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Zinc for COVID-19
43 studies from 451 scientists
55,200 patients in 18 countries
Statistically significant lower risk for mortality, ventilation, hospitalization, progression, recovery, and viral clearance.
17 studies from 17 teams in 9 countries show statistically significant improvements.
Over-supplementation may be detrimental.
COVID-19 Zinc studies. Dec 2023.
0 0.5 1 1.5+ All studies 27% With exclusions 32% Mortality 29% Hospitalization 19% Recovery 20% Cases 22% Viral clearance 21% RCTs 39% RCT mortality 24% Sufficiency 72% Prophylaxis 21% Early 41% Late 27% Favorszinc Favorscontrol
The European Food Safety Authority has found evidence for a causal relationship between the intake of zinc and optimal immune system function Galmés, Galmés (B). Over-supplementation may be detrimental Bioaccessibility of supplements varies widely Ośko. Recent:
Zinc has been officially adopted in all or part of 10 countries. Submit updates/corrections.
Dec 3
Covid Analysis Zinc for COVID-19: real-time meta analysis of 58 studies (43 treatment studies and 15 sufficiency studies)
Statistically significant lower risk is seen for mortality, ventilation, hospitalization, progression, recovery, and viral clearance. 17 studies from 17 independent teams in 9 countries show statistically significant improvements. • Met..
Sep 22
Seely et al., BMJ Open, doi:10.1136/bmjopen-2023-073761 Dietary supplements to reduce symptom severity and duration in people with SARS-CoV-2: a double-blind randomised controlled trial
14% improved recovery (p=0.41). Early terminated low-risk population (no hospitalization) very late treatment (mean 8 days) RCT with 44 patients treated with vitamin C, D, K, and zinc, and 46 control patients, showing no significant differences. Authors acknowledge that..
Aug 9
Herrera-Quintana et al., Metabolites, doi:10.3390/metabo13080931 Evolution of Status of Trace Elements and Metallothioneins in Patients with COVID-19: Relationship with Clinical, Biochemical, and Inflammatory Parameters
Prospective study of 86 critical COVID-19 patients in Spain showing that low zinc levels were predictive of severity. There was a high prevalence of zinc deficiency.
Jul 26
Wozniak et al., Nutrients, doi:10.3390/nu15153308 Association of Trace Element Levels with Outcomes in Critically Ill COVID-19 Patients
47% lower mortality (p=0.3) and 62% lower progression (p=0.06). Retrospective 345 COVID-19 patients in Switzerland, showing significantly different zinc levels with ICU patients < hospitalized patients < outpatients. For ICU patients, there was higher mortality, septic shock, and mechanical ventilatio..
Jul 18
İşler et al., Life and Medical Sciences, doi:10.54584/lms.2023.39 Evaluation of the Serum Zinc Level in Patients Followed in Hospital with the Diagnosis of COVID-19 in Samsun Province, Türkiye
88% fewer cases (p=0.04). Retrospective 51 COVID-19 patients and 26 healthy controls in Turkey, showing significantly lower zinc levels in COVID-19 patients, and zinc deficiency associated with COVID-19 in unadjusted results.
Jul 18
Ali et al., American Journal of Medical and Physical Education, 1:1 Biochemical changes of electrolytes and trace elements among patient with coronavirus disease-19 (COVID-19) in Khartoum state
Retrospective 50 COVID-19 patients and 50 healthy controls in Sudan, showing significantly lower zinc levels in COVID-19 patients, and an inverse correlation between zinc levels and COVID-19 severity.
Jul 15
Graydon et al., Current Research in Immunology, doi:10.1016/j.crimmu.2023.100064 High baseline frequencies of natural killer cells are associated with asymptomatic SARS-CoV-2 infection
Analysis of 88 COVID+ patients in the USA showing that a higher frequency of natural killer (NK) cells was associated with asymptomatic infection. Improved NK cell numbers and functioning has been shown for exercise [Oh], better sleep [Ir..
Jul 14
Lupi et al., Frontiers in Immunology, doi:10.3389/fimmu.2023.1148595 Persistent and transient olfactory deficits in COVID-19 are associated to inflammation and zinc homeostasis
Analysis of gene expression in the olfactory epithelium of 21 COVID-19 patients with persistent, transient, or no loss of smell. Authors find: - Patients with persistent smell loss had higher expression of metallothionein genes involved i..
Jul 11
Partap et al., Current Developments in Nutrition, doi:10.1016/j.cdnut.2023.101971 Vitamin D and zinc supplementation to improve treatment outcomes among COVID-19 patients in India: results from a double-blind randomized placebo-controlled trial
5% higher ventilation (p=0.82), 6% higher hospital discharge (p=0.8), and 10% improved recovery (p=0.67). Early terminated factorial RCT with 46 vitamin D, 48 zinc, 44 vitamin D + zinc, and 43 placebo patients in India. The most serious outcome (ventilation) numbers do not seem realistic. Authors do not specify outcomes per group, but with on..
Jul 1
Ibrahim et al., Pakistan Journal of Pharmaceutical Sciences, doi:10.36721/PJPS.2023.36.4.REG.1031-1043.1 Clinical importance of zinc as monotherapy in modulating RT-PCR cycle threshold values and antibody levels in cases of COVID 19 patients
Analysis of 75 patients in Saudi Arabia showing that zinc treatment increased salivary zinc levels and lowered the viral burden in COVID-19 cases. COVID-19 patients had lower salivary zinc levels compared to healthy controls. Salivary zin..
Jun 29
Wu et al., Journal of Infection, doi:10.1016/j.jinf.2023.06.021 The association between zinc deficiency, and clinical outcomes of COVID-19
71% lower mortality (p=0.005), 27% lower combined mortality/hospitalization (p=0.03), and 18% lower hospitalization (p=0.21). TriNetX PSM retrospective 10,935 COVID-19 patients, showing higher mortality with zinc deficiency.
Jun 27
Tran et al., In Vivo, doi:10.21873/invivo.13262 Therapeutic Efficacy of AFree Oral Spray on the Symptoms and Course of Moderate and Severe COVID-19 in the Field Hospital
84% improved recovery (p<0.0001) and 78% improved viral clearance (p=0.06). RCT 200 hospitalized patients in Vietnam, showing faster recovery with an oral spray containing zinc, propolis, xylitol, ginger, and DMSO.
Jun 20
Mahjoub et al., Explore, doi:10.1016/j.explore.2023.06.009 Melatonin, vitamins and minerals supplements for the treatment of Covid-19 and Covid-like illness: a prospective, randomized, double-blind multicenter study.
67% improved recovery (p=0.32). RCT 164 low-risk (no hospitalizations) patients in Tunisia, showing improved recovery with zinc, melatonin, and vitamins A-E. This study includes COVID-19 and COVID-like illness, with 49% of 128 patients receiving a PCR test being COVID-1..
Jun 14
Orellana-Manzano et al., Frontiers in Pharmacology, doi:10.3389/fphar.2023.1197973 A report on SARS-CoV-2 first wave in Ecuador: drug consumption dynamics
Retrospective 10,175 people PCR tested in Ecuador, showing lower risk of PCR+ with multivitamin use and suggesting higher risk with acetaminophen use. The study analyzed drug consumption for COVID-19 symptoms during the 14 days before the..
Jun 13
Al-Fartusie et al., Journal of Trace Elements in Medicine and Biology, doi:10.1016/j.jtemb.2023.127242 A Comparative Study of Serum Zn, Cu, Mg, Mn, Cr, and Fe Levels and Their Association with the Vulnerability of Iraqi COVID-19 Patients
Retrospective 40 COVID-19 patients, 40 patients post COVID-19 recovery, and 40 healthy controls in Iraq, showing significantly lower zinc levels in COVID-19 patients.
Jun 10
Rheingold et al., Cureus, doi:10.7759/cureus.40231 Zinc Supplementation Associated With a Decrease in Mortality in COVID-19 Patients: A Meta-Analysis
37% lower mortality (p<0.0001). Meta analysis showing lower mortality in COVID-19 patients with zinc treatment.
