COVID-19: Poor outcomes in patients with zinc deficiency

Abstract

Background: Zinc is a trace element with potent immunoregulatory and antiviral properties, and is utilized in the treatment of coronavirus disease 2019 (COVID-19). However, we do not know the clinical significance of serum Zinc levels in COVID-19 patients. The aim of this study was to determine the clinical significance of serum zinc in COVID-19 patients and to establish a correlation with disease severity. Methods: This was a prospective study of fasting zinc levels in COVID-19 patients at the time of hospitalization. An initial comparative analysis was conducted between COVID-19 patients and healthy controls. COVID-19 patients with zinc deficiency were compared to those with normal zinc levels. Results: COVID-19 patients (n = 47) showed significantly lower zinc levels when compared to healthy controls (n = 45): median 74.5 (interquartile range 53.4-94.6) mg/dl vs 105.8 (interquartile range 95.65-120.90) mg/dl (p < 0.001). Amongst the COVID-19 patients, 27 (57.4%) were found to be zinc deficient. These patients were found to have higher rates of complications (p = 0.009), acute respiratory distress syndrome (18.5% vs 0%, p = 0.06), corticosteroid therapy (p = 0.02), prolonged hospital stay (p = 0.05), and increased mortality (18.5% vs 0%, p = 0.06). The odds ratio (OR) of developing complications was 5.54 for zinc deficient COVID-19 patients. Conclusions: The study data clearly show that a significant number of COVID-19 patients were zinc deficient. These zinc deficient patients developed more complications, and the deficiency was associated with a prolonged hospital stay and increased mortality.

Dietary Supplements during COVID-19 Outbreak. Results of Google Trends Analysis Supported by PLifeCOVID-19 Online Studies

“…Indeed, there is some scientific evidence on immune-boosting, anti-inflammatory, antioxidant, and antiviral properties of several bioactive compounds and foods, including vitamins D and C, zinc, selenium, garlic, ginger, turmeric, lactoferrin, elderberry, or Nigella sativa , however they cannot be freely extrapolated to the effects on the SARS-CoV-2 virus [ 9 , 11 , 14 , 22 , 23 , 34 ]. Recently, the compounds like vitamin D, vitamin C, zinc, probiotics, curcumin, quercetin have been extensively studied in the context of coronavirus [ 34 , 35 , 36 ]. Initial surveys have found them to possess an anti-SARS-CoV-2 effect, and suggest they might provide both prophylactic and adjuvant therapy against COVID-19 effects, therefore, they are being fast-tracked into clinical trials [ 34 , 35 ].…”

“…Recently, the compounds like vitamin D, vitamin C, zinc, probiotics, curcumin, quercetin have been extensively studied in the context of coronavirus [ 34 , 35 , 36 ]. Initial surveys have found them to possess an anti-SARS-CoV-2 effect, and suggest they might provide both prophylactic and adjuvant therapy against COVID-19 effects, therefore, they are being fast-tracked into clinical trials [ 34 , 35 ]. Recent studies have linked deficiency of zinc [ 35 ], selenium [ 37 ], or vitamin C [ 36 , 38 ] to poorer COVID-19 outcomes.…”

“…Initial surveys have found them to possess an anti-SARS-CoV-2 effect, and suggest they might provide both prophylactic and adjuvant therapy against COVID-19 effects, therefore, they are being fast-tracked into clinical trials [ 34 , 35 ]. Recent studies have linked deficiency of zinc [ 35 ], selenium [ 37 ], or vitamin C [ 36 , 38 ] to poorer COVID-19 outcomes. Existing studies have shown that adequate serum levels of vitamin D and C may reduce the incidence of a COVID-19-related “cytokine storm” [ 36 , 39 ], which is further correlated to lung injury and unfavorable prognosis of COVID-19 [ 40 ].…”

Zinc against COVID-19? Symptom surveillance and deficiency risk groups

“…There has been one case study report describing beneficial effects of zinc supplementation for COVID-19 progression [ 157 ], and more recently, the first in vivo evidence of zinc supplementation for better COVID-19 outcomes [ 158 ]. It has also been reported that COVID-19 patients had significantly lower zinc levels compared with healthy individuals, and this was associated with a greater than 5-fold increased likelihood of developing complications [ 159 ]. Since supplementation strategies will be different for preexisting zinc deficiency versus a deficiency acquired during SARS-CoV-2 infection, with acute deficiency during viral infection requiring active monitoring and interventions, it is important to distinguish these cases and their combination.…”

Zinc supplement augments the suppressive effects of repurposed drugs of NF-kappa B inhibitor on ACE2 expression in human lung cell lines in vitro

“…Zinc has been shown to mediate antiviral effects through improving the mucociliary clearance of virus, strengthening the integrity of the epithelium, decreasing viral replication, preserving antiviral immunity, attenuating the risk of hyperinflammation, supporting anti-oxidative effects (11). Observational studies have reported that lower baseline zinc levels in hospitalized adults were associated with a higher risk of mortality, complications, and longer hospital stay following SARS-CoV-2 infection (12), suggesting potential benefits of zinc supplementation in reducing COVID-19 morbidity and mortality. Moreover, the clinical trials on zinc supplementation in combination with other drugs such as hydroxychloroquine or chloroquine have been registered (13), and the anticipated results coming soon.…”