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Other Treatments Global Adoption
Zinc COVID-19 studies. Recent:
Zinc has been officially adopted for early treatment in all or part of 3 countries. Submit updates/corrections.
Aug 16
Early, Late, PrEP, PEP Covid Analysis (Preprint) (meta analysis)
Zinc for COVID-19: real-time meta analysis of 43 studies
Details   • Statistically significant improvements are seen for mortality, ventilation, hospitalization, progression, and viral clearance. 13 studies from 13 independent teams in 7 different countries show statistically significant improvements in ..
Aug 4
Levels Bego et al., Journal of Trace Elements in Medicine and Biology, doi:10.1016/j.jtemb.2022.127055 Association of Trace Element Status in COVID-19 Patients with Disease Severity
Details   Analysis of 210 hospitalized patients in Bosnia and Herzegovina with serum levels measured on admission, showing significantly lower zinc and selenium levels in patients that died or had severe cases, compared to mild cases.
Jul 25
PrEPPEP Balmforth et al., Journal of Clinical Virology, doi:10.1016/j.jcv.2022.105248
symp. case, ↓47.4%, p<0.0001
Evaluating the efficacy and safety of a novel prophylactic nasal spray in the prevention of SARS-CoV-2 infection: A multi-centre, double blind, placebo-controlled, randomised trial.
Details   648 patient RCT pHOXWELL nasal spray in India, showing significantly lower IgGS+ and significantly lower symptomatic cases with treatment. pHOXWELL includes a combination of natural virucidal agents and is designed to mimic the fluid surr..
Jun 27
Late Alahmari et al., Healthcare, doi:10.3390/healthcare10071201
hosp. time, ↓30.2%, p<0.0001
Factors Associated with Length of Hospital Stay among COVID-19 Patients in Saudi Arabia: A Retrospective Study during the First Pandemic Wave
Details   Retrospective 977 hospitalized patients in Saudi Arabia, showing significantly shorter hospitalization with zinc treatment.
Jun 17
PrEPPEP Stambouli et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.06.016
symp. case, ↓68.4%, p=0.36
COVID-19 prophylaxis with Doxycycline and Zinc in Health Care Workers: A prospective randomized double-blind clinical tria
Details   Prophylaxis RCT with 59 zinc + doxycycline, 56 doxycycline, and 57 placebo healthcare workers, showing lower symptomatic cases and significantly improved Ct values with the addition of zinc to doxycycline treatment. Doxycycline 100mg/day ..
May 30
Early Kumar et al., Cureus, doi:10.7759/cureus.25467
no recov., ↓89.2%, p=0.05
Efficacy and Safety of Aspirin, Promethazine, and Micronutrients for Rapid Clinical Recovery in Mild to Moderate COVID-19 Patients: A Randomized Controlled Clinical Trial
Details   RCT 260 patients in India, 130 treated with aspirin, promethazine, vitamin C, D, B3, zinc, and selenium, showing faster recovery with treatment. There was no hospitalization, ICU admission, or supplemental oxygen requirements in either gr..
May 27
PrEPPEP Galmés et al., Nutrients, doi:10.3390/nu14112254 Suboptimal Consumption of Relevant Immune System Micronutrients Is Associated with a Worse Impact of COVID-19 in Spanish Populations
Details   Ecological study in Spain, showing lower intake of vitamin D, A, B9, and zinc in regions with the highest COVID-19 incidence and mortality. Vitamin D intake was associated with lower prevalence, incidence, and a combined incidence+mortali..
May 23
Meta Tabatabaeizadeh, S., European Journal of Medical Research, doi:10.1186/s40001-022-00694-z
death, ↓43.0%, p=0.0002
Zinc supplementation and COVID-19 mortality: a meta-analysis
Details   Meta analysis of five zinc treatment studies for COVID-19, showing significantly lower mortality.
May 13
Late Zangeneh et al., Obesity Medicine, doi:10.1016/j.obmed.2022.100420
death, ↑21.0%, p=0.66
Survival analysis based on body mass index in patients with Covid-19 admitted to the intensive care unit of Amir Al-Momenin Hospital in Arak – 2021
Details   Retrospective 193 ICU patients in Iran, showing no significant difference with zinc treatment.
