, Zinc in infection and inflammation, Nutrients, doi:10.3390/nu9060624
Hemilä, Chalker, Vitamin C for preventing and treating the common cold, Cochrane Database Syst Rev, doi:10.1002/14651858.CD000980.pub4
Hemilä, Vitamin C and infections, Nutrients, doi:10.3390/nu9040339
Hemilä, Vitamin C, respiratory infections and the immune system, Trends Immunol, doi:10.1016/j.it.2003.09.004
Hemilä, Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage, JRSM Open, doi:10.1177/2054270417694291
Huang, Wang, Li, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet, doi:10.1016/S0140-6736(20)30183-5
Krenn, Gaudernak, Holzer, Lanke, Van Kuppeveld et al., Antiviral activity of the zinc ionophores pyrithione and hinokitiol against picornavirus infections, J Virol, doi:10.1128/JVI.01543-08
Li, Moore, Vasilieva, Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus, Nature, doi:10.1038/nature02145
Singh, Das, Zinc for the common cold, Cochrane Database Syst Rev, doi:10.1002/14651858.CD001364.pub3
Velthuis, Van Den Worm, Sims, Baric, Snijder et al., Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture, PLoS Pathog, doi:10.1371/journal.ppat.1001176
Wang, Il'giovine, Mehra, Nissen, Desai, None
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention, JAMA, doi:https://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2020.2648&utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jamanetworkopen.2021.0369
{ 'indexed': {'date-parts': [[2024, 4, 5]], 'date-time': '2024-04-05T12:59:44Z', 'timestamp': 1712321984982}, 'reference-count': 17, 'publisher': 'American Medical Association (AMA)', 'issue': '2', 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'DOI': '10.1001/jamanetworkopen.2021.0369', 'type': 'journal-article', 'created': {'date-parts': [[2021, 2, 13]], 'date-time': '2021-02-13T01:40:31Z', 'timestamp': 1613180431000}, 'page': 'e210369', 'source': 'Crossref', 'is-referenced-by-count': 254, 'title': 'Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and ' 'Reduction Among Ambulatory Patients With SARS-CoV-2 Infection', 'prefix': '10.1001', 'volume': '4', 'author': [ { 'given': 'Suma', 'family': 'Thomas', 'sequence': 'first', 'affiliation': [{'name': 'Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio'}]}, { 'given': 'Divyang', 'family': 'Patel', 'sequence': 'additional', 'affiliation': [{'name': 'Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio'}]}, { 'given': 'Barbara', 'family': 'Bittel', 'sequence': 'additional', 'affiliation': [{'name': 'Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio'}]}, { 'given': 'Kathy', 'family': 'Wolski', 'sequence': 'additional', 'affiliation': [{'name': 'Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio'}]}, { 'given': 'Qiuqing', 'family': 'Wang', 'sequence': 'additional', 'affiliation': [{'name': 'Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio'}]}, { 'given': 'Anirudh', 'family': 'Kumar', 'sequence': 'additional', 'affiliation': [{'name': 'Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio'}]}, { 'given': 'Zachary J.', 'family': 'Il’Giovine', 'sequence': 'additional', 'affiliation': [{'name': 'Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio'}]}, { 'given': 'Reena', 'family': 'Mehra', 'sequence': 'additional', 'affiliation': [ {'name': 'Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio'}, { 'name': 'Neurologic Institute, Respiratory Institute, Lerner Research ' 'Institute, Cleveland Clinic, Cleveland, Ohio'}]}, { 'given': 'Carla', 'family': 'McWilliams', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Infectious Diseases, Cleveland Clinic Florida, ' 'Weston'}]}, { 'given': 'Steve E.', 'family': 'Nissen', 'sequence': 'additional', 'affiliation': [{'name': 'Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio'}]}, { 'given': 'Milind Y.', 'family': 'Desai', 'sequence': 'additional', 'affiliation': [ { 'name': 'Heart and Vascular Institute, Cleveland Clinic, Cleveland, ' 'Ohio'}]}], 'member': '10', 'published-online': {'date-parts': [[2021, 2, 12]]}, 'reference': [ { 'issue': '10223', 'key': 'zoi210024r1', 'doi-asserted-by': 'publisher', 'first-page': '497', 'DOI': '10.1016/S0140-6736(20)30183-5', 'article-title': 'Clinical features of patients infected with 2019 novel coronavirus in ' 'Wuhan, China.', 'volume': '395', 'author': 'Huang', 'year': '2020', 'journal-title': 'Lancet'}, { 'issue': '13', 'key': 'zoi210024r3', 'doi-asserted-by': 'publisher', 'first-page': '1239', 'DOI': '10.1001/jama.2020.2648', 'article-title': 'Characteristics of and important lessons from the coronavirus disease ' '2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases ' 'from the Chinese Center for Disease Control and Prevention.', 'volume': '323', 'author': 'Wu', 'year': '2020', 'journal-title': 'JAMA'}, { 'issue': '6', 'key': 'zoi210024r4', 'doi-asserted-by': 'crossref', 'DOI': '10.3390/nu9060624', 'article-title': 'Zinc in infection and inflammation.', 'volume': '9', 'author': 'Gammoh', 