May 21
Chen et al., Nutrition, doi:10.1016/j.nut.2023.112087 Early oral nutritional supplement improves COVID-19 outcomes among hospitalized older patients during the omicron wave
PSM retrospective 1,181 COVID-19 patients ≥60 years old in China, showing significantly lower mortality with a nutritional supplement. Hospitalization time and viral clearance time was improved with earlier initiation of treatment. The su..
May 13
Jiménez et al., Journal of Trace Elements in Medicine and Biology, doi:10.1016/j.jtemb.2023.127200 Zinc Levels of Patients With A Moderate to Severe COVID-19 Infection at Hospital Admission and After 4th Days of Ward Hospitalization and Their Clinical Outcome
55% lower progression (p=0.22). Prospective analysis of 100 hospitalized COVID-19 patients in Spain, showing higher risk of death/mechanical ventilation/ICU admission with zinc levels <79µg/dL, without statistical significance.
May 11
Kyagambiddwa et al., Infection and Drug Resistance, doi:10.2147/idr.s405256 Thirty-Day Outcomes of Young and Middle-Aged Adults Admitted with Severe COVID-19 in Uganda: A Retrospective Cohort Study
25% lower mortality (p=0.28). Retrospective 246 severe COVID-19 patients in Uganda, showing lower mortality with zinc treatment in unadjusted results, without statistical significance.
May 3
Abuhelwa, Z., Translation: The University of Toledo Journal of Medical Sciences, doi:10.46570/utjms.vol11-2023-749 Do Zinc Supplements Reduce Mortality in Patients with COVID-19?
34% lower mortality (p<0.0001). Systematic review and meta analysis of 6 studies showing lower mortality with zinc treatment.
Apr 20
Fan et al., BioMetals, doi:10.1007/s10534-023-00501-0 Zinc and selenium status in coronavirus disease 2019
Meta analysis showing increased risk of COVID-19 with zinc deficiency and selenium deficiency. Zinc deficiency was also associated with severity, while there was no significant association for mortality.
Apr 19
Beheshti et al., Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2023.04.012 Correlation of vitamin D levels with serum parameters in Covid-19 patients
Retrospective 140 COVID-19 patients in Iran showing no significant difference in zinc levels between outpatients, hospitalized patients, and ICU patients.
Apr 18
Equey et al., Clinical Nutrition, doi:10.1016/j.clnu.2023.04.007 Association of plasma zinc levels with anti-SARS-CoV-2 IgG and IgA seropositivity in the general population: a case-control study
Case control study with 199 COVID-19 cases and 447 controls in Switzerland, showing lower zinc levels associated with higher SARS-CoV-2 IgG and IgA seropositivity.
Apr 1
Reino-Gelardo et al., Nutrients, doi:10.3390/nu15071736 Effect of an Immune-Boosting, Antioxidant and Anti-Inflammatory Food Supplement in Hospitalized COVID-19 Patients: A Prospective Randomized Pilot Study
61% lower mortality (p=0.05). RCT 162 late stage (65% on oxygen) patients in Spain, 78 treated with probiotics, prebiotics, vitamin D, zinc, and selenium, showing lower mortality with treatment, statistically significant only within the patients with high severity at ..
Apr 1
Abbas et al., Biochemical and Cellular Archives, 22:1 Effectiveness of Zinc and ROS on Testosterone Hormone Levels forRecovering COVID-19 Patients
Analysis of 70 recovered COVID-19 patients and 50 controls in Iraq, showing significantly lower zinc levels in COVID-19 patients.
Mar 31
Alfawaz et al., Heliyon, doi:10.1016/j.heliyon.2023.e15042 The relation between dietary zinc and immune status in saudi adults
Survey of 252 adults in Saudi Arabia, showing higher zinc intake associated with an improved immune status score.
Mar 21
Lahaye et al., Nutrients, doi:10.3390/nu15061516 Minerals and Antioxidant Micronutrients Levels and Clinical Outcome in Older Patients Hospitalized for COVID-19 during the First Wave of the Pandemic
28% lower mortality (p=0.26) and 53% lower severe cases (p=0.02). Retrospective 235 hospitalized COVID-19 patients in France, showing lower zinc levels associated with severe cases. Results are provided for zinc levels as a continuous value.
Mar 21
Asoudeh et al., Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2023.03.013 The association between dietary intakes of zinc, vitamin C and COVID-19 severity and related symptoms: A cross-sectional study
57% lower severe cases (p=0.03). Retrospective 250 recovered COVID-19 patients, showing lower risk of severe cases with higher zinc intake.
Mar 21
Young et al., Research Square, doi:10.21203/ Novel Protocol Using a Comprehensive Training ‘N’ Treatment (TNT) Approach Rapidly Reverses Olfactory and Gustatory Dysfunction in Patients with Acute Loss of Taste and Smell Induced by SARS-CoV-2 Infection
Retrospective 5 patients in the USA, showing 100% recovery of post-COVID-19 taste and smell disorders with a treatment protocol including zinc, vitamin A, B-complex, vitamin D, and alpha lipoic acid in addition to saline nasal irrigation,..
Mar 15
Schloss et al., Inflammopharmacology, doi:10.1007/s10787-023-01183-3 Nutritional deficiencies that may predispose to long COVID
Review of 22 nutritional factors that have been linked to COVID-19 outcomes, the role of nutrients in COVID-19 infection, and the prevalence of multiple nutritional deficiencies in the population.
Mar 4
Ibrahim Alhajjaji et al., Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2023.02.011 Effect of zinc supplementation on symptom reduction and length of hospital stay among pediatric patients with Coronavirus Disease 2019 (COVID-19)
88% lower mortality (p=0.13), 26% lower ventilation (p=0.75), 3% lower ICU admission (p=1), and 73% lower progression (p=0.004). Retrospective 101 hospitalized pediatric patients in Saudi Arabia, showing zinc treatment associated with lower respiratory failure and shorter hospitalization in unadjusted results. Patients receiving zinc were older. Authors note elevat..
Feb 28
Boukef et al., NCT05670444 Melatonin, Vitamins and Minerals Supplements for the Treatment of Covid-19 and Covid-like Illness: Results of a Prospective, Randomised, Double-blinded Multicentre Study
150 patient zinc early treatment RCT with results not reported over 9 months after completion.
Feb 15
Xie et al., Critical Reviews in Food Science and Nutrition, doi:10.1080/10408398.2023.2174948 Micronutrient perspective on COVID-19: Umbrella review and reanalysis of meta-analyses
Systematic review and meta analysis of micronutrient supplementation, showing zinc supplementation associated with lower mortality. Note that forest plots have OR>1 favoring supplementation.
Feb 2
Arora et al., Nutrients, doi:10.3390/nu15030771 Global Dietary and Herbal Supplement Use during COVID-19—A Scoping Review
Review of 14 global studies showing that the most frequently used dietary supplements during COVID-19 were vitamin C, vitamin D, zinc, and multivitamins. The most common reason was for improved immune system functioning or reduced COVID-1..
Jan 30
Sallam et al., Journal of Food and Nutrition Research, doi:10.12691/jfnr-11-1-10 Dietary Supplement Use among Children Whose Parents Work at National Research Centre: A Pilot Study
Survey of dietary supplementation showing high usage, and greater use by more highly educated people. The survey covered 200 children whose parents were employees of a research center in Egypt, showing 50% prevalence of supplementation du..
Jan 16
Viglione et al., The Gazette of Medical Sciences, doi:10.46766/thegms.pubheal.22120905 Intravenous high dose vitamin C and ozonated saline effective treatment for Covid -19: The Evolution of Local Standard of Care
Retrospective 479 high risk outpatients in the USA treated with a protocol including intravenous vitamin C, vitamin D, zinc, quercetin, bromelain, lactoferrin, HCQ, ivermectin, ozonated saline, azithromycin, ceftriaxone, methylprednisolon..
Jan 10
Almasaud et al., Nutrients, doi:10.3390/nu15020340 Association of Serum Zinc and Inflammatory Markers with the Severity of COVID-19 Infection in Adult Patients
Prospective study of 123 COVID+ patients and 48 controls, showing significantly lower zinc levels in COVID-19 patients, and a negative correlation between zinc levels and COVID-19 severity. Moderate and severe cases were significantly old..