Apr 30
Levels Voelkle et al., Nutrients, doi:10.3390/nu14091862
death/ICU, ↓77.1%, p=0.007
Prevalence of Micronutrient Deficiencies in Patients Hospitalized with COVID-19: An Observational Cohort Study
Details   Prospective study of 57 consecutive hospitalized COVID-19 patients in Switzerland, showing higher risk of mortality/ICU admission with vitamin A, vitamin D, and zinc deficiency, with statistical significance only for vitamin A and zinc. A..
Mar 31
Late Arora et al., Journal of Infection, doi:10.1016/j.jinf.2021.12.039
progression, ↓95.0%, p<0.0001
Risk factors for Coronavirus disease-associated mucormycosis
Details   Retrospective 152 COVID-associated mucormycosis cases and 200 controls, showing lower risk of COVID-associated mucormycosis with zinc treatment.
Mar 30
PrEPPEP Citu et al., Nutrients, doi:10.3390/nu14071445
severe case, ↓17.6%, p=1.00
Calcium, Magnesium, and Zinc Supplementation during Pregnancy: The Additive Value of Micronutrients on Maternal Immune Response after SARS-CoV-2 Infection
Details   Retrospective 448 pregnant women with COVID-19. Patients with calcium, zinc, and magnesium supplementation, or magnesium only, had a significantly higher titer of SARS-CoV-2 anti-RBD antibodies. There was no statistically significant diff..
Mar 28
Levels Maares et al., Nutrients, doi:10.3390/nu14071407 Free Zinc as a Predictive Marker for COVID-19 Mortality Risk
Details   Analysis of 33 COVID-19 patients and 86 control patients in Germany, showing lower free serum zinc levels associated with COVID-19 and mortality.
Mar 23
Levels Ghanei et al., European Journal of Clinical Nutrition, doi:10.1038/s41430-022-01095-5 Low serum levels of zinc and 25-hydroxyvitmain D as potential risk factors for COVID-19 susceptibility: a pilot case-control study
Details   Case control study with 90 COVID-19 cases and 95 matched controls in Iran, showing significantly lower zinc levels for cases.
Mar 10
Review DiGuilio et al., International Journal of Molecular Sciences, doi:10.3390/ijms23062995 (Review)
Micronutrient Improvement of Epithelial Barrier Function in Various Disease States: A Case for Adjuvant Therapy
Details   Review of epithelial and endothelial barrier compromise and associated disease risk including COVID-19, and the potential benefits of vitamin A, vitamin D, and zinc for improving barrier function.
Feb 28
PrEPPEP Shehab et al., Tropical Journal of Pharmaceutical Research, doi:10.4314/tjpr.v21i2.13
severe case, ↓47.4%, p=0.24
Immune-boosting effect of natural remedies and supplements on progress of, and recovery from COVID-19 infection
Details   Retrospective survey-based analysis of 349 COVID-19 patients, showing a lower risk of severe cases with vitamin D, zinc, turmeric, and honey prophylaxis in unadjusted analysis, without statistical significance. REC/UG/2020/03.
Feb 28
PrEPPEP Nimer et al., Bosnian Journal of Basic Medical Sciences, doi:10.17305/bjbms.2021.7009
hosp., ↑25.4%, p=0.21
The impact of vitamin and mineral supplements usage prior to COVID-19 infection on disease severity and hospitalization
Details   Retrospective survey based analysis of 2,148 COVID-19 recovered patients in Jordan, showing no significant differences in the risk of severity and hospitalization with zinc prophylaxis.
Feb 26
In Vitro Hajdrik et al., Foods, doi:10.3390/foods11050694 (In Vitro)
In Vitro
In Vitro Determination of Inhibitory Effects of Humic Substances Complexing Zn and Se on SARS-CoV-2 Virus Replication
Details   In Vitro study of a humic substance containing vitamin C, selemium ions, and zinc ions, showing 50% SARS-CoV-2 inhibition at picomolar concentrations.
Feb 24
Review Kory et al., Journal of Clinical Medicine Research, doi:10.14740/jocmr4658 (Review)
“MATH+” Multi-Modal Hospital Treatment Protocol for COVID-19 Infection: Clinical and Scientific Rationale
Details   Review of the data supporting the MATH+ hospital treatment protocol for COVID-19.
