Evaluation of the Effect of Zinc, Quercetin, Bromelain and Vitamin C on COVID-19 Patients

Abstract

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new strain of coronavirus. There are three phases of COVID-19: early infection stage, pulmonary stage and hyper-inflammation stage respectively. It is important to prevent lung or other organs injuries by preventing phase-II and phase-III via pharmacological or non-pharmacological treatments. This was a case series study done on twenty-two patients confirmed to be infected with SARS-CoV-2 and diagnosed with COVID-19. Patients in this study have been used quercetin 800 mg, bromelain 165 mg, zinc acetate 50 mg and ascorbic acid 1 g once daily as supplements for 3 to 5 days during SARS-CoV-2 infection. The aim of this study is to evaluate the safety and efficacy of quercetin, bromelain, zinc and ascorbic acid combination supplements on patients with COVID-19. The mean levels of WBC, ANC, ALC, AMC and AST were normal among all included patients before and after taking quercetin, bromelain, zinc and ascorbic acid supplements (P-value > 0.05). Quercetin 800 mg, bromelain 165 mg, zinc acetate 50 mg and ascorbic acid 1 g once daily supplements were safe for patients infected with SARS-CoV-2 and may prevent poor prognosis. Randomized clinical trials needed in the future to ensure the efficacy of quercetin, bromelain, zinc and vitamin c combination.

Oral Co-Supplementation of Curcumin, Quercetin, and Vitamin D3 as an Adjuvant Therapy for Mild to Moderate Symptoms of COVID-19—Results From a Pilot Open-Label, Randomized Controlled Trial

“…Several clinical trials, in particular, have investigated the anti-inflammatory and immunomodulatory pharmacological effects of curcumin in patients with COVID-19 and revealed improvement in serum CRP levels, a significant reduction in the gene expression, and/or serum levels of IFN-γ, IL-1β, IL-6, IL-10, IL-17, IL-21, IL-23, IL-35, retinoic acid-related orphan receptor-C, forkhead box P3, transforming growth factor beta, granulocyte-macrophage colony-stimulating factor, and frequency of T helper 17 cells ( Salehi et al, 2020 ; Ahmadi et al, 2021 ; Tahmasebi et al, 2021a ; Tahmasebi et al, 2021b ; Hassaniazad et al, 2021 ; Asadirad et al, 2022 ). Similarly, several randomized clinical trials involving patients with COVID-19 have also revealed multiple treatment benefits for quercetin adjuvant therapy, including faster negativization of the SARS-CoV-2, early amelioration of the acute symptoms, reduction in the serum levels of inflammatory markers such as CRP, LDH, ferritin, and alkaline phosphatase ( Kamel et al, 2020 ; Di Pierro et al, 2021a ; Di Pierro et al, 2021b ; Onal et al, 2021 ; Shohan et al, 2022 ). Moreover, with vitamin D3 adjuvant supplementation, early negativization of the SARS-CoV-2 and improvement in the acute symptoms have also been reported in patients with early-stage of COVID-19 ( Opko Press Release, 2021 ; Sabico et al, 2021 ; Sanchez-Zuno et al, 2021 ; Rastogi et al, 2022 ).…”

Investigation of potential effects of quercetin on COVID-19 treatment: a systematic review of randomized controlled trials

“…24 In a case series study, researchers reported that the intake of 800 mg/day of quercetin, 50 mg zinc acetate, 165 mg bromelain, and 1000 mg vitamin C supplements with antiviral medication by patients with COVID-19 infection was safe and improved the course of the disease. 17 It has also been shown to act as a zinc ionophore and increase the entry of zinc into cells to inhibit viral intracellular replication. 45 According to the results of a randomized controlled trial by Di Pierro et al 22 discussed in the current review, they observed that the intake of 1500 mg/day of quercetin Phytosome® in the first week and 1000 mg/day of quercetin in the second week (corresponding to 600 mg and 400 mg of quercetin per day, respectively) in addition to standard treatment for 2 weeks disclosed the ability to clear the COVID-19 virus and improve clinical symptoms, and statistically shortened the rate of conversion of RT-PCR test from positive to negative.…”

“…[11][12][13] It exerts its antioxidant effect by removing free radicals and maintaining oxidative balance, and its anti-inflammatory and anti-allergic effects by inhibiting the lipoxygenase and cyclooxygenase pathway. 12,14 In clinical studies, quercetin has been shown to have antiviral 15,16 and anti-inflammatory effects 16 , relieve respiratory symptoms 16 , prevent poor prognosis 17 and reduce hospitalization 18 in COVID-19 patients.…”

An emerging natural antioxidant therapy for COVID‐19 infection patients: Current and future directions

“…Quercetin was used in combination with other natural compounds such as vitamin C, zinc, and bromelain for the determination of their effects on COVID‐19 patients. Quercetin 800 mg, bromelain 165 mg, zinc acetate 50 mg, and ascorbic acid 1 g once daily supplements may prevent poor SARS‐CoV‐2 prognosis and were safe for infected patients even if randomized clinical trials are needed in the future to ensure the efficacy of the mixture (A. Ahmed et al., 2020).…”