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Zinc deficiency as a possible risk factor for increased susceptibility and severe progression of Corona Virus Disease 19

Wessels et al., British Journal of Nutrition, doi:10.1017/S0007114521000738
Mar 2021  
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Zinc for COVID-19
2nd treatment shown to reduce risk in July 2020
 
*, now with p = 0.00000064 from 45 studies, recognized in 17 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 77 treatments. c19early.org
Review of the possible association between zinc deficiency and increased susceptibility to and severity of COVID-19. Authors propose multiple mechanisms by which pre-existing zinc deficiency may increase the risk of severe COVID-19 progression, including impaired immune response, elevated inflammation and cytokine storm, vascular complications, and delayed tissue regeneration. Authors note that serum zinc levels are lower in COVID-19 patients and inversely correlated with disease severity and mortality, which could reflect pre-existing deficiency or virus-induced changes, and call for clinical studies of zinc treatment for COVID-19.
Reviews covering zinc for COVID-19 include1-10.
Wessels et al., 1 Mar 2021, peer-reviewed, 4 authors. Contact: lrink@ukaachen.de.
This PaperZincAll
Zinc deficiency as a possible risk factor for increased susceptibility and severe progression of Corona Virus Disease 19
Inga Wessels, Benjamin Rolles, Alan J Slusarenko, Dr Lothar Rink
British Journal of Nutrition, doi:10.1017/s0007114521000738
The importance of Zn for human health becomes obvious during Zn deficiency. Even mild insufficiencies of Zn cause alterations in haematopoiesis and immune functions, resulting in a proinflammatory phenotype and a disturbed redox metabolism. Although immune system malfunction has the most obvious effect, the functions of several tissue cell types are disturbed if Zn supply is limiting. Adhesion molecules and tight junction proteins decrease, while cell death increases, generating barrier dysfunction and possibly organ failure. Taken together, Zn deficiency both weakens the resistance of the human body towards pathogens and at the same time increases the danger of an overactive immune response that may cause tissue damage. The case numbers of Corona Virus Disease 19 (COVID-19) are still increasing, which is causing enormous problems for health systems and economies. There is an urgent need to reduce both the number of severe cases and the resulting deaths. While therapeutic options are still under investigation, and first vaccines have been approved, cost-effective ways to reduce the likelihood of or even prevent infection, and the transition from mild symptoms to more serious detrimental disease, are highly desirable. Nutritional supplementation might be an effective option to achieve these aims. In this review, we discuss known Zn deficiency effects in the context of an infection with Severe Acute Respiratory Syndrome-Coronavirus-2 and its currently known pathogenic mechanisms and elaborate on how severe pre-existing Zn deficiency may pre-dispose patients to a severe progression of COVID-19. First published clinical data on the association of Zn homoeostasis with COVID-19 and registered studies in progress are listed.
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Although immune system malfunction has the most obvious effect, the ' 'functions of several tissue cell types are disturbed if Zn supply is limiting. Adhesion ' 'molecules and tight junction proteins decrease, while cell death increases, generating ' 'barrier dysfunction and possibly organ failure. Taken together, Zn deficiency both weakens ' 'the resistance of the human body towards pathogens and at the same time increases the danger ' 'of an overactive immune response that may cause tissue damage. The case numbers of Corona ' 'Virus Disease 19 (COVID-19) are still increasing, which is causing enormous problems for ' 'health systems and economies. There is an urgent need to reduce both the number of severe ' 'cases and the resulting deaths. While therapeutic options are still under investigation, and ' 'first vaccines have been approved, cost-effective ways to reduce the likelihood of or even ' 'prevent infection, and the transition from mild symptoms to more serious detrimental disease, ' 'are highly desirable. Nutritional supplementation might be an effective option to achieve ' 'these aims. In this review, we discuss known Zn deficiency effects in the context of an ' 'infection with Severe Acute Respiratory Syndrome-Coronavirus-2 and its currently known ' 'pathogenic mechanisms and elaborate on how severe pre-existing Zn deficiency may pre-dispose ' 'patients to a severe progression of COVID-19. First published clinical data on the ' 'association of Zn homoeostasis with COVID-19 and registered studies in progress are ' 'listed.</jats:p>', 'DOI': '10.1017/s0007114521000738', 'type': 'journal-article', 'created': {'date-parts': [[2021, 3, 1]], 'date-time': '2021-03-01T07:12:02Z', 'timestamp': 1614582722000}, 'page': '214-232', 'update-policy': 'http://dx.doi.org/10.1017/policypage', 'source': 'Crossref', 'is-referenced-by-count': 32, 'title': 'Zinc deficiency as a possible risk factor for increased susceptibility and severe progression of ' 'Corona Virus Disease 19', 'prefix': '10.1017', 'volume': '127', 'author': [ {'given': 'Inga', 'family': 'Wessels', 'sequence': 'first', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-7393-861X', 'authenticated-orcid': False, 'given': 'Benjamin', 'family': 'Rolles', 'sequence': 'additional', 'affiliation': []}, {'given': 'Alan J.', 'family': 'Slusarenko', 'sequence': 'additional', 'affiliation': []}, {'given': 'Lothar', 'family': 'Rink', 'sequence': 'additional', 'affiliation': []}], 'member': '56', 'published-online': {'date-parts': [[2021, 3, 1]]}, 'reference': [ { 'key': 'S0007114521000738_ref206', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.bbapap.2010.06.010'}, { 'key': 'S0007114521000738_ref261', 'unstructured': '261. 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