Supplementary Data — Zinc reduces COVID-19 risk: real-time meta-analysis of 40 studies

October 2026

Zinc COVID-19 outcomes

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk
Derwand79%0.21 · 0.03–1.47death1/14113/377CT2 Derwand82%0.18 · 0.07–0.54hosp.4/14158/377CT2 Thomas (RCT)−44%1.44 · 0.36–5.71hosp.5/583/50COVIDAtoZ Thomas (RCT)12%0.88 · 0.67–1.16recov. time58 (n)50 (n)COVIDAtoZ Aldwihi24%0.76 · 0.51–1.08hosp.53/199184/539 Asimi97%0.03 · 0.00–0.44ventilation0/2709/86CT2 Asimi99%0.01 · 0.00–0.16hosp.0/27024/86CT2 Asimi100%0.00 · 0.00–0.08severe case0/27051/86CT2 Mayberry53%0.47 · 0.33–0.65death938 (n)1,090 (n) Mayberry64%0.36 · 0.27–0.47ventilation938 (n)1,090 (n) Mayberry60%0.40 · 0.31–0.52ICU938 (n)1,090 (n) Mayberry58%0.42 · 0.33–0.54death/v/ICU938 (n)1,090 (n) Mayberry85%0.15 · 0.10–0.22progression938 (n)1,090 (n) Abdallah (DB RCT)30%0.70 · 0.36–1.31death15/23122/239VIZIR Abdallah (DB RCT)38%0.62 · 0.37–0.99death/ICU24/23140/239VIZIR Abdallah (DB RCT)54%0.46 · 0.23–0.88ICU12/23127/239VIZIR Abdallah (DB RCT)42%0.58 · 0.39–0.87oxygen31/23155/239VIZIR Abdallah (DB RCT)23%0.77 · 0.65–0.91oxygen108/231145/239VIZIR Abdallah (DB RCT)29%0.71 · 0.57–0.88no recov.82/231120/239VIZIR Abdallah (DB RCT)14%0.86 · 0.80–0.93no recov.180/231216/239VIZIR Abdallah (DB RCT)69%0.31 · 0.03–2.61hosp.1/854/100VIZIR Abdallah (DB RCT)33%0.67 · 0.59–0.75hosp. time146 (n)134 (n)VIZIR Abdallah (DB RCT)25%0.75 · 0.65–0.87recov. time85 (n)100 (n)VIZIR Carlucci38%0.62 · 0.46–0.84death/HPC54/411119/521 Carlucci18%0.82 · 0.54–1.25ventilation29/41162/521 Carlucci23%0.77 · 0.53–1.10ICU38/41182/521 Krishnan18%0.82 · 0.62–1.09death31/5861/94 Yao34%0.66 · 0.41–1.07death73/19621/46 Frontera (PSM)37%0.63 · 0.44–0.91death121/1,006424/2,467CT2 Frontera (PSM)24%0.76 · 0.60–0.96death121/1,006424/2,467CT2 Rosenthal−16%1.16 · 1.05–1.28deathn/an/a Patel (DB RCT)20%0.80 · 0.15–4.18death2/153/18 Mulhem46%0.54 · 0.43–0.68death256/1,596260/1,623 Gadhiya−41%1.41 · 0.69–2.57death21/5434/229 Al Sulaiman (ICU)36%0.64 · 0.37–1.10death23/8232/82ICU patients Al Sulaiman (ICU)48%0.52 · 0.29–0.92death19/8231/82ICU patients Al Sulaiman (ICU)−25%1.25 · 0.84–1.87ICU82 (n)82 (n)ICU patients Al Sulaiman (ICU)−6%1.06 · 0.85–1.33hosp. time82 (n)82 (n)ICU patients Frontera33%0.67 · 0.44–1.03PASC382 (all patients) Frontera57%0.43 · 0.23–0.83PASC382 (all patients) Elavarasi65%0.35 · 0.24–0.56death486 (n)1,201 (n) Kaplan (RCT)−14%1.14 · 0.08–16.63ventilation1/141/16ReszinateCT2 Kaplan (RCT)−14%1.14 · 0.08–16.63ICU1/141/16ReszinateCT2 Kaplan (RCT)−14%1.14 · 0.08–16.63hosp.1/141/16ReszinateCT2 Alahmari30%0.70 · 0.63–0.78hosp. time130 (n)847 (n) Doocy41%0.59 · 0.19–1.85death3/2821/116 Ibrahim Alhajjaji88%0.12 · 0.01–2.24death0/444/57 Ibrahim Alhajjaji26%0.74 · 0.23–2.37ventilation4/447/57 Ibrahim Alhajjaji3%0.97 · 0.45–2.10ICU9/4412/57 Ibrahim