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

Joachimiak, Marcin P.

doi:10.1371/journal.pntd.0008895

Cited by 65 publications

(63 citation statements)

References 145 publications

(69 reference statements)

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“…In this regard, plasma zinc/albumin ratio could be considered as an alternative surrogate marker for functional zinc status [3]. Nevertheless, a (hypothetical) zinc deficiency is usually associated with low plasma concentration of zinc (<70 µg/dL), which are frequently detected transiently during infections or persistently in the elderly and in patients with chronic disease comorbidities that predispose to severe forms of COVID-19 [44][45][46][47][48]. Moreover, zinc ions have been shown to induce in vitro both inhibition of RNA virus replication and antiviral immune activity [44][45][46][47][48].…”

Section: Targeting Of Sars-cov-2-upregulated Zinc-dependent Pathwaysmentioning

confidence: 99%

“…Nevertheless, a (hypothetical) zinc deficiency is usually associated with low plasma concentration of zinc (<70 µg/dL), which are frequently detected transiently during infections or persistently in the elderly and in patients with chronic disease comorbidities that predispose to severe forms of COVID-19 [44][45][46][47][48]. Moreover, zinc ions have been shown to induce in vitro both inhibition of RNA virus replication and antiviral immune activity [44][45][46][47][48]. For these reasons, zinc supplementation has been proposed as an adjunct therapy for COVID-19, with several clinical trials underway [44][45][46][47][48] and a report indicating that zinc supplementation does not give protection from SARS-CoV-2 infection [49].…”

Section: Targeting Of Sars-cov-2-upregulated Zinc-dependent Pathwaysmentioning

confidence: 99%

“…Moreover, zinc ions have been shown to induce in vitro both inhibition of RNA virus replication and antiviral immune activity [44][45][46][47][48]. For these reasons, zinc supplementation has been proposed as an adjunct therapy for COVID-19, with several clinical trials underway [44][45][46][47][48] and a report indicating that zinc supplementation does not give protection from SARS-CoV-2 infection [49]. On the other hand, zinc displacement by ranitidine bismuth citrate has been shown to exhibit potent anti-SARS-CoV-2 activity in vivo [10], suggesting that reduction (rather than increase) of zinc-mediated activities may be effective against COVID-19.…”

Section: Targeting Of Sars-cov-2-upregulated Zinc-dependent Pathwaysmentioning

confidence: 99%

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Upregulation of the Renin–Angiotensin System Pathways and SARS-CoV-2 Infection: The Rationale for the Administration of Zinc-Chelating Agents in COVID-19 Patients

Zamai

2021

Cells

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The article describes the rationale for the administration of zinc-chelating agents in COVID-19 patients. In a previous work I have highlighted that the binding of the SARS-CoV spike proteins to the zinc-metalloprotease ACE2 has been shown to induce ACE2 shedding by activating the zinc-metalloprotease ADAM17, which ultimately leads to systemic upregulation of ACE2 activity. Moreover, based on experimental models, it was also shown the detrimental effect of the excessive systemic activity of ACE2 through its downstream pathways, which leads to “clinical” manifestations resembling COVID-19. In this regard, strong upregulation of circulating ACE2 activity was recently reported in COVID-19 patients, thus supporting the previous hypothesis that COVID-19 may derive from upregulation of ACE2 activity. Based on this, a reasonable hypothesis of using inhibitors that curb the upregulation of both ACE2 and ADAM17 zinc-metalloprotease activities and consequent positive feedback-loops (initially triggered by SARS-CoV-2 and subsequently sustained independently on viral trigger) is proposed as therapy for COVID-19. In particular, zinc-chelating agents such as citrate and ethylenediaminetetraacetic acid (EDTA) alone or in combination are expected to act in protecting from COVID-19 at different levels thanks to their both anticoagulant properties and inhibitory activity on zinc-metalloproteases. Several arguments are presented in support of this hypothesis and based on the current knowledge of both beneficial/harmful effects and cost/effectiveness, the use of chelating agents in the prevention and therapy of COVID-19 is proposed. In this regard, clinical trials (currently absent) employing citrate/EDTA in COVID-19 are urgently needed in order to shed more light on the efficacy of zinc chelators against SARS-CoV-2 infection in vivo.