Feb 23
PrEPPEP Kumar et al., Cureus, doi:10.7759/cureus.22528
death, ↓20.0%, p=0.71
Role of Zinc and Clinicopathological Factors for COVID-19-Associated Mucormycosis (CAM) in a Rural Hospital of Central India: A Case-Control Study
Details   Case control study of 105 COVID-19 patients in India, 55 with mucormycosis and 50 without, showing zinc prophylaxis and diabetes both associated with mucormycosis in unadjusted results. This is likely confounded because zinc supplementati..
Feb 8
Levels Ivanova et al., Journal of Trace Elements in Medicine and Biology, doi:10.1016/j.jtemb.2022.126944 Evaluation of zinc, copper, and Cu:Zn ratio in serum, and their implications in the course of COVID-19
Details   Retrospective 75 COVID-19 hospitalized patients and 68 healthy controls in Bulgaria, showing mortality associated with lower zinc levels.
Jan 30
PrEPPEP Chen et al., Environmental Geochemistry and Health, doi:10.1007/s10653-022-01204-0 Geographical distribution of trace elements (selenium, zinc, iron, copper) and case fatality rate of COVID-19: a national analysis across conterminous USA
Details   Analysis of the geographical association between concentrations of selenium, zinc, iron, and copper in surface soils and COVID-19 case fatality rates, showing low zinc levels associated with higher case fatality rates.
Jan 29
PrEPPEP Mohajeri et al., Mediterranean Journal of Nutrition and Metabolism, doi:10.3233/MNM-211521 The difference in the dietary inflammatory index, functional food, and antioxidants intake between COVID -19 patients and healthy persons
Details   Retrospective dietary survey analysis of 500 COVID-19 patients and 500 healthy matched controls in Iran, showing that COVID-19 patients had lower daily consumption of vitamin C, vitamin D, vitamin E, zinc, and selenium. IR.ARUMS.REC.1400...
Jan 22
Levels PVSN et al., Biological Trace Element Research, doi:10.1007/s12011-022-03124-7 Comparative Analysis of Serum Zinc, Copper and Magnesium Level and Their Relations in Association with Severity and Mortality in SARS-CoV-2 Patients
Details   Analysis of 150 COVID+ hospitalized patients in India, showing lower zinc levels associated with higher severity.
Jan 22
Levels Ekemen Keleş et al., European Journal of Pediatrics, doi:10.1007/s00431-021-04348-w
hosp., ↓75.3%, p=0.01
Serum zinc levels in pediatric patients with COVID-19
Details   Prospective study of 100 COVID+ pediatric patients in Turkey, showing significantly increased risk of hospitalization for patients with zinc deficiency.
Dec 16
Early Mayberry et al., Critical Care Medicine, doi:10.1097/01.ccm.0000807104.82650.d6
death, ↓53.5%, p<0.0001
Zinc use is associated with improved outcomes in COVID-19: results from the CRUSH-COVID registry
Details   Retrospective 2,028 COVID patients in the USA, showing significantly lower mortality, ventilation, ICU admission, and progression to ARDS with zinc use, defined as at least one dose from one week prior to admission to 48 hours after admis..
Dec 13
PrEPPEP Gordon et al., Frontiers in Medicine, doi:10.3389/fmed.2021.756707
death, ↓67.6%, p=0.48
A Case-Control Study for the Effectiveness of Oral Zinc in the Prevention and Mitigation of COVID-19
Details   Prospective study of zinc supplementation with 104 patients randomized to receive 10mg, 25mg, or 50mg of zinc picolinate daily, and a matched sample of 96 control patients from the adjacent clinic that did not routinely recommend/use zinc..
Nov 15
Levels Ramos et al., Global Journal of Health Science, doi:10.5539/gjhs.v14n1p1
cases, ↓23.6%, p=0.64
Vitamin D, Zinc and Iron in Adult Patients with Covid-19 and Their Action in the Immune Response as Biomarkers
Details   Retrospective 13 COVID-19 patients and 7 controls in Brazil, showing no significant difference in zinc deficiency.
Oct 25
Late Leal-Martínez et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph19031172 (preprint 10/25/2021)
death, ↓85.7%, p=0.03
Effect of a Nutritional Support System to Increase Survival and Reduce Mortality in Patients with COVID-19 in Stage III and Comorbidities: A Blinded Randomized Controlled Clinical Trial
Details   80 patient RCT with 40 patients treated with a comprehensive regimen of nutritional support, showing significantly lower mortality with treatment. Treatment contained cholecalciferol, vitamin C, zinc, spirulina maxima, folic acid, glutami..