Jan 3
Ram et al., Research Square, doi:10.21203/ Analysis of trace elements (Zn and Cu) levels in COVID-19 patients with ICU and Non-ICU hospitalization
Prospective analysis of 122 hospitalized COVID-19 patients, showing significantly lower zinc levels in ICU patients compared with non-ICU patients. Zinc levels were lower in non-survivors compared with survivors, without statistical signi..
Nov 28
Demircan et al., Frontiers in Immunology, doi:10.3389/fimmu.2022.1022673 Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe
Retrospective 551 COVID-19 patients in Europe, showing an inverse association between selenium or zinc levels and mortality.
Nov 26
Sharif et al., Nutrients, doi:10.3390/nu14235029 Impact of Zinc, Vitamins C and D on Disease Prognosis among Patients with COVID-19 in Bangladesh: A Cross-Sectional Study
40% lower severe cases (p=0.0001). Retrospective 962 COVID-19 patients in Bangladesh, showing significantly lower severity with vitamin C, vitamin D, and zinc supplementation, and improved results from the combination of all three.
Nov 4
Abdallah et al., Clinical Infectious Diseases, doi:10.1093/cid/ciac807 Twice daily oral zinc in the treatment of patients with Coronavirus Disease-19: A randomized double-blind controlled trial
30% lower mortality (p=0.27), 38% lower combined mortality/ICU admission (p=0.04), 54% lower ICU admission (p=0.01), and 42% lower need for oxygen therapy (p=0.009). RCT 470 patients with symptoms ≤7 days, showing significantly lower ICU admission and combined mortality/ICU admission with zinc treatment. Greater benefit was seen for patients treated within 3 days. 25mg elemental zinc bid for 15 days. ..
Nov 3
Olczak-Pruc et al., Annals of Agricultural and Environmental Medicine, doi:10.26444/aaem/155846 The effect of zinc supplementation on the course of COVID-19 – A systematic review and meta-analysis
39% lower mortality (p=0.08). Systematic review and meta analysis of 9 zinc studies, showing significantly lower in-hospital mortality with treatment.
Oct 31
Maradi et al., Reports of Biochemistry & Molecular Biology, 11:3 Importance of Microminerals for Maintaining Antioxidant Function After COVID-19-induced Oxidative Stress
Retrospective 100 COVID-19 patients and 100 healthy controls in India, showing significantly lower zinc levels in COVID-19 patients.
Oct 30
Adrean et al., Cureus, doi:10.7759/cureus.30881 Does Prophylactic Oral Zinc Reduce the Risk of Contracting COVID-19?
12% more cases (p=0.58). Retrospective 8,426 patients in the USA, showing no significant difference in cases with zinc prophylaxis. Severity results were not reported due to the small number of events.
Oct 19
Doocy et al., PLOS Global Public Health, doi:10.1371/journal.pgph.0000924 Clinical progression and outcomes of patients hospitalized with COVID-19 in humanitarian settings: A prospective cohort study in South Sudan and Eastern Democratic Republic of the Congo
41% lower mortality (p=0.41). Prospective study of 144 hospitalized COVID-19 patients in the DRC and South Sudan, showing lower mortality with zinc treatment, without statistical significance.
Oct 18
Cosentino et al., Journal of Clinical Medicine, doi:10.3390/jcm11206138 Early Outpatient Treatment of COVID-19: A Retrospective Analysis of 392 Cases in Italy
Retrospective 392 outpatients in Italy showing 0.2% mortality with early treatment, compared with >3% in Italy at the time. Treatment varied for individual patients and included HCQ, vitamin D, vitamin C, vitamin A, zinc, quercetin, bromh..
Oct 7
Jabbar et al., Journal of Pharmaceutical Negative Results, doi:10.47750/pnr.2022.13.04.044 Assessment of Some Physiological Parameters and Trace Elements in Covid 19 Patients, Iraq
Analysis of 100 COVID-19 and 100 healthy patients in Iraq, showing significantly lower zinc levels for COVID-19 patients.
Sep 24
Mansour et al., The Egyptian Journal of Internal Medicine, doi:10.1186/s43162-022-00159-z Association of serum zinc level and clinical outcome in Egyptian COVID-19 patients
Retrospective 30 ICU patients and 30 non-ICU hospitalized patients in Egypt, showing lower zinc levels in ICU patients. All patients received zinc supplementation.
Sep 19
Mosadegh et al., Microbial Pathogenesis, doi:10.1016/j.micpath.2022.105792 The effect of Nutrition Bio-shield superfood (NBS) on disease severity and laboratory biomarkers in patients with COVID-19: A randomized clinical trial
61% lower mortality (p=0.002) and 28% shorter hospitalization (p=0.001). RCT 70 hospitalized severe COVID-19 patients in Iran, showing lower mortality and improved clinical markers with treatment combining vitamins A, B1–B3, B5, B6, B9, C, D, K, and magnesium, potassium, phosphorus, sulfur, manganese, calcium,..
Sep 2
Foshati et al., Food Science & Nutrition, doi:10.1002/fsn3.3034 Antioxidants and clinical outcomes of patients with coronavirus disease 2019: A systematic review of observational and interventional studies
Systematic review showing that vitamin C, vitamin D, selenium, and zinc can improve COVID-19 clinical outcomes.
Aug 24
Bayraktar et al., Biological Trace Element Research, doi:10.1007/s12011-022-03400-6 Evaluation of the Relationship Between Aquaporin-1, Hepcidin, Zinc, Copper, and İron Levels and Oxidative Stress in the Serum of Critically Ill Patients with COVID-19
Analysis of 45 COVID-19 ICU patients and 45 healthy controls, showing significantly lower zinc levels in COVID-19 patients.
Aug 23
Mahmoud et al., International journal of health sciences, doi:10.53730/ijhs.v6nS5.12091 Relationship of contactin-1 with a number of trace elements in Iraqi rheumatoid arthritis patients with and without COVID-19
Retrospective 56 rheumatoid arthritis patients, 28 with COVID-19, showing lower zinc levels in COVID-19 patients.
Aug 9
Kladnik et al., Journal of Enzyme Inhibition and Medicinal Chemistry, doi:10.1080/14756366.2022.2108417 Zinc pyrithione is a potent inhibitor of PLPro and cathepsin L enzymes with ex vivo inhibition of SARS-CoV-2 entry and replication
Ex Vivo study showing zinc pyrithione to be a potent inhibitor of SARS-CoV-2 entry and replication.
Aug 9
Vásquez-Procopio et al., Frontiers in Cell and Developmental Biology, doi:10.3389/fcell.2022.935363 Inflammatory-Metal Profile as a Hallmark for COVID-19 Severity During Pregnancy
Prospective study of 163 COVID+ and 34 COVID- pregnant women in Mexico, showing significantly lower zinc levels in patients with severe COVID-19.
Aug 4
Doğan et al., Journal of Tropical Pediatrics, doi:10.1093/tropej/fmac072 The Clinical Significance of Vitamin D and Zinc Levels with Respect to Immune Response in COVID-19 Positive Children
77% fewer cases (p=0.003). Prospective study of 88 pediatric COVID-19 patients and 88 healthy controls, showing significantly lower zinc and vitamin D levels in COVID-19 patients.
Aug 4
Bego et al., Journal of Trace Elements in Medicine and Biology, doi:10.1016/j.jtemb.2022.127055 Association of Trace Element Status in COVID-19 Patients with Disease Severity
Analysis of 210 hospitalized patients in Bosnia and Herzegovina with serum levels measured on admission, showing significantly lower zinc and selenium levels in patients that died or had severe cases, compared to mild cases.
Jul 25
Balmforth et al., Journal of Clinical Virology, doi:10.1016/j.jcv.2022.105248 Evaluating the efficacy and safety of a novel prophylactic nasal spray in the prevention of SARS-CoV-2 infection: A multi-centre, double blind, placebo-controlled, randomised trial.
47% fewer symptomatic cases (p<0.0001) and 63% lower IgG positivity (p<0.0001). 648 patient RCT pHOXWELL nasal spray in India, showing significantly lower IgGS+ and significantly lower symptomatic cases with treatment. pHOXWELL includes a combination of natural virucidal agents and is designed to mimic the fluid surr..
