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Analysis of the predictive factors for a critical illness of COVID-19 during treatment - relationship between serum zinc level and critical illness of COVID-19

Yasui et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.09.008
Sep 2020  
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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.
Retrospective 62 hospitalized patients, 29 with serum zinc data, showing significantly lower serum zinc levels for severe COVID-19 cases (intubation) compared with mild and moderate cases, p = 0.005. Authors recommend zinc supplementation.
risk of mechanical ventilation, 92.5% lower, RR 0.08, p = 0.001, high zinc levels 1 of 20 (5.0%), low zinc levels 6 of 9 (66.7%), NNT 1.6, zinc >= 70μg/dL.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yasui et al., 7 Sep 2020, retrospective, Japan, peer-reviewed, 10 authors.
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Analysis of the predictive factors for a critical illness of COVID-19 during treatment - relationship between serum zinc level and critical illness of COVID-19 −
Yukako Yasui, Hiroyuki Yasui, Kumiko Suzuki, Takako Saitou, Yoshiki Yamamoto, Toshihiko Ishizaka, Kouji Nishida, Shingo Yoshihara, Iwao Gohma, Yoshihiko Ogawa
International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.09.008
Because most severely ill patients with COVID-19 in our hospital showed zinc deficiency, we aimed to examine the relationship between the patient's serum zinc level and severe cases of COVID-19. Methods: Serum zinc <70 mg/dL was defined as the criterion for hypozincemia, and patients continuously with serum zinc <70 mg/dL were classified in the hypozincemia cohort. To evaluate whether hypozincemia could be a predictive factor for a critical illness of COVID-19, we performed a multivariate analysis by employing logistic regression analysis. Results: Prolonged hypozincemia was found to be a risk factor for a severe case of COVID-19. In evaluating the relationship between the serum zinc level and severity of patients with COVID-19 by multivariate logistic regression analysis, critical illness can be predicted through the sensitivity and false specificity of a ROC curve with an error rate of 10.3% and AUC of 94.2% by only two factors: serum zinc value (P = 0.020) and LDH value (P = 0.026). Conclusions: Proper management of the prediction results in this study can contribute to establishing and maintaining a safe medical system, taking the arrival of the second wave, and the spread of COVID-19 in the future into consideration.
Conflict of interest We declare no conflict of interests, no competing financial interests, or personal relationships that could have influenced this study.
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