Melatonin, Zinc, and Vitamin C: Potential Adjuvant Treatment for COVID-19 Patients

Borges, Leandro; Gennari-Felipe, Matheus; Dias, B; Hatanaka, Elaine

doi:10.3389/fnut.2021.821824

Cited by 15 publications

(13 citation statements)

References 59 publications

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“…Of note, vitamin C will be highly effective among patients with deficiency (hypovitaminosis C) [ 53 ]. Despite a limited number of randomized clinical trials, and conflicting results from some, Borges et al found vitamin C as a likely beneficial adjuvant treatment for COVID-19 patients, particularly due to a reduction of inflammation and better oxygen functioning when vitamin C is provided [ 54 ]. The same conclusion is suggested by Vollbracht and Kraft, who stressed the role of vitamin C in Long-COVID.…”

Section: Discussionmentioning

confidence: 99%

Vitamin C Supplementation for the Treatment of COVID-19: A Systematic Review and Meta-Analysis

et al. 2022

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Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe respiratory syndrome coronavirus 2 (SARS-CoV-2), millions of people have died, and the medical system has faced significant difficulties. Our purpose was to perform a meta-analysis to estimate the effect of vitamin C on in-hospital mortality and the ICU or hospital length of stay for patients diagnosed with COVID-19. We conducted a systematic review with meta-analysis in the following databases: PubMed, Web of Science, Scopus and Cochrane Central Register of Controlled Trials. We included studies that evaluated the effect of vitamin C supplementation, compared with standard treatment in COVID-19 patients who are ≥18 y of age. Nineteen trials were included in the meta-analysis. In-hospital mortality with and without vitamin C supplementation was 24.1% vs. 33.9% (OR = 0.59; 95%CI: 0.37 to 0.95; p = 0.03), respectively. Sub-analysis showed that, in randomized clinical trials, in-hospital mortality varied and amounted to 23.9% vs. 35.8% (OR = 0.44; 95%CI: 0.25 to 0.76; p = 0.003), respectively. In the non-randomized trials, in-hospital mortality was 24.2% vs. 33.5% (OR = 0.72; 95%CI: 0.38 to 1.39; p = 0.33), respectively. The ICU length of stay was longer in patients treated with vitamin C vs. standard therapy, 11.1 (7.3) vs. 8.3 (4.7) days (MD = 1.91; 95%CI: 0.89 to 2.93; p < 0.001), respectively. Acute kidney injury in patients treated with and without vitamin C varied and amounted to 27.8% vs. 45.0% (OR = 0.56; 95%CI: 0.40 to 0.78; p < 0.001), respectively. There were no differences in the frequency of other adverse events among patients’ treatment with and without vitamin C (all p > 0.05). The use of vitamin C reduces hospital mortality. The length of stay in the ICU is longer among patients treated with vitamin C. In terms of patient safety, vitamin C has an acceptable profile. Low doses of vitamin C are effective and safe. Despite some evidence of the usefulness of vitamin C in modifying the course of COVID-19, it is too early to modify guidelines and recommendations. Further studies, in particular randomized clinical trials, are necessary.

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Section: Discussionmentioning

confidence: 99%

Vitamin C Supplementation for the Treatment of COVID-19: A Systematic Review and Meta-Analysis

et al. 2022

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“…The absorption of zinc increases in a diet containing protein, histidine, methionine, and citrate. However, some drugs ( Figure 1 ) and compounds/elements (e.g., phytic acid, cadmium, high doses of iron, and casein) lower the bioavailability of zinc by complexing with it [ 24 , 25 , 26 , 27 ]. Accordingly, it is imperative to identify compounds that increase or decrease the absorption of zinc during zinc therapy.…”

Section: Zincmentioning

confidence: 99%

“…After ingestion, zinc is released as Zn +2 ions and absorbed up to an extent of 33% in a normal healthy person, wherein a decrease in zinc absorption takes place with an increase in age. The zinc is transported to cells through transport proteins [ 24 , 25 ], where it demonstrates its biological effects, including antioxidant, immunostimulant, and antiviral effects ( Figure 1 ). Zinc deficiency can cause many effects, including growth hindrance, delayed sexual development, skin problems, diarrhea, alopecia, decreased appetite, osteoporosis, and increased susceptibility to viral infections.…”

Section: Zincmentioning

confidence: 99%

“…Accordingly, zinc supplements and zinc-based medicines are effective in the treatment of many illnesses ( Figure 1 ). At the same time, excessive use of zinc can cause many side effects, and can demonstrate drug–drug and drug–disease interactions ( Figure 1 ) [ 24 , 25 , 26 , 27 ].

Figure 1 Mechanisms of action, uses, side effects, and interactions of zinc.…”

Section: Zincmentioning

confidence: 99%

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Development of Therapeutic and Prophylactic Zinc Compositions for Use against COVID-19: A Glimpse of the Trends, Inventions, and Patents

et al. 2022

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Zinc is an essential nutrient for human health; it is involved in the catalytic, structural, and regulatory functions of the human cellular system. Different compositions of zinc, as well as its pharmaceutically acceptable salts, are available on the market. Recent studies have demonstrated the role of zinc in combating COVID-19. It has been determined that zinc prevents the entry of SARS-CoV-2 into cells by lowering the expression of ACE-2 receptors and inhibiting the RNA-dependent RNA polymerase of SARS-CoV-2. Zinc also prevents the cytokine storm that takes place after the entry of SARS-CoV-2 into the cell, via its anti-inflammatory activity. The authors believe that no study has yet been published that has reviewed the trends, inventions, and patent literature of zinc compositions to treat/prevent COVID-19. Accordingly, this review has been written in order to fill this gap in the literature. The information about the clinical studies and the published patents/patent applications was retrieved from different databases. This review covers patent literature on zinc compositions up to 31 January 2022. Many important patents/patent applications for zinc-based compositions filed by innovative universities and industries were identified. The patent literature revealed zinc compositions in combination with zinc ionophores, antioxidants, antivirals, antibiotics, hydroxychloroquine, heparin, ivermectin, and copper. Most of these studies were supported by clinical trials. The patent literature supports the potential of zinc and its pharmaceutical compositions as possible treatments for COVID-19. The authors believe that countless zinc-based compositions are still unexplored, and there is an immense opportunity to evaluate a considerable number of the zinc-based compositions for use against COVID-19.

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“…Furthermore, zinc therapy has been shown to reduce inflammatory cytokines (IL-1 and IL-6), enhancing type-I IFN response [ 37 ]. Hence, using zinc supplementation along with other therapeutic regimens can be proven as a more effective strategy to combat viral infections like SARS-CoV-2 [ 23 , 38 ].…”

Section: Immunomodulatory Effects Of Zincmentioning

confidence: 99%

Immunomodulatory effects of zinc and its impact on COVID-19 severity

Dhawan

Emran

Priyanaka

et al. 2022

Annals of Medicine &Amp; Surgery

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Melatonin, Zinc, and Vitamin C: Potential Adjuvant Treatment for COVID-19 Patients

Cited by 15 publications

References 59 publications

Vitamin C Supplementation for the Treatment of COVID-19: A Systematic Review and Meta-Analysis

Vitamin C Supplementation for the Treatment of COVID-19: A Systematic Review and Meta-Analysis

Development of Therapeutic and Prophylactic Zinc Compositions for Use against COVID-19: A Glimpse of the Trends, Inventions, and Patents

Immunomodulatory effects of zinc and its impact on COVID-19 severity

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