Oct 12
PrEP, Early Worcel et al., Annals of Palliative Medicine, doi:10.21037/apm-21-1707 Low mortality from COVID-19 at a nursing facility in France following a combined preventive and active treatment protocol
Details   Report on the relatively low mortality and relatively mild COVID-19 symptoms at a French nursing facility that has adopted several treatments including vitamin D, zinc, anticoagulants, corticosteroids, and a multivitamin.
Oct 11
Early Majeed et al., Evidence-Based Complementary and Alternative Medicine, doi:10.1155/2021/8447545
ventilation, ↓66.2%, p=1.00
A Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy and Safety of a Nutritional Supplement (ImmuActive) for COVID-19 Patients
Details   RCT 100 patients in India, 50 treated with ImmuActive (curcumin, andrographolides, resveratrol, zinc, selenium, and piperine), showing improved recovery with treatment.
Oct 1
Late Kaplan et al., SSRN, 10.2139/ssrn.3934228 (Preprint)
ventilation, ↑14.3%, p=1.00
Resveratrol and Zinc in the Treatment of Outpatients With COVID-19 – The Reszinate Study - A Phase 1/2 Randomized Clinical Trial Utilizing Home Patient-Obtained Nasal and Saliva Viral Sampling
Details   Small RCT of zinc plus resveratrol in COVID-19+ outpatients, showing no significant differences in viral clearance or symptoms. Although the treatment group was older (46.3 vs. 38.5) and had more severe baseline symptoms, they had similar..
Sep 22
Levels Du Laing et al., Nutrients, doi:10.3390/nu13103304
death, ↓79.0%, p=0.01
Course and Survival of COVID-19 Patients with Comorbidities in Relation to the Trace Element Status at Hospital Admission
Details   Retrospective 73 hospitalized COVID-19 patients in Belgium, showing higher risk of mortality with selenium deficiency and zinc deficiency.
Sep 17
Levels Singh et al., Frontiers in Immunology, doi:10.3389/fimmu.2021.699389 Nutritional Immunity, Zinc Sufficiency, and COVID-19 Mortality in Socially Similar European Populations
Details   Analysis of zinc sufficiency showing a positive correlation between sufficiency and COVID-19 within European countries. Unmeasured confounders are likely to be significant, for example the higher sufficiency countries also have significan..
Sep 3
Levels Jahromi et al., BMC Infectious Diseases, doi:10.1186/s12879-021-06617-3 The correlation between serum selenium, zinc, and COVID-19 severity: an observational study
Details   Prospective analysis of 84 patients in Iran, showing higher selenium and zinc levels associated with a decrease in serum CRP level. There was no statistically significant association between selenium/zinc levels and disease severity.
Sep 1
PrEPPEP Bagheri et al., Journal of Family & Reproductive Health, doi:10.18502/jfrh.v14i3.4668
progression, ↓60.4%, p=0.41
Supplement Usage Pattern in a Group of COVID- 19 Patients in Tehran
Details   Retrospective 510 patients in Iran, showing lower risk of severity with vitamin D (statistically significant) and zinc (not statistically significant) supplementation. IR.TUMS.VCR.REC.1398.1063.
Aug 31
Late Arrieta et al., Nutrition, doi:10.1016/j.nut.2021.111467 Serum zinc and copper in people with COVID-19 and zinc supplementation in parenteral nutrition
Details   Retrospective 35 COVID-19 patients on parenteral nutrition on Spain, showing serum zinc levels inversely associated with length of hospital stay. There was no significant association between zinc and mortality (p>0.1, actual results are n..
Aug 28
Late Assiri et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.030
death, ↑80.8%, p=0.44
COVID-19 related treatment and outcomes among COVID-19 ICU patients: A retrospective cohort study
Details   Retrospective 118 ICU patients in Saudi Arabia showing no significant differences in unadjusted results with zinc, vitamin D, and favipiravir treatment.
Aug 26
Levels Golabi et al., Nutrients, doi:10.3390/nu13103368 (preprint 8/26/2021) The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study
Details   Analysis of vitamin D and zinc levels in 53 PCR+ outpatients and 53 matched controls, showing lower zinc levels in COVID-19 patients, and increased risk of cases and symptoms with vitamin D deficiency. There was no significant difference ..
