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Zinc for COVID-19
38 studies from 402 scientists
45,372 patients in 16 countries
Statistically significant improvement for mortality, ventilation, hospitalization, recovery, and viral clearance.
15 studies from 15 independent teams in 8 countries show statistically significant improvements in isolation.
COVID-19 Zinc studies. Dec 2022. c19early.org/z
0 0.5 1 1.5+ All studies 28% With exclusions 30% Mortality 28% Hospitalization 30% Recovery 22% Cases 22% Viral clearance 21% RCTs 39% RCT mortality 24% Sufficiency 74% Prophylaxis 30% Early 41% Late 26% Favorszinc Favorscontrol
Zinc COVID-19 studies. Recent:
Maradi
Sharif
Olczak-Pruc
Abdallah
Adrean
Jabbar
Mosadegh.
Zinc has been officially adopted for early treatment in all or part of 6 countries. Submit updates/corrections.
Dec 2
Covid Analysis (Preprint) (meta analysis) Zinc for COVID-19: real-time meta analysis of 49 studies
Statistically significant improvements are seen for mortality, ventilation, hospitalization, recovery, and viral clearance. 15 studies from 15 independent teams in 8 different countries show statistically significant improvements in iso..
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 (meta analysis) 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 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
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 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 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 (Review) 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 survey based analysis of 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) 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 (Review) “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.
Dec 16
2021
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
2021
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
2021
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 25
2021
Leal-Martínez et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph19031172 (date from earlier 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
2021
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
2021
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 1
2021
Kaplan et al., SSRN, 10.2139/ssrn.3934228 (Preprint) 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
2021
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
2021
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
2021
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
2021
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
2021
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
2021
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
2021
Golabi et al., Nutrients, doi:10.3390/nu13103368 (date from earlier 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
2021
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
2021
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
2021
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
2021
Elavarasi et al., medRxiv, doi:10.1101/2021.08.10.21261855 (Preprint) 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.
Jul 27
2021
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
2021
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
2021
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
2021
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
2021
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
2021
Panchariya et al., Chemical Communications, doi:10.1039/D1CC03563K (In Vitro) 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
2021
Verschelden et al., medRxiv, doi:10.1101/2021.06.09.21258271 (Preprint) 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
2021
Al Sulaiman et al., Critical Care, doi:10.1186/s13054-021-03785-1 (date from earlier 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
2021
Asimi et al., Endocrine Abstracts, doi:10.1530/endoabs.73.PEP14.2 (Preprint) 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
2021
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
2021
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
2021
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
2021
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
2021
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
2021
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
2021
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
2021
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
2021
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 25
2021
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
2021
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
2021
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
2021
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
2021
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
2021
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
2021
Sethuram et al., Reproductive Sciences, doi:10.1007/s43032-020-00400-6 (Review) 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
2021
Joachimiak et al., PLOS Neglected Tropical Diseases, doi:10.1371/journal.pntd.0008895 (Review) 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..
Dec 30
2020
McCullough et al., Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm.2020.04.264 (Review) 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
2020
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
2020
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. IRCT20151228025732N52.
Dec 10
2020
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
2020
Louca et al., BMJ Nutrition, Prevention & Health, doi:10.1136/bmjnph-2021-000250 (date from earlier 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
2020
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. We note that Egypt has a low rate of zinc deficiency so supplementation is less lik..
Nov 18
2020
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
2020
Frontera et al., Research Square, doi:10.21203/rs.3.rs-94509/v1 (Preprint) 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
2020
Tomasa-Irriguible et al., Metabolites, doi:10.3390/metabo11090565 (date from earlier 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
2020
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
2020
Vogel-González et al., Nutrients, doi:10.3390/nu13020562 (date from earlier 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
2020
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
2020
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
2020
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 22
2020
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]. [ncbi.nlm.nih.gov] notes that the study would be more informative if baseline serum zinc levels were known.
Jul 20
2020
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
2020
Derwand et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106214 (date from earlier 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
2020
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
2020
Carlucci et al., J. Med. Microbiol., Sep 15, 2020, doi: 10.1099/jmm.0.001250 (date from earlier 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.
2010
te Velthuis et al., PLOS Pathogens 2010, 6:11, doi:10.1371/journal.ppat.1001176 (In Vitro) 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..
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