Jun 27
Alahmari et al., Healthcare, doi:10.3390/healthcare10071201 Factors Associated with Length of Hospital Stay among COVID-19 Patients in Saudi Arabia: A Retrospective Study during the First Pandemic Wave
30% shorter hospitalization (p<0.0001). Retrospective 977 hospitalized patients in Saudi Arabia, showing significantly shorter hospitalization with zinc treatment.
Jun 17
Stambouli et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.06.016 COVID-19 prophylaxis with Doxycycline and Zinc in Health Care Workers: A prospective randomized double-blind clinical tria
68% fewer symptomatic cases (p=0.36), 5% fewer cases (p=1), and 21% improved viral load (p<0.0001). Prophylaxis RCT with 59 zinc + doxycycline, 56 doxycycline, and 57 placebo healthcare workers, showing lower symptomatic cases and significantly improved Ct values with the addition of zinc to doxycycline treatment. Doxycycline 100mg/day ..
May 31
Abdulla et al., Archives of Razi Institute, doi:10.22092/ARI.2022.358363.2208 Haematological parameters in COVID-19 patients: association with severity of the disease
Retrospective 76 COVID-19 patients in Iraq, showing no significant difference in zinc levels based on severity.
May 30
Kumar et al., Cureus, doi:10.7759/cureus.25467 Efficacy and Safety of Aspirin, Promethazine, and Micronutrients for Rapid Clinical Recovery in Mild to Moderate COVID-19 Patients: A Randomized Controlled Clinical Trial
89% improved recovery (p=0.05). RCT 260 patients in India, 130 treated with aspirin, promethazine, vitamin C, D, B3, zinc, and selenium, showing faster recovery with treatment. There was no hospitalization, ICU admission, or supplemental oxygen requirements in either gr..
May 27
Galmés et al., Nutrients, doi:10.3390/nu14112254 Suboptimal Consumption of Relevant Immune System Micronutrients Is Associated with a Worse Impact of COVID-19 in Spanish Populations
Ecological study in Spain, showing lower intake of vitamin D, A, B9, and zinc in regions with the highest COVID-19 incidence and mortality. Vitamin D intake was associated with lower prevalence, incidence, and a combined incidence+mortali..
May 25
Güerri-Fernández et al., NCT05778383 Zinc-based Nutritional Immunity to Lower Inflammation, Viral Load and COVID-19 Mortality During SARS-CoV-2 Infection.
75 patient zinc late treatment RCT with results not reported over 1.5 years after completion.
May 23
Tabatabaeizadeh, S., European Journal of Medical Research, doi:10.1186/s40001-022-00694-z Zinc supplementation and COVID-19 mortality: a meta-analysis
43% lower mortality (p=0.0002). Meta analysis of five zinc treatment studies for COVID-19, showing significantly lower mortality.
May 13
Zangeneh et al., Obesity Medicine, doi:10.1016/j.obmed.2022.100420 Survival analysis based on body mass index in patients with Covid-19 admitted to the intensive care unit of Amir Al-Momenin Hospital in Arak – 2021
21% higher mortality (p=0.66). Retrospective 193 ICU patients in Iran, showing no significant difference with zinc treatment.
Apr 30
Voelkle et al., Nutrients, doi:10.3390/nu14091862 Prevalence of Micronutrient Deficiencies in Patients Hospitalized with COVID-19: An Observational Cohort Study
77% lower combined mortality/ICU admission (p=0.007). Prospective study of 57 consecutive hospitalized COVID-19 patients in Switzerland, showing higher risk of mortality/ICU admission with vitamin A, vitamin D, and zinc deficiency, with statistical significance only for vitamin A and zinc. A..
Mar 31
Arora et al., Journal of Infection, doi:10.1016/j.jinf.2021.12.039 Risk factors for Coronavirus disease-associated mucormycosis
95% lower progression (p<0.0001). Retrospective 152 COVID-associated mucormycosis cases and 200 controls, showing lower risk of COVID-associated mucormycosis with zinc treatment.
Mar 30
Citu et al., Nutrients, doi:10.3390/nu14071445 Calcium, Magnesium, and Zinc Supplementation during Pregnancy: The Additive Value of Micronutrients on Maternal Immune Response after SARS-CoV-2 Infection
18% lower severe cases (p=1). Retrospective 448 pregnant women with COVID-19. Patients with calcium, zinc, and magnesium supplementation, or magnesium only, had a significantly higher titer of SARS-CoV-2 anti-RBD antibodies. There was no statistically significant diff..
Mar 28
Maares et al., Nutrients, doi:10.3390/nu14071407 Free Zinc as a Predictive Marker for COVID-19 Mortality Risk
Analysis of 33 COVID-19 patients and 86 control patients in Germany, showing lower free serum zinc levels associated with COVID-19 and mortality.
Mar 23
Ghanei et al., European Journal of Clinical Nutrition, doi:10.1038/s41430-022-01095-5 Low serum levels of zinc and 25-hydroxyvitmain D as potential risk factors for COVID-19 susceptibility: a pilot case-control study
Case control study with 90 COVID-19 cases and 95 matched controls in Iran, showing significantly lower zinc levels for cases.
Mar 10
DiGuilio et al., International Journal of Molecular Sciences, doi:10.3390/ijms23062995 Micronutrient Improvement of Epithelial Barrier Function in Various Disease States: A Case for Adjuvant Therapy
Review of epithelial and endothelial barrier compromise and associated disease risk including COVID-19, and the potential benefits of vitamin A, vitamin D, and zinc for improving barrier function.
Feb 28
Shehab et al., Tropical Journal of Pharmaceutical Research, doi:10.4314/tjpr.v21i2.13 Immune-boosting effect of natural remedies and supplements on progress of, and recovery from COVID-19 infection
47% lower severe cases (p=0.24). Retrospective survey-based analysis of 349 COVID-19 patients, showing a lower risk of severe cases with vitamin D, zinc, turmeric, and honey prophylaxis in unadjusted analysis, without statistical significance. REC/UG/2020/03.
Feb 28
Nimer et al., Bosnian Journal of Basic Medical Sciences, doi:10.17305/bjbms.2021.7009 The impact of vitamin and mineral supplements usage prior to COVID-19 infection on disease severity and hospitalization
25% higher hospitalization (p=0.21) and 13% higher severe cases (p=0.46). Retrospective 2,148 COVID-19 recovered patients in Jordan, showing no significant differences in the risk of severity and hospitalization with zinc prophylaxis.
Feb 26
Hajdrik et al., Foods, doi:10.3390/foods11050694 In Vitro Determination of Inhibitory Effects of Humic Substances Complexing Zn and Se on SARS-CoV-2 Virus Replication
In Vitro study of a humic substance containing vitamin C, selemium ions, and zinc ions, showing 50% SARS-CoV-2 inhibition at picomolar concentrations.
Feb 24
Kory et al., Journal of Clinical Medicine Research, doi:10.14740/jocmr4658 “MATH+” Multi-Modal Hospital Treatment Protocol for COVID-19 Infection: Clinical and Scientific Rationale
Review of the data supporting the MATH+ hospital treatment protocol for COVID-19.
Feb 23
Kumar et al., Cureus, doi:10.7759/cureus.22528 Role of Zinc and Clinicopathological Factors for COVID-19-Associated Mucormycosis (CAM) in a Rural Hospital of Central India: A Case-Control Study
20% lower mortality (p=0.71). Case control study of 105 COVID-19 patients in India, 55 with mucormycosis and 50 without, showing zinc prophylaxis and diabetes both associated with mucormycosis in unadjusted results. This is likely confounded because zinc supplementati..
Feb 12
Nedić et al., JBIC Journal of Biological Inorganic Chemistry, doi:10.1007/s00775-022-01931-w Major trace elements and their binding proteins in the early phase of Covid-19 infection
Analysis of 60 COVID-19 patients and 60 matched controls, showing higher zinc levels in COVID-19 patients. The concentration of zinc was close to the lower reference limit in healthy people, and above the reference limit in 20 out of 60 C..