Aug 25
Levels Pour et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.08.053 Serum trace elements levels and clinical outcomes among Iranian COVID‐19 patients
Details   Prospective analysis of 114 ICU patients and 112 matched non-ICU patients in Iran, showing mortality associated with lower zinc levels. There was no significant difference in zinc levels between ICU and non-ICU patients. IR.TBZMED.REC.139..
Aug 18
Levels Shakeri et al., Journal of Medical Virology, doi:10.1002/jmv.27277 Evaluation of the relationship between serum levels of zinc, vitamin B12, vitamin D, and clinical outcomes in patients with COVID-19
Details   Retrospective 293 hospitalized patients in Iran showing lower levels of zinc, vitamin B12, and vitamin D in patients that died, with statistical significance reached only for zinc.
Aug 17
Late Capone et al., Cureus, doi:10.7759/cureus.9809 Characterization of Critically Ill COVID-19 Patients at a Brooklyn Safety-Net Hospital
Details   Retrospective 102 ICU patients in the USA, 73 receiving vitamin C and zinc, showing a negative correlation of treatment with mortality, but not reaching statistical significance (p = 0.31).
Aug 12
Late Elavarasi et al., medRxiv, doi:10.1101/2021.08.10.21261855 (Preprint)
death, ↓65.1%, p<0.0001
Clinical features, demography and predictors of outcomes of SARS-CoV-2 infection in a tertiary care hospital in India - a cohort study
Details   Retrospective 2017 hospitalized patients in India, showing lower mortality with zinc treatment.
Jul 27
PrEPPEP Israel et al., Epidemiology and Global Health Microbiology and Infectious Disease, doi:10.7554/eLife.68165
hosp., ↓>99.99%, p=0.04
Identification of drugs associated with reduced severity of COVID-19: A case-control study in a large population
Details   Case control study examining medication usage with a healthcare database in Israel, showing lower risk of hospitalization with calcium + zinc supplements (defined as being picked up within 35 days prior to PCR+), however only 10 patients ..
Jul 9
Early Rabail et al., Food Science & Nutrition, doi:10.1002/fsn3.2458 Nutritional and lifestyle changes required for minimizing the recovery period in home quarantined COVID-19 patients of Punjab, Pakistan
Details   Survey of 80 recovered COVID-19 patients in Pakistan, showing faster recovery with vitamin C, vitamin D, and zinc supplementation.
Jul 6
PrEPPEP Margolin et al., Journal of Evidence-Based Integrative Medicine, doi:10.1177/2515690X211026193
cases, ↓94.4%, p=0.003
20-Week Study of Clinical Outcomes of Over-the-Counter COVID-19 Prophylaxis and Treatment
Details   Retrospective 113 outpatients, 53 (patient choice) treated with zinc, quercetin, vitamin C/D/E, l-lysine, and quina, showing lower cases with treatment. Results are subject to selection bias and limited information on the groups is provid..
Jun 24
Levels Beigmohammadi et al., Nutrition, doi:10.1016/j.nut.2021.111400 The association between serum levels of micronutrients and the severity of disease in patients with COVID-19
Details   Retrospective 60 ICU patients in Iran, showing that lower levels of vitamin D, magnesium, and zinc were significantly associated with higher APACHE scores (P = 0.001, 0.028, and <0.001, respectively) and higher lung involvement (P = 0.002..
Jun 20
Late Notz et al., Nutrients, doi:10.3390/nu13062113 Clinical Significance of Micronutrient Supplementation in Critically Ill COVID-19 Patients with Severe ARDS
Details   Retrospective 22 ICU patients, showing most patients had low selenium status biomarkers and low zinc levels, and reporting on treatment with nutrient supplementation including selenium and zinc. Authors conclude that sufficient selenium a..
Jun 15
In Vitro Panchariya et al., Chemical Communications, doi:10.1039/D1CC03563K (In Vitro)
In Vitro
Zinc2+ ion inhibits SARS-CoV-2 main protease and viral replication in vitro
Details   In Silico and In Vitro study showing that ionic zinc inhibits SARS-CoV-2 main protease (Mpro) and inhibits viral replication. Zinc acetate inhibited viral replication in Vero E6 cells, while zinc glycinate and zinc gluconate did not at no..