'year': '2017', 'journal-title': 'Nutrients'}, { 'issue': '4', 'key': 'zoi210024r5', 'doi-asserted-by': 'crossref', 'DOI': '10.3390/nu9040339', 'article-title': 'Vitamin C and infections.', 'volume': '9', 'author': 'Hemilä', 'year': '2017', 'journal-title': 'Nutrients'}, { 'issue': '1', 'key': 'zoi210024r6', 'article-title': 'Vitamin C for preventing and treating the common cold.', 'author': 'Hemilä', 'year': '2013', 'journal-title': 'Cochrane Database Syst Rev'}, { 'issue': '2', 'key': 'zoi210024r7', 'doi-asserted-by': 'crossref', 'DOI': '10.1002/14651858.CD001364.pub3', 'article-title': 'Zinc for the common cold.', 'author': 'Singh', 'year': '2011', 'journal-title': 'Cochrane Database Syst Rev'}, { 'issue': '1', 'key': 'zoi210024r8', 'doi-asserted-by': 'publisher', 'first-page': '20', 'DOI': '10.1128/AAC.25.1.20', 'article-title': 'Reduction in duration of common colds by zinc gluconate lozenges in a ' 'double-blind study.', 'volume': '25', 'author': 'Eby', 'year': '1984', 'journal-title': 'Antimicrob Agents Chemother'}, { 'issue': '5', 'key': 'zoi210024r9', 'doi-asserted-by': 'crossref', 'DOI': '10.1177/2054270417694291', 'article-title': 'Zinc lozenges and the common cold: a meta-analysis comparing zinc ' 'acetate and zinc gluconate, and the role of zinc dosage.', 'volume': '8', 'author': 'Hemilä', 'year': '2017', 'journal-title': 'JRSM Open'}, { 'issue': '1', 'key': 'zoi210024r10', 'doi-asserted-by': 'publisher', 'first-page': '265', 'DOI': '10.1186/s13054-019-2538-y', 'article-title': 'Vitamin C administration in the critically ill: a summary of recent ' 'meta-analyses.', 'volume': '23', 'author': 'Carr', 'year': '2019', 'journal-title': 'Crit Care'}, { 'issue': '11', 'key': 'zoi210024r11', 'doi-asserted-by': 'crossref', 'DOI': '10.1371/journal.ppat.1001176', 'article-title': 'Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in ' 'vitro and zinc ionophores block the replication of these viruses in ' 'cell culture.', 'volume': '6', 'author': 'te Velthuis', 'year': '2010', 'journal-title': 'PLoS Pathog'}, { 'issue': '6965', 'key': 'zoi210024r12', 'doi-asserted-by': 'publisher', 'first-page': '450', 'DOI': '10.1038/nature02145', 'article-title': 'Angiotensin-converting enzyme 2 is a functional receptor for the SARS ' 'coronavirus.', 'volume': '426', 'author': 'Li', 'year': '2003', 'journal-title': 'Nature'}, { 'issue': '1', 'key': 'zoi210024r13', 'doi-asserted-by': 'publisher', 'first-page': '58', 'DOI': '10.1128/JVI.01543-08', 'article-title': 'Antiviral activity of the zinc ionophores pyrithione and hinokitiol ' 'against picornavirus infections.', 'volume': '83', 'author': 'Krenn', 'year': '2009', 'journal-title': 'J Virol'}, { 'issue': '11', 'key': 'zoi210024r14', 'doi-asserted-by': 'publisher', 'first-page': '579', 'DOI': '10.1016/j.it.2003.09.004', 'article-title': 'Vitamin C, respiratory infections and the immune system.', 'volume': '24', 'author': 'Hemilä', 'year': '2003', 'journal-title': 'Trends Immunol'}, { 'issue': '4', 'key': 'zoi210024r15', 'doi-asserted-by': 'publisher', 'first-page': '581', 'DOI': '10.1080/03079459208418879', 'article-title': 'Ascorbic acid and infectious bronchitis infections in broilers.', 'volume': '21', 'author': 'Davelaar', 'year': '1992', 'journal-title': 'Avian Pathol'}, { 'issue': '3', 'key': 'zoi210024r16', 'first-page': '279', 'article-title': 'Zinc gluconate lozenges for common cold: a double-blind clinical trial.', 'volume': '37', 'author': 'Weismann', 'year': '1990', 'journal-title': 'Dan Med Bull'}, { 'issue': '9', 'key': 'zoi210024r17', 'doi-asserted-by': 'crossref', 'DOI': '10.1001/jamanetworkopen.2020.19722', 'article-title': 'Association of vitamin D status and other clinical characteristics with ' 'COVID-19 test results.', 'volume': '3', 'author': 'Meltzer', 'year': '2020', 'journal-title': 'JAMA Netw Open'}, { 'key': 'zoi210024r2', 'unstructured': 'US Centers for Disease Control and Prevention. COVID-19. Accessed ' 'January 12, 2021. https://www.cdc.gov/coronavirus/2019-ncov/index.html'}], 'container-title': 'JAMA Network Open', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2776305/thomas_2021_oi_210024_1612460884.60692.pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 12, 17]], 'date-time': '2022-12-17T04:10:12Z', 'timestamp': 1671250212000}, 'score': 1, 'resource': {'primary': {'URL': 'https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776305'}}, 'subtitle': ['The COVID A to Z Randomized Clinical Trial'], 'short-title': [], 'issued': {'date-parts': [[2021, 2, 12]]}, 'references-count': 17, 'journal-issue': {'issue': '2', 'published-print': {'date-parts': [[2021, 2, 1]]}}, 'URL': 'http://dx.doi.org/10.1001/jamanetworkopen.2021.0369', 'relation': {}, 'ISSN': ['2574-3805'], 'subject': ['General Medicine'], 'container-title-short': 'JAMA Netw Open', 'published': {'date-parts': [[2021, 2, 12]]}}
Loading..
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
  or use drag and drop   
Submit