Alhajjaji73%0.27 · 0.10–0.74progression4/4419/57 Ibrahim Alhajjaji29%0.71 · 0.54–0.94hosp. time44 (n)57 (n) Kyagambiddwa25%0.75 · 0.44–1.25death20/8922/73 Seely (DB RCT)48%0.52 · 0.10–2.71progression2/424/44CT2 Seely (DB RCT)14%0.86 · 0.61–1.22no recov.34 (n)24 (n)CT2 Seely (DB RCT)29%0.71 · 0.28–1.75no recov.7/347/24CT2 Seely (DB RCT)29%0.71 · 0.31–1.65no recov.32 (n)31 (n)CT2 Seely (DB RCT)14%0.86 · 0.37–1.97no recov.33 (n)30 (n)CT2 Seely (DB RCT)50%0.50 · 0.19–1.34no recov.32 (n)33 (n)CT2 Seely (DB RCT)−12%1.12 · 0.82–1.54no recov.30 (n)25 (n)CT2 Seely (DB RCT)−4%1.04 · 0.77–1.40recov. time34 (n)24 (n)CT2 Seely (DB RCT)12%0.88 · 0.19–4.02PASC3/333/29CT2 Seely (DB RCT)36%0.64 · 0.16–2.65PASC3/354/30CT2 Seely (DB RCT)1%0.99 · 0.34–2.93PASC6/355/29CT2 Milan56%0.44 · 0.18–1.09death9/1298/51 Milan13%0.87 · 0.44–1.71ventilation22/12910/51 Milan10%0.90 · 0.48–1.69ICU25/12911/51 Gómez-Zor.. (RCT)67%0.33 · 0.01–7.83death0/351/34MARZINC Gómez-Zor.. (RCT)76%0.24 · 0.06–1.06progression2/358/34MARZINC Gómez-Zor.. (RCT)40%0.60 · 0.34–1.05no recov.35 (n)34 (n)MARZINC Gómez-Zor.. (RCT)42%0.58 · 0.32–1.03no recov.35 (n)34 (n)MARZINC Louca1%0.99 · 0.93–1.06casespopulation-based cohort Mahto37%0.63 · 0.22–1.49IgG+10/3883/651 Bejan18%0.82 · 0.22–3.13ventilation155 (n)9,074 (n) Bejan30%0.70 · 0.19–2.54ICU155 (n)9,112 (n) Holt7%0.93 · 0.59–1.44cases21/750425/14,477COVIDENCE UK Abdulateef13%0.87 · 0.38–1.97hosp.7/11123/317 Seet (CLUS. RCT)50%0.50 · 0.34–0.75symp. case33/63464/619OT1 Seet (CLUS. RCT)27%0.73 · 0.55–0.97cases300/634433/619OT1 Bagheri60%0.40 · 0.04–3.53severe case33 (n)477 (n) Bagheri41%0.59 · 0.14–1.61hosp.4/33167/477 Gordon68%0.32 · 0.01–7.87death0/1041/96 Gordon85%0.15 · 0.02–0.58symp. case2/1049/96 Nimer−25%1.25 · 0.87–1.77hosp.41/326178/1,822 Nimer−13%1.13 · 0.81–1.56severe case46/326214/1,822 Shehab47%0.53 · 0.19–1.47severe case4/6522/188 Stambouli (DB RCT)68%0.32 · 0.03–2.95symp. case1/593/56 Stambouli (DB RCT)5%0.95 · 0.29–3.10cases5/595/56 Stambouli (DB RCT)21%0.79 · 0.73–0.84viral load59 (n)56 (n) Adrean−12%1.12 · 0.74–1.70cases30/2,11180/6,315 Sharif40%0.60 · 0.46–0.77severe casen/an/a Asoudeh57%0.43 · 0.21–0.90severe case250 (all patients) Seifi31%0.69 · 0.52–0.94hosp.n/an/aper unit change
00.511.52+
1 OT: comparison with other treatment
2 CT: study uses combined treatment
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← Zinc
reduces risk
Zinc
increases risk →
Fig. S1. All outcomes.
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Fig. S2. Comparison of results for RCTs versus observational studies. For COVID-19 treatments, there is no significant difference between the results of RCTs and observational studies. Observational studies do not systematically over or underestimate efficacy. For high-cost treatments, there is a non-significant trend towards RCTs showing greater efficacy.