Jun 12
Levels Verschelden et al., medRxiv, doi:10.1101/2021.06.09.21258271 (Preprint) Plasma zinc status and hyperinflammatory syndrome in hospitalized COVID-19 patients: an observational study
Details   Prospective study of 139 hospitalized COVID-19 patients, showing 96% had zinc deficiency. Higher zinc levels were associated with a shorter length of hospitalization. Mortality and ventilation was lower with higher zinc levels, but not re..
Jun 7
Late Al Sulaiman et al., Critical Care, doi:10.1186/s13054-021-03785-1 (preprint 6/7/2021)
death, ↓36.0%, p=0.11
Evaluation of Zinc Sulfate as an Adjunctive Therapy in COVID-19 Critically Ill Patients: a Two Center Propensity-score Matched Study
Details   Retrospective 266 ICU patients showing lower mortality with zinc treatment (very close to statistical significance), and higher odds of acute kidney injury. NRC21R/287/07.
May 22
Early Asimi et al., Endocrine Abstracts, doi:10.1530/endoabs.73.PEP14.2 (Preprint)
ventilation, ↓97.4%, p<0.0001
Selenium, zinc, and vitamin D supplementation affect the clinical course of COVID-19 infection in Hashimoto’s thyroiditis
Details   Retrospective 356 Hashimoto's thyroiditis outpatients, 270 taking vitamin D, zinc, and selenium, showing significantly lower hospitalization with treatment. Authors adjust for age, gender, BMI, and smoking status, reporting statistically ..
May 3
Levels Fromonot et al., Clinical Nutrition, doi:10.1016/j.clnu.2021.04.042
hosp., ↓89.2%, p=0.002
Hypozincemia in the early stage of COVID-19 is associated with an increased risk of severe COVID-19
Details   Analysis of 240 consecutive patients in France, showing significantly higher zinc deficiency in COVID-19 patients, and significantly greater risk of hospitalization for COVID-19 patients with zinc deficiency. 2020PI087.
Apr 18
Levels Elham et al., Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2021.03.040 Serum vitamin D, calcium, and zinc levels in patients with COVID-19
Details   Case control study with 93 hospitalized patients in Iran and 186 control patients, showing significantly lower vitamin D, zinc, and calcium levels in cases. IR.SHOUSHTAR.REC.1399.017.
Apr 15
Levels Skalny et al., Metabolites, doi:10.3390/metabo11040244 Serum Zinc, Copper, and Other Biometals Are Associated with COVID-19 Severity Markers
Details   Analysis of serum metal levels in 150 COVID-19 patients and 44 controls, finding that COVID-19 severity was associated with lower serum Ca, Fe, Se, Zn levels when compared to controls.
Apr 14
PrEPPEP Seet et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.04.035
symp. case, ↓49.7%, p=0.0007
Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial
Details   Prophylaxis RCT in Singapore with 3,037 low risk patients, showing lower serious cases, lower symptomatic cases, and lower confirmed cases of COVID-19 with all treatments (ivermectin, HCQ, PVP-I, and Zinc + vitamin C) compared to vitamin ..
Apr 8
PrEPPEP Abdulateef et al., Open Medicine, doi:10.1515/med-2021-0273
hosp., ↓13.1%, p=0.83
COVID-19 severity in relation to sociodemographics and vitamin D use
Details   Survey of 428 recovered COVID-19 patients in Iraq, showing fewer hospital visits for patients on prophylactic vitamin C or D. Hospitalization was lower for those on vitamin C, D, or zinc, without statistical significance.
Apr 8
Late Gadhiya et al., BMJ Open, doi:10.1136/bmjopen-2020-042549
death, ↑40.9%, p=0.33
Clinical characteristics of hospitalised patients with COVID-19 and the impact on mortality: a single-network, retrospective cohort study from Pennsylvania state
Details   Retrospective 283 patients in the USA showing higher mortality with all treatments (not statistically significant). Confounding by indication is likely. In the supplementary appendix, authors note that the treatments were usually given fo..
Apr 7
Late Mulhem et al., BMJ Open, doi:10.1136/bmjopen-2020-042042
death, ↓45.6%, p<0.0001
3219 hospitalised patients with COVID-19 in Southeast Michigan: a retrospective case cohort study
Details   Retrospective database analysis of 3,219 hospitalized patients in the USA. Very different results in the time period analysis (Table S2), and results significantly different to other studies for the same medications (e.g., heparin OR 3.06..