Feb 8
Ivanova et al., Journal of Trace Elements in Medicine and Biology, doi:10.1016/j.jtemb.2022.126944 Evaluation of zinc, copper, and Cu:Zn ratio in serum, and their implications in the course of COVID-19
Retrospective 75 COVID-19 hospitalized patients and 68 healthy controls in Bulgaria, showing mortality associated with lower zinc levels.
Jan 30
Chen et al., Environmental Geochemistry and Health, doi:10.1007/s10653-022-01204-0 Geographical distribution of trace elements (selenium, zinc, iron, copper) and case fatality rate of COVID-19: a national analysis across conterminous USA
Analysis of the geographical association between concentrations of selenium, zinc, iron, and copper in surface soils and COVID-19 case fatality rates, showing low zinc levels associated with higher case fatality rates.
Jan 29
Mohajeri et al., Mediterranean Journal of Nutrition and Metabolism, doi:10.3233/MNM-211521 The difference in the dietary inflammatory index, functional food, and antioxidants intake between COVID-19 patients and healthy persons
Retrospective dietary survey analysis of 500 COVID-19 patients and 500 healthy matched controls in Iran, showing that COVID-19 patients had lower daily consumption of vitamin C, vitamin D, vitamin E, zinc, and selenium. IR.ARUMS.REC.1400...
Jan 22
PVSN et al., Biological Trace Element Research, doi:10.1007/s12011-022-03124-7 Comparative Analysis of Serum Zinc, Copper and Magnesium Level and Their Relations in Association with Severity and Mortality in SARS-CoV-2 Patients
Analysis of 150 COVID+ hospitalized patients in India, showing lower zinc levels associated with higher severity.
Jan 22
Ekemen Keleş et al., European Journal of Pediatrics, doi:10.1007/s00431-021-04348-w Serum zinc levels in pediatric patients with COVID-19
75% lower hospitalization (p=0.01). Prospective study of 100 COVID+ pediatric patients in Turkey, showing significantly increased risk of hospitalization for patients with zinc deficiency.
Jan 7
Al-Saleh et al., BioMetals, doi:10.1007/s10534-021-00355-48 Essential metals, vitamins and antioxidant enzyme activities in COVID-19 patients and their potential associations with the disease severity
Prospective study of 155 COVID-19 patients in Saudi Arabia, showing that 25% of patients were zinc deficient (<0.693 μg/mL). There were no significant differences in zinc levels between the asymptomatic, mild, moderate and severe COVID-19..
Dec 16
Mayberry et al., Critical Care Medicine, doi:10.1097/01.ccm.0000807104.82650.d6 Zinc use is associated with improved outcomes in COVID-19: results from the CRUSH-COVID registry
53% lower mortality (p<0.0001), 64% lower ventilation (p<0.0001), 60% lower ICU admission (p<0.0001), and 58% lower combined mortality/ICU admission (p<0.0001). Retrospective 2,028 COVID patients in the USA, showing significantly lower mortality, ventilation, ICU admission, and progression to ARDS with zinc use, defined as at least one dose from one week prior to admission to 48 hours after admis..
Dec 13
Gordon et al., Frontiers in Medicine, doi:10.3389/fmed.2021.756707 A Case-Control Study for the Effectiveness of Oral Zinc in the Prevention and Mitigation of COVID-19
85% fewer symptomatic cases (p=0.02). Prospective study of zinc supplementation with 104 patients randomized to receive 10mg, 25mg, or 50mg of zinc picolinate daily, and a matched sample of 96 control patients from the adjacent clinic that did not routinely recommend/use zinc..
Nov 15
Ramos et al., Global Journal of Health Science, doi:10.5539/gjhs.v14n1p1 Vitamin D, Zinc and Iron in Adult Patients with Covid-19 and Their Action in the Immune Response as Biomarkers
24% fewer cases (p=0.64). Retrospective 13 COVID-19 patients and 7 controls in Brazil, showing no significant difference in zinc deficiency.
Oct 30
Correa et al., NCT04902976 Evaluation of SARS-COV-2 Viral Load of Covid-19 Patients After Rinsing With Oral Antimicrobial Mouthwashes
105 patient zinc late treatment RCT with results not reported over 2 years after completion.
Oct 25
Leal-Martínez et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph19031172 (date from preprint) Effect of a Nutritional Support System to Increase Survival and Reduce Mortality in Patients with COVID-19 in Stage III and Comorbidities: A Blinded Randomized Controlled Clinical Trial
86% lower mortality (p=0.03) and 57% lower ventilation (p=0.31). 80 patient RCT with 40 patients treated with a comprehensive regimen of nutritional support, showing significantly lower mortality with treatment. Treatment contained cholecalciferol, vitamin C, zinc, spirulina maxima, folic acid, glutami..
Oct 12
Worcel et al., Annals of Palliative Medicine, doi:10.21037/apm-21-1707 Low mortality from COVID-19 at a nursing facility in France following a combined preventive and active treatment protocol
Report on the relatively low mortality and relatively mild COVID-19 symptoms at a French nursing facility that has adopted several treatments including vitamin D, zinc, anticoagulants, corticosteroids, and a multivitamin.
Oct 11
Majeed et al., Evidence-Based Complementary and Alternative Medicine, doi:10.1155/2021/8447545 A Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy and Safety of a Nutritional Supplement (ImmuActive) for COVID-19 Patients
43% improved recovery (p=0.004) and 6% faster viral clearance (p=0.47). RCT 100 patients in India, 50 treated with ImmuActive (curcumin, andrographolides, resveratrol, zinc, selenium, and piperine), showing improved recovery with treatment.
Oct 4
Kocak et al., Biological Trace Element Research, doi:10.1007/s12011-021-02946-1 Evaluation of Serum Trace Element Levels and Biochemical Parameters of COVID-19 Patients According to Disease Severity
Analysis of 60 COVID-19 patients and 32 healthy controls, showing that zinc and selenium levels were significantly lower in COVID-19 patients compared to controls. Zinc levels decreased with increasing disease severity from asymptomatic t..
Oct 1
Kaplan et al., SSRN, 10.2139/ssrn.3934228 Resveratrol and Zinc in the Treatment of Outpatients With COVID-19 – The Reszinate Study - A Phase 1/2 Randomized Clinical Trial Utilizing Home Patient-Obtained Nasal and Saliva Viral Sampling
14% higher ventilation (p=1), 14% higher ICU admission (p=1), and 14% higher hospitalization (p=1). Small RCT of zinc plus resveratrol in COVID-19+ outpatients, showing no significant differences in viral clearance or symptoms. Although the treatment group was older (46.3 vs. 38.5) and had more severe baseline symptoms, they had similar..
Sep 22
Du Laing et al., Nutrients, doi:10.3390/nu13103304 Course and Survival of COVID-19 Patients with Comorbidities in Relation to the Trace Element Status at Hospital Admission
79% lower mortality (p=0.01). Retrospective 73 hospitalized COVID-19 patients in Belgium, showing higher risk of mortality with selenium deficiency and zinc deficiency.
Sep 17
Singh et al., Frontiers in Immunology, doi:10.3389/fimmu.2021.699389 Nutritional Immunity, Zinc Sufficiency, and COVID-19 Mortality in Socially Similar European Populations
Analysis of zinc sufficiency showing a positive correlation between sufficiency and COVID-19 within European countries. Unmeasured confounders are likely to be significant, for example the higher sufficiency countries also have significan..
Sep 3
Razeghi Jahromi et al., BMC Infectious Diseases, doi:10.1186/s12879-021-06617-3 The correlation between serum selenium, zinc, and COVID-19 severity: an observational study
Prospective analysis of 84 patients in Iran, showing higher selenium and zinc levels associated with a decrease in serum CRP level. There was no statistically significant association between selenium/zinc levels and disease severity.
Sep 1
Sharmin et al., NCT04558424 Randomized, Double -Blind, Placebo Controlled, Trial to Evaluate the Effect of Zinc and Ascorbic Acid Supplementation in COVID-19 Positive Hospitalized Patients in BSMMU
Estimated 50 patient zinc late treatment RCT with results not reported over 2 years after estimated completion.
