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Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Research Article

Clinical Outcomes of Zinc Supplementation Among COVID-19 Patients

Author(s): Andrew D. Berti, Pramodini B. Kale-Pradhan, Christopher A. Giuliano*, Bianca N. Aprilliano, Christopher R. Miller, Basma T. Alyashae, Ashish Bhargava and Leonard B. Johnson

Volume 17, Issue 4, 2022

Published on: 14 April, 2022

Page: [366 - 369] Pages: 4

DOI: 10.2174/1574886317666220317115023

Price: $65

Abstract

Background: Zinc supplementation is frequently prescribed during the treatment of COVID-19. However, the evidence supporting the efficacy of this intervention is mixed.

Objective: Establish the clinical utility of zinc supplementation to alter disease severity in COVID- 19 illness.

Methods: We performed a multicenter, retrospective, observational chart review of patients admitted to Ascension St. John Hospital or Detroit Medical Center from January 1st, 2020 to May 31st, 2020. All included patients received concomitant hydroxychloroquine due to its zinc ionophore activity. Our primary outcome was a change in Sequential Organ Failure Assessment (SOFA) score with secondary outcomes including all-cause mortality, need for intubation, and QTc prolongation as a safety outcome.

Results: We identified 489 patients who received zinc and 587 patients who did not. The primary outcome showed a small difference in the change in SOFA score in patients receiving zinc in univariate analysis (1.08 vs. 1.43, p=0.02), but this difference was not significant after adjustment for confounding factors such as receipt of corticosteroids and ICU admission. Mortality was not different between those that received zinc compared to those that did not (32.7% vs. 35.9%, p=0.268).

Conclusion: Our retrospective study, including 1064 patients hospitalized in Detroit, demonstrated no differences in mortality or disease severity with zinc combination. Furthermore, prospective studies are needed to establish the utility of zinc in the treatment of COVID-19.

Keywords: Zinc, COVID-19, SARS-CoV-2, nutritional support, multiple organ failure, organ dysfunction scores.

Graphical Abstract
[1]
Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): A review. JAMA 2020; 324(8): 782-93.
[http://dx.doi.org/10.1001/jama.2020.12839] [PMID: 32648899]
[2]
Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus disease 2019 Case surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69(24): 759-65.
[http://dx.doi.org/10.15585/mmwr.mm6924e2] [PMID: 32555134]
[3]
Gautret P, Lagier J-C, Parola P, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: Results of an open-label non-randomized clinical trial. Int J Antimicrob Agents 2020; 56(1): 105949.
[http://dx.doi.org/10.1016/j.ijantimicag.2020.105949] [PMID: 32205204]
[4]
Cortegiani A, Ingoglia G, Ippolito M, Giarratano A, Einav S. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. J Crit Care 2020; 57: 279-83.
[http://dx.doi.org/10.1016/j.jcrc.2020.03.005] [PMID: 32173110]
[5]
Wu C, Liu Y, Yang Y, et al. Analysis of therapeutic targets for SARS-CoV-2 and discovery of potential drugs by computational methods. Acta Pharm Sin B 2020; 10(5): 766-88.
[http://dx.doi.org/10.1016/j.apsb.2020.02.008] [PMID: 32292689]
[6]
Kupferschmidt K. Big studies dim hopes for hydroxychloroquine. Science 2020; 368(6496): 1166-7.
[http://dx.doi.org/10.1126/science.368.6496.1166] [PMID: 32527806]
[7]
Hemilä H. Zinc lozenges and the common cold: A meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage. JRSM Open 2017; 8(5): 2054270417694291.
[http://dx.doi.org/10.1177/2054270417694291] [PMID: 28515951]
[8]
te Velthuis AJW, van den Worm SHE, Sims AC, Baric RS, Snijder EJ, van Hemert MJ. Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoS Pathog 2010; 6(11): e1001176.
[http://dx.doi.org/10.1371/journal.ppat.1001176] [PMID: 21079686]
[9]
Derwand R, Scholz M. Does zinc supplementation enhance the clinical efficacy of chloroquine/hydroxychloroquine to win today’s battle against COVID-19? Med Hypotheses 2020; 142: 109815.
[http://dx.doi.org/10.1016/j.mehy.2020.109815] [PMID: 32408070]
[10]
Abd-Elsalam S, Soliman S, Esmail ES, et al. Do zinc supplements enhance the clinical efficacy of hydroxychloroquine? A randomized, multicenter trial. Biol Trace Elem Res 2021; 199(10): 3642-6.
[http://dx.doi.org/10.1007/s12011-020-02512-1] [PMID: 33247380]
[11]
Carlucci PM, Ahuja T, Petrilli C, Rajagopalan H, Jones S, Rahimian J. Zinc sulfate in combination with a zinc ionophore may improve outcomes in hospitalized COVID-19 patients. J Med Microbiol 2020; 69(10): 1228-34.
[http://dx.doi.org/10.1099/jmm.0.001250] [PMID: 32930657]
[12]
de Grooth H-J, Geenen IL, Girbes AR, Vincent J-L, Parienti J-J, Oudemans-van Straaten HM. SOFA and mortality endpoints in randomized controlled trials: A systematic review and meta-regression analysis. Crit Care 2017; 21(1): 38.
[http://dx.doi.org/10.1186/s13054-017-1609-1] [PMID: 28231816]

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