Mar 30
PrEPPEP Holt et al., Thorax, doi:10.1136/thoraxjnl-2021-217487
cases, ↓6.8%, p=0.77
Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK)
Details   Prospective survey-based study with 15,227 people in the UK, showing lower risk of COVID-19 cases with vitamin A, vitamin D, zinc, selenium, probiotics, and inhaled corticosteroids; and higher risk with metformin and vitamin C. Statistica..
Feb 25
Late Patel et al., Journal of Medical Virology, doi:10.1002/jmv.26895
death, ↓20.0%, p=1.00
A pilot double‐blind safety and feasibility randomized controlled trial of high‐dose intravenous zinc in hospitalized COVID‐19 patients
Details   Small early terminated RCT with 33 hospitalized patients in Australia, 15 treated with zinc, showing no significant difference in clinical outcomes. Treatment increased zinc levels above the deficiency cutoff. Intravenous zinc 0.5mg/kg/da..
Feb 15
PrEPPEP Mahto et al., American Journal of Blood Research, 11:1
IgG+, ↓36.8%, p=0.35
Seroprevalence of IgG against SARS-CoV-2 and its determinants among healthcare workers of a COVID-19 dedicated hospital of India
Details   Retrospective 689 healthcare workers in India, showing no significant difference in IgG positivity with zinc prophylaxis.
Feb 13
Levels Dubourg et al., Journal of Microbiology, Immunology and Infection, doi:10.1016/j.jmii.2021.01.012 Low blood zinc concentrations in patients with poor clinical outcome during SARS-CoV-2 infection: is there a need to supplement with Zinc COVID-19 patients?
Details   Retrospective 275 patients showing zinc levels significantly lower in patients with poor outcomes, 840 vs. 970 µg/L, p< 0.0001.
Feb 12
Early Thomas et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.0369
hosp., ↑43.7%, p=0.72
Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial
Details   Small 214 low-risk outpatient RCT showing non-statistically significant faster recovery with zinc and with vitamin C. Study performed in the USA where zinc deficiency is relatively uncommon. The zinc dosage is relatively low, 50mg zinc gl..
Feb 1
Levels Muhammad et al., SAGE Open Medicine, doi:10.1177/2050312121991246 Deficiency of antioxidants and increased oxidative stress in COVID-19 patients: A cross-sectional comparative study in Jigawa, Northwestern Nigeria
Details   Case control study with 50 symptomatic COVID-19 patients and 21 healthy controls in Nigeria, showing that COVID-19 patients had significantly lower levels of selenium and zinc, and vitamins A, C, and E. Control patients were younger than ..
Jan 7
Early Abdelmaksoud et al., Biological Trace Element Research, doi:10.1007/s12011-020-02546-5 Olfactory Disturbances as Presenting Manifestation Among Egyptian Patients with COVID-19: Possible Role of Zinc
Details   134 COVID-19 patients, 49 treated with zinc, showing faster recovery of olfactory function in patients treated with zinc (median 7 vs. 18 days). There was no difference in overall recovery time. There were 4 deaths but authors do not indi..
Jan 7
Review Sethuram et al., Reproductive Sciences, doi:10.1007/s43032-020-00400-6 (Review)
Potential Role of Zinc in the COVID-19 Disease Process and its Probable Impact on Reproduction
Details   Review of zinc deficiency and supplementation for COVID-19, including potential impacts on reproductive health.
Jan 4
Review Joachimiak et al., PLOS Neglected Tropical Diseases, doi:10.1371/journal.pntd.0008895 (Review)
Zinc against COVID-19? Symptom surveillance and deficiency risk groups
Details   Literature review concluding that zinc should be included as part of preventative supplementation for COVID-19, in general for support of immune health, and should also be considered in the context of zinc deficiency acquired during a vir..
Dec 30
Review McCullough et al., Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm.2020.04.264 (Review)
Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19)
Details   Review urging early treatment of COVID-19 with sequential multidrug treatment that has been shown to be safe and effective. Proposed treatment includes zinc, vitamin D & C, quercetin, and depending on age, comorbidities, and symptoms may ..