Sep 1
Bagheri et al., Journal of Family & Reproductive Health, doi:10.18502/jfrh.v14i3.4668 Supplement Usage Pattern in a Group of COVID-19 Patients in Tehran
60% lower severe cases (p=0.41) and 41% lower hospitalization (p=0.37). Retrospective 510 patients in Iran, showing lower risk of severity with vitamin D (statistically significant) and zinc (not statistically significant) supplementation. IR.TUMS.VCR.REC.1398.1063.
Aug 31
Arrieta et al., Nutrition, doi:10.1016/j.nut.2021.111467 Serum zinc and copper in people with COVID-19 and zinc supplementation in parenteral nutrition
Retrospective 35 COVID-19 patients on parenteral nutrition on Spain, showing serum zinc levels inversely associated with length of hospital stay. There was no significant association between zinc and mortality (p>0.1, actual results are n..
Aug 28
Assiri et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.030 COVID-19 related treatment and outcomes among COVID-19 ICU patients: A retrospective cohort study
81% higher mortality (p=0.44). Retrospective 118 ICU patients in Saudi Arabia showing no significant differences in unadjusted results with zinc, vitamin D, and favipiravir treatment.
Aug 26
Golabi et al., Nutrients, doi:10.3390/nu13103368 (date from preprint) The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study
Analysis of vitamin D and zinc levels in 53 PCR+ outpatients and 53 matched controls, showing lower zinc levels in COVID-19 patients, and increased risk of cases and symptoms with vitamin D deficiency. There was no significant difference ..
Aug 25
Bagher Pour et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.08.053 Serum trace elements levels and clinical outcomes among Iranian COVID-19 patients
Prospective analysis of 114 ICU patients and 112 matched non-ICU patients in Iran, showing mortality associated with lower zinc levels. There was no significant difference in zinc levels between ICU and non-ICU patients. IR.TBZMED.REC.139..
Aug 18
Shakeri et al., Journal of Medical Virology, doi:10.1002/jmv.27277 Evaluation of the relationship between serum levels of zinc, vitamin B12, vitamin D, and clinical outcomes in patients with COVID-19
Retrospective 293 hospitalized patients in Iran showing lower levels of zinc, vitamin B12, and vitamin D in patients that died, with statistical significance reached only for zinc.
Aug 17
Capone et al., Cureus, doi:10.7759/cureus.9809 Characterization of Critically Ill COVID-19 Patients at a Brooklyn Safety-Net Hospital
Retrospective 102 ICU patients in the USA, 73 receiving vitamin C and zinc, showing a negative correlation of treatment with mortality, but not reaching statistical significance (p = 0.31).
Aug 12
Elavarasi et al., medRxiv, doi:10.1101/2021.08.10.21261855 Clinical features, demography and predictors of outcomes of SARS-CoV-2 infection in a tertiary care hospital in India - a cohort study
65% lower mortality (p<0.0001). Retrospective 2017 hospitalized patients in India, showing lower mortality with zinc treatment.
Aug 4
Hosseini et al., Infectious Diseases in Clinical Practice, doi:10.1097/IPC.0000000000001051 Comparing Serum Levels of Vitamin D and Zinc in Novel Coronavirus–Infected Patients and Healthy Individuals in Northeastern Iran, 2020
Analysis of 56 COVID-19 patients and 46 healthy control patients in Iran. Severe cases had lower levels of zinc compared with non-severe cases and healthy controls.
Jul 27
Israel et al., Epidemiology and Global Health Microbiology and Infectious Disease, doi:10.7554/eLife.68165 Identification of drugs associated with reduced severity of COVID-19: A case-control study in a large population
100% lower hospitalization (p=0.04). Case control study examining medication usage with a healthcare database in Israel, showing lower risk of hospitalization with calcium + zinc supplements (defined as being picked up within 35 days prior to PCR+), however only 10 patients ..
Jul 9
Rabail et al., Food Science & Nutrition, doi:10.1002/fsn3.2458 Nutritional and lifestyle changes required for minimizing the recovery period in home quarantined COVID-19 patients of Punjab, Pakistan
Survey of 80 recovered COVID-19 patients in Pakistan, showing faster recovery with vitamin C, vitamin D, and zinc supplementation.
Jul 6
Margolin et al., Journal of Evidence-Based Integrative Medicine, doi:10.1177/2515690X211026193 20-Week Study of Clinical Outcomes of Over-the-Counter COVID-19 Prophylaxis and Treatment
94% fewer cases (p=0.003). Retrospective 113 outpatients, 53 (patient choice) treated with zinc, quercetin, vitamin C/D/E, l-lysine, and quina, showing lower cases with treatment. Results are subject to selection bias and limited information on the groups is provid..
Jun 24
Beigmohammadi et al., Nutrition, doi:10.1016/j.nut.2021.111400 The association between serum levels of micronutrients and the severity of disease in patients with COVID-19
Retrospective 60 ICU patients in Iran, showing that lower levels of vitamin D, magnesium, and zinc were significantly associated with higher APACHE scores (P = 0.001, 0.028, and <0.001, respectively) and higher lung involvement (P = 0.002..
Jun 20
Notz et al., Nutrients, doi:10.3390/nu13062113 Clinical Significance of Micronutrient Supplementation in Critically Ill COVID-19 Patients with Severe ARDS
Retrospective 22 ICU patients, showing most patients had low selenium status biomarkers and low zinc levels, and reporting on treatment with nutrient supplementation including selenium and zinc. Authors conclude that sufficient selenium a..
Jun 15
Panchariya et al., Chemical Communications, doi:10.1039/D1CC03563K Zinc2+ ion inhibits SARS-CoV-2 main protease and viral replication in vitro
In Silico and In Vitro study showing that ionic zinc inhibits SARS-CoV-2 main protease (Mpro) and inhibits viral replication. Zinc acetate inhibited viral replication in Vero E6 cells, while zinc glycinate and zinc gluconate did not at no..
Jun 12
Verschelden et al., medRxiv, doi:10.1101/2021.06.09.21258271 Plasma zinc status and hyperinflammatory syndrome in hospitalized COVID-19 patients: an observational study
Prospective study of 139 hospitalized COVID-19 patients, showing 96% had zinc deficiency. Higher zinc levels were associated with a shorter length of hospitalization. Mortality and ventilation was lower with higher zinc levels, but not re..
Jun 7
Al Sulaiman et al., Critical Care, doi:10.1186/s13054-021-03785-1 (date from preprint) Evaluation of Zinc Sulfate as an Adjunctive Therapy in COVID-19 Critically Ill Patients: a Two Center Propensity-score Matched Study
36% lower mortality (p=0.11), 25% longer ICU admission (p=0.28), and 6% longer hospitalization (p=0.61). Retrospective 266 ICU patients showing lower mortality with zinc treatment (very close to statistical significance), and higher odds of acute kidney injury. NRC21R/287/07.
May 22
Asimi et al., Endocrine Abstracts, doi:10.1530/endoabs.73.PEP14.2 Selenium, zinc, and vitamin D supplementation affect the clinical course of COVID-19 infection in Hashimoto’s thyroiditis
97% lower ventilation (p<0.0001), 99% lower hospitalization (p<0.0001), and 100% lower severe cases (p<0.0001). Retrospective 356 Hashimoto's thyroiditis outpatients, 270 taking vitamin D, zinc, and selenium, showing significantly lower hospitalization with treatment. Authors adjust for age, gender, BMI, and smoking status, reporting statistically ..
May 11
Aldwihi et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph18105086 Patients’ Behavior Regarding Dietary or Herbal Supplements before and during COVID-19 in Saudi Arabia
24% lower hospitalization (p=0.16). Retrospective survey-based analysis of 738 COVID-19 patients in Saudi Arabia, showing lower hospitalization with vitamin C, turmeric, zinc, and nigella sativa, and higher hospitalization with vitamin D. For vitamin D, most patients contin..
May 3
Fromonot et al., Clinical Nutrition, doi:10.1016/j.clnu.2021.04.042 Hypozincemia in the early stage of COVID-19 is associated with an increased risk of severe COVID-19
89% lower hospitalization (p=0.002) and 28% fewer cases (p=0.003). Analysis of 240 consecutive patients in France, showing significantly higher zinc deficiency in COVID-19 patients, and significantly greater risk of hospitalization for COVID-19 patients with zinc deficiency. 2020PI087.