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Section: Targeting Of Sars-cov-2-upregulated Zinc-dependent Pathwaysmentioning

confidence: 99%

Section: Targeting Of Sars-cov-2-upregulated Zinc-dependent Pathwaysmentioning

confidence: 99%

Section: Targeting Of Sars-cov-2-upregulated Zinc-dependent Pathwaysmentioning

confidence: 99%

See 1 more Smart Citation

Upregulation of the Renin–Angiotensin System Pathways and SARS-CoV-2 Infection: The Rationale for the Administration of Zinc-Chelating Agents in COVID-19 Patients

Zamai

2021

Cells

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“…Zinc is not stored in the body and thus must be obtained daily through diet or supplements [ 121 ]. Considering the above, normal zinc serum blood levels of 0.66–1.00 mcg/mL or urine test 20–967 mcg/mL 24 h should be determined [ 125 ].…”

Section: Resultsmentioning

confidence: 99%

Guidelines for Reopening a Nation in a SARS-CoV-2 Pandemic: A Path Forward

Baker

Greiner

2021

Medicina

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Action, not fear, is the path forward in the coronavirus infectious disease 2019 (COVID-19) pandemic. Since early 2020, the world’s nations have faced conundrums over severe acute respiratory syndrome corona virus type 2 (SARS-CoV-2) infections resulting in COVID-19 resulting in national closures, and thus, a clear understandable plan that nations can implement is required to reopen. The healthcare benefits of reopening a nation more likely than not exceed the benefits of continued pandemic-related closure. Pandemic-related closures have resulted in countless delayed or avoided urgent care evaluations. Furthermore, routine care of acute and chronic illnesses, including evaluations, diagnoses, and treatments, has also been delayed. Isolation, loss of income, and fear have resulted in mental health conditions or exacerbated existing conditions. The magnitude of untoward ramifications is unknown and may ultimately represent an inestimable degree of danger and morbidity, and even death. Purpose. The pandemic of SARS-CoV-2 has created an atmosphere of fear of COVID-19 that has directly and indirectly injured the world’s population. Since this has resulted in increasing morbidity and mortality, creating economic chaos, and near systemic collapse of educational systems with no well described plan forward, it is the purpose of this study to provide guidelines that provide a path forward to safely open a nation. Physicians often equipped by their education, training, and experiences across disciplines are uniquely positioned to comprehend, coordinate, and teach other physicians, business owners, and municipal and government leaders from guidelines. As such, physicians may take the lead in a path forward to reopening a nation, including opening businesses, educational facilities, and religious establishments, while minimizing the risk of SARS-CoV-2 infection. Method. Reviews of the literature among the disciplines of environmental air, sanitation, social interaction, medical testing, vaccination, protection, and disease prevention and safety allowed for the conceptualization and eventual genesis of identifiable interventions which either reduce the viral load in the environment or inactivate the virus from replication. Each of the guidelines was selected based on the principle that it involved the elimination or inactivation of the viral particle. With a reduction in viral load or inactivation of replication, the implementation of these guidelines is expected to allow for reopening a nation with an increased level of safety. Results. The guidelines identified, including air exchange (ventilation), air filtration, personal protective filtering devices (masks), hand hygiene, social distancing, screening and testing, vaccines, high-risk patient protection, medical management, and adjunctive therapies, are described and referenced. Conclusions. In that the pandemic is primarily a public health issue, the path forward is best coordinated by local, regional, and national physicians. Many physicians with a breadth of experiences are uniquely positioned to coordinate the implementation of these interdisciplinary guidelines. Using these guidelines as a planned, coordinated action, not fear, is a path forward. Nations have a decision to make: closuring versus opening.

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“…Besides, the current global pandemic increases the possibility of added worsening effect of nutritional status during lockdown (to prevent transmission of COVID-19 virus), which has a significant influence on the health system of low and middle-income countries (LMICs) [30][31][32] . Around 70% of mortality in LMICs is due to diet-correlated Non-Communicable Diseases (NCDs) misery, and it remains indeed an ongoing public health challenge 29,33 . Thereby, COVID-19 imposes additional public health challenges.…”

mentioning

confidence: 99%