Dec 23
Levels Gonçalves et al., Nutrition in Clinical Practice, doi:10.1002/ncp.10612
severe case, ↓82.3%, p<0.001
Association Between Low Zinc Levels and Severity of Acute Respiratory Distress Syndrome by New Coronavirus SARS-CoV-2
Details   Retrospective 169 ICU patients in Brazil, 214 with low zinc levels, showing an association between low zinc levels and severe ARDS. CAAE 30608,020.9.0000.8114.
Dec 15
Late Darban et al., Journal of Cellular & Molecular Anesthesia, doi:10.22037/jcma.v6i2.32182
progression, ↓33.3%, p=1.00
Efficacy of High Dose Vitamin C, Melatonin and Zinc in Iranian Patients with Acute Respiratory Syndrome due to Coronavirus Infection: A Pilot Randomized Trial
Details   Small RCT in Iran with 20 ICU patients, 10 treated with high-dose vitamin C, melatonin, and zinc, not showing significant differences. IRCT20151228025732N52.
Dec 10
Late Rosenthal et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2020.29058
death, ↑16.0%, p=0.003
Risk Factors Associated With In-Hospital Mortality in a US National Sample of Patients With COVID-19
Details   Retrospective database analysis of 64,781 hospitalized patients in the USA, showing lower mortality with vitamin C or vitamin D (authors do not distinguish between the two), and higher mortality with zinc and HCQ, statistically significan..
Nov 30
PrEPPEP Louca et al., BMJ Nutrition, Prevention & Health, doi:10.1136/bmjnph-2021-000250 (preprint 11/30/20)
cases, ↓0.9%, p=0.80
Modest effects of dietary supplements during the COVID-19 pandemic: insights from 445 850 users of the COVID-19 Symptom Study app
Details   Survey analysis of dietary supplements showing no significant difference in PCR+ cases with zinc usage. These results are for PCR+ cases only, they do not reflect potential benefits for reducing the severity of cases. A number of biases c..
Nov 29
Late Abd-Elsalam et al., Biological Trace Element Research, doi:10.1007/s12011-020-02512-1
death, ↓1.0%, p=0.99
Do Zinc Supplements Enhance the Clinical Efficacy of Hydroxychloroquine?: a Randomized, Multicenter Trial
Details   191 patient RCT in Egypt comparing the addition of zinc to HCQ, not showing a significant difference. No information on baseline zinc values was recorded. We note that Egypt has a low rate of zinc deficiency so supplementation is less lik..
Nov 18
In Silico Pormohammad et al., International Journal of Molecular Medicine, doi:10.3892/ijmm.2020.4790
In Silico
Zinc and SARS‑CoV‑2: A molecular modeling study of Zn interactions with RNA‑dependent RNA‑polymerase and 3C‑like proteinase enzymes
Details   In Silico analysis supporting the hypothesis that Zn would bind and regulate the enzymatic activities of 3CLpro and RdRp of SARS‑CoV-2 and therefore inhibit viral replication. Since Zn has established immune health benefits, is readily av..
Oct 26
Late Frontera et al., Research Square, doi:10.21203/ (Preprint)
death, ↓37.0%, p=0.01
Treatment with Zinc is Associated with Reduced In-Hospital Mortality Among COVID-19 Patients: A Multi-Center Cohort Study
Details   Retrospective 3,473 hospitalized patients showing 37% lower mortality with HCQ+zinc. PSM aHR 0.63, p=0.015 regression aHR 0.76, p = 0.023
Oct 26
Levels Tomasa-Irriguible et al., Metabolites, doi:10.3390/metabo11090565 (preprint 10/26/2020)
ventilation, ↓49.3%, p=0.06
Low Levels of Few Micronutrients May Impact COVID-19 Disease Progression: An Observational Study on the First Wave
Details   Retrospective 120 hospitalized patients in Spain showing zinc deficiency associated with higher ICU admission.
Oct 20
PrEPPEP Heller et al., Redox Biology, doi:10.1016/j.redox.2020.101764 Prediction of Survival Odds in COVID-19 by Zinc, Age and Selenoprotein P as Composite Biomarker
Details   Analysis of 35 COVID-19 patients showing a significant correlation for serum zinc levels between COVID-19 patients and controls, and between COVID-19 survivors and non-survivors.
Oct 11
Levels Vogel-González et al., Nutrients, doi:10.3390/nu13020562 (preprint 10/11/2020)
death, ↓77.2%, p=0.0005
Low Zinc Levels at Admission Associates with Poor Clinical Outcomes in SARS-CoV-2 Infection