Apr 18
Elham et al., Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2021.03.040 Serum vitamin D, calcium, and zinc levels in patients with COVID-19
Case control study with 93 hospitalized patients in Iran and 186 control patients, showing significantly lower vitamin D, zinc, and calcium levels in cases. IR.SHOUSHTAR.REC.1399.017.
Apr 15
Skalny et al., Metabolites, doi:10.3390/metabo11040244 Serum Zinc, Copper, and Other Biometals Are Associated with COVID-19 Severity Markers
Analysis of serum metal levels in 150 COVID-19 patients and 44 controls, finding that COVID-19 severity was associated with lower serum Ca, Fe, Se, Zn levels when compared to controls.
Apr 14
Seet et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.04.035 Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial
50% fewer symptomatic cases (p=0.0007) and 27% fewer cases (p=0.03). Prophylaxis RCT in Singapore with 3,037 low risk patients, showing lower serious cases, lower symptomatic cases, and lower confirmed cases of COVID-19 with all treatments (ivermectin, HCQ, PVP-I, and Zinc + vitamin C) compared to vitamin ..
Apr 8
Abdulateef et al., Open Medicine, doi:10.1515/med-2021-0273 COVID-19 severity in relation to sociodemographics and vitamin D use
13% lower hospitalization (p=0.83). Survey of 428 recovered COVID-19 patients in Iraq, showing fewer hospital visits for patients on prophylactic vitamin C or D. Hospitalization was lower for those on vitamin C, D, or zinc, without statistical significance.
Apr 8
Gadhiya et al., BMJ Open, doi:10.1136/bmjopen-2020-042549 Clinical characteristics of hospitalised patients with COVID-19 and the impact on mortality: a single-network, retrospective cohort study from Pennsylvania state
41% higher mortality (p=0.33). Retrospective 283 patients in the USA showing higher mortality with all treatments (not statistically significant). Confounding by indication is likely. In the supplementary appendix, authors note that the treatments were usually given fo..
Apr 7
Mulhem et al., BMJ Open, doi:10.1136/bmjopen-2020-042042 3219 hospitalised patients with COVID-19 in Southeast Michigan: a retrospective case cohort study
46% lower mortality (p<0.0001). Retrospective database analysis of 3,219 hospitalized patients in the USA. Very different results in the time period analysis (Table S2), and results significantly different to other studies for the same medications (e.g., heparin OR 3.06..
Mar 30
Holt et al., Thorax, doi:10.1136/thoraxjnl-2021-217487 Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK)
7% fewer cases (p=0.77). Prospective survey-based study with 15,227 people in the UK, showing lower risk of COVID-19 cases with vitamin A, vitamin D, zinc, selenium, probiotics, and inhaled corticosteroids; and higher risk with metformin and vitamin C. Statistica..
Feb 28
Bejan et al., Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.2376 (date from preprint) DrugWAS: Drug‐wide Association Studies for COVID‐19 Drug Repurposing
18% lower ventilation (p=0.78) and 30% lower ICU admission (p=0.6). Retrospective 9,748 COVID-19 patients in the USA showing lower ventilation and ICU admission with zinc prophylaxis, without statistical significance.
Feb 25
Patel et al., Journal of Medical Virology, doi:10.1002/jmv.26895 A pilot double-blind safety and feasibility randomized controlled trial of high-dose intravenous zinc in hospitalized COVID-19 patients
20% lower mortality (p=1). 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/da..
Feb 15
Mahto et al., American Journal of Blood Research, 11:1 Seroprevalence of IgG against SARS-CoV-2 and its determinants among healthcare workers of a COVID-19 dedicated hospital of India
37% lower IgG positivity (p=0.35). Retrospective 689 healthcare workers in India, showing no significant difference in IgG positivity with zinc prophylaxis.
Feb 13
Dubourg et al., Journal of Microbiology, Immunology and Infection, doi:10.1016/j.jmii.2021.01.012 Low blood zinc concentrations in patients with poor clinical outcome during SARS-CoV-2 infection: is there a need to supplement with Zinc COVID-19 patients?
Retrospective 275 patients showing zinc levels significantly lower in patients with poor outcomes, 840 vs. 970 µg/L, p< 0.0001.
Feb 12
Thomas et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.0369 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
44% higher hospitalization (p=0.72) and 12% faster recovery (p=0.38). 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 gl..
Feb 1
Muhammad et al., SAGE Open Medicine, doi:10.1177/2050312121991246 Deficiency of antioxidants and increased oxidative stress in COVID-19 patients: A cross-sectional comparative study in Jigawa, Northwestern Nigeria
Case control study with 50 symptomatic COVID-19 patients and 21 healthy controls in Nigeria, showing that COVID-19 patients had significantly lower levels of selenium and zinc, and vitamins A, C, and E. Control patients were younger than ..
Jan 7
Abdelmaksoud et al., Biological Trace Element Research, doi:10.1007/s12011-020-02546-5 Olfactory Disturbances as Presenting Manifestation Among Egyptian Patients with COVID-19: Possible Role of Zinc
134 COVID-19 patients, 49 treated with zinc, showing faster recovery of olfactory function in patients treated with zinc (median 7 vs. 18 days). There was no difference in overall recovery time. There were 4 deaths but authors do not indi..
Jan 7
Sethuram et al., Reproductive Sciences, doi:10.1007/s43032-020-00400-6 Potential Role of Zinc in the COVID-19 Disease Process and its Probable Impact on Reproduction
Review of zinc deficiency and supplementation for COVID-19, including potential impacts on reproductive health.
Jan 4
Joachimiak et al., PLOS Neglected Tropical Diseases, doi:10.1371/journal.pntd.0008895 Zinc against COVID-19? Symptom surveillance and deficiency risk groups
Literature review concluding that zinc should be included as part of preventative supplementation for COVID-19, in general for support of immune health, and should also be considered in the context of zinc deficiency acquired during a vir..
Jan 1
Alkattan et al., Alexandria Journal of Medicine, doi:10.1080/20905068.2020.1870788 Correlation between Micronutrient plasma concentration and disease severity in COVID-19 patients
Analysis of 80 hospitalized COVID-19 patients in Saudi Arabia, showing lower zinc levels for severe patients, without statistical significance.
Dec 30
McCullough et al., Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm.2020.04.264 Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19)
Review urging early treatment of COVID-19 with sequential multidrug treatment that has been shown to be safe and effective. Proposed treatment includes zinc, vitamin D & C, quercetin, and depending on age, comorbidities, and symptoms may ..
Dec 23
Gonçalves et al., Nutrition in Clinical Practice, doi:10.1002/ncp.10612 Association Between Low Zinc Levels and Severity of Acute Respiratory Distress Syndrome by New Coronavirus SARS-CoV-2
82% lower severe cases (p=0.001). Retrospective 169 ICU patients in Brazil, 214 with low zinc levels, showing an association between low zinc levels and severe ARDS. CAAE 30608,020.9.0000.8114.
Dec 15
Darban et al., Journal of Cellular & Molecular Anesthesia, doi:10.22037/jcma.v6i2.32182 Efficacy of High Dose Vitamin C, Melatonin and Zinc in Iranian Patients with Acute Respiratory Syndrome due to Coronavirus Infection: A Pilot Randomized Trial
33% lower progression (p=1) and 6% shorter ICU admission (p=0.3). Small RCT in Iran with 20 ICU patients, 10 treated with high-dose vitamin C, melatonin, and zinc, not showing significant differences.
Dec 10
Rosenthal et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2020.29058 Risk Factors Associated With In-Hospital Mortality in a US National Sample of Patients With COVID-19
16% higher mortality (p=0.003). Retrospective database analysis of 64,781 hospitalized patients in the USA, showing lower mortality with vitamin C or vitamin D (authors do not distinguish between the two), and higher mortality with zinc and HCQ, statistically significan..
Nov 30
Louca et al., BMJ Nutrition, Prevention & Health, doi:10.1136/bmjnph-2021-000250 (date from preprint) Modest effects of dietary supplements during the COVID-19 pandemic: insights from 445 850 users of the COVID-19 Symptom Study app
1% fewer cases (p=0.8). Survey analysis of dietary supplements showing no significant difference in PCR+ cases with zinc usage. These results are for PCR+ cases only, they do not reflect potential benefits for reducing the severity of cases. A number of biases c..
Nov 29
Abd-Elsalam et al., Biological Trace Element Research, doi:10.1007/s12011-020-02512-1 Do Zinc Supplements Enhance the Clinical Efficacy of Hydroxychloroquine?: a Randomized, Multicenter Trial
1% lower mortality (p=0.99), 34% lower ventilation (p=0.54), 6% improved recovery (p=0.97), and 4% shorter hospitalization (p=0.55). 191 patient RCT in Egypt comparing the addition of zinc to HCQ, not showing a significant difference. No information on baseline zinc values was recorded. Egypt has a low rate of zinc deficiency so supplementation may be less likely to be..
Nov 18
Pormohammad et al., International Journal of Molecular Medicine, doi:10.3892/ijmm.2020.4790 Zinc and SARS-CoV-2: A molecular modeling study of Zn interactions with RNA-dependent RNA-polymerase and 3C-like proteinase enzymes
In Silico analysis supporting the hypothesis that Zn would bind and regulate the enzymatic activities of 3CLpro and RdRp of SARS-CoV-2 and therefore inhibit viral replication. Since Zn has established immune health benefits, is readily av..
Oct 26
Frontera et al., Research Square, doi:10.21203/ Treatment with Zinc is Associated with Reduced In-Hospital Mortality Among COVID-19 Patients: A Multi-Center Cohort Study
37% lower mortality (p=0.02). Retrospective 3,473 hospitalized patients showing 37% lower mortality with HCQ+zinc. PSM aHR 0.63, p=0.015 regression aHR 0.76, p = 0.023
Oct 26
Tomasa-Irriguible et al., Metabolites, doi:10.3390/metabo11090565 (date from preprint) Low Levels of Few Micronutrients May Impact COVID-19 Disease Progression: An Observational Study on the First Wave
49% lower ventilation (p=0.06) and 52% lower ICU admission (p=0.02). Retrospective 120 hospitalized patients in Spain showing zinc deficiency associated with higher ICU admission.
Oct 20
Heller et al., Redox Biology, doi:10.1016/j.redox.2020.101764 Prediction of Survival Odds in COVID-19 by Zinc, Age and Selenoprotein P as Composite Biomarker
Analysis of 35 COVID-19 patients showing a significant correlation for serum zinc levels between COVID-19 patients and controls, and between COVID-19 survivors and non-survivors.
Oct 11
Vogel-González et al., Nutrients, doi:10.3390/nu13020562 (date from preprint) Low Zinc Levels at Admission Associates with Poor Clinical Outcomes in SARS-CoV-2 Infection
77% lower mortality (p=0.0005), 71% lower ICU admission (p<0.0001), and 68% faster recovery (p=0.001). Retrospective 249 PCR+ hospitalized patients in Spain, 58 with zinc levels on admission <50 μg/dL, showing higher mortality and ICU admission, and slower recovery with low zinc levels.
Sep 10
Jothimani et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.09.014 COVID-19: Poor outcomes in patients with zinc deficiency
90% lower mortality (p=0.06) and 92% lower ICU admission (p=0.02). Prospective study of zinc levels in 47 hospitalized COVID-19 patients and 45 healthy controls. COVID-19 patients had significantly lower zinc levels (74.5 vs. 105.8 median μg/dl, p < 0.001). 57.4% of COVID-19 patients were zinc deficient,..
Sep 8
Galmés et al., Nutrients, doi:10.3390/nu12092738 Current State of Evidence: Influence of Nutritional and Nutrigenetic Factors on Immunity in the COVID-19 Pandemic Framework
Ecological study of European countries analyzing 10 vitamins and minerals endorsed by the European Food Safety Authority as having sufficient evidence for a causal relationship between intake and optimal immune system function: vitamins D..
Sep 7
Yasui et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.09.008 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
92% lower ventilation (p=0.001). 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.
Jul 31
Ajili et al., NCT04377646 A Study of Hydroxychloroquine and Zinc in the Prevention of COVID-19 Infection in Military Healthcare Workers (COVID-Milit)
Estimated 660 participant zinc prophylaxis RCT with results not reported over 3 years after estimated completion.
Jul 22
Yao et al., Chest, doi:10.1016/j.chest.2020.06.082 The Minimal Effect of Zinc on the Survival of Hospitalized Patients With COVID-19
34% lower mortality (p=0.09). Retrospective 242 hospitalized patients in the USA showing adjusted hazard ratio for zinc treatment, aHR 0.66 [0.41-1.07]. [] notes that the study would be more informative if baseline serum zinc levels were known.
Jul 20
Krishnan et al., J Clin Anesth., doi:10.1016/j.jclinane.2020.110005 Clinical comorbidities, characteristics, and outcomes of mechanically ventilated patients in the State of Michigan with SARS-CoV-2 pneumonia
18% lower mortality (p=0.18). Retrospective 152 mechanically ventilated patients in the USA showing unadjusted lower mortality with vitamin C, vitamin D, HCQ, and zinc treatment, statistically significant only for vitamin C.
Jul 3
Derwand et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106214 (date from preprint) COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study
79% lower mortality (p=0.12) and 82% lower hospitalization (p=0.001). 79% lower mortality and 82% lower hospitalization with early HCQ+AZ+Z. Retrospective 518 patients (141 treated, 377 control).
Jun 6
Finzi et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.06.006 Treatment of SARS-CoV-2 with high dose oral zinc salts: A report on four patients
Case report on 4 patients treated with high dose zinc. All patients experienced significant improvement after one day.
May 8
Carlucci et al., J. Med. Microbiol., Sep 15, 2020, doi: 10.1099/jmm.0.001250 (date from preprint) Zinc sulfate in combination with a zinc ionophore may improve outcomes in hospitalized COVID-19 patients
38% lower combined mortality/hospice (p=0.002), 18% lower ventilation (p=0.4), and 23% lower ICU admission (p=0.17). Retrospective 932 patients showing that the addition of zinc to HCQ+AZ reduced mortality / transfer to hospice, ICU admission, and the need for ventilation.
Apr 6
Derwand et al., Medical Hypotheses, doi:10.1016/j.mehy.2020.109815 (date from preprint) Does zinc supplementation enhance the clinical efficacy of chloroquine/hydroxychloroquine to win today's battle against COVID-19?
Hypothesis that HCQ/CQ + zinc will be more effective than HCQ/CQ alone for COVID-19.
Sep 30
Rolles et al., Journal of Functional Foods, doi:10.1016/j.jff.2018.07.027 Influence of zinc deficiency and supplementation on NK cell cytotoxicity
In Vitro study showing improved natural killer (NK) cell function with zinc. showed that a lower frequency of natural killer cells was associated with symptomatic COVID-19 infection.
Nov 4
te Velthuis et al., PLOS Pathogens 2010, 6:11, doi:10.1371/journal.ppat.1001176 Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture
Shows that the combination of Zn2+ and a zinc ionophore (pyrithione) at low concentrations inhibits the replication of SARS-CoV and equine arteritis virus (EAV) in cell culture. Recommends further study of the use of zinc ionophores as an..
Oct 1
EFSA, EFSA Journal, doi:10.2903/j.efsa.2009.1229 Scientific Opinion on the substantiation of health claims related to zinc and function of the immune system (ID 291, 1757), DNA synthesis and cell division (ID 292, 1759), protection of DNA, proteins and lipids from oxidative damage (ID 294, 1758), maintenance of bone (ID 295, 1756), cognitive function (ID 296), fertility and reproduction (ID 297, 300), reproductive development (ID 298), muscle function (ID 299), metabolism of fatty acids (ID 302), maintenance of joints (ID 305), function of the heart and blood vessels (ID 306), prostate function (ID 307), thyroid function (ID 308), acid-base metabolism (ID 360), vitamin A metabolism (ID 361) and maintenance of vision (ID 361) pursuant to Article 13(1) of Regulation (EC) No 1924/2006
European Food Safety Administration review concluding that there is a causal relationship between the intake of zinc and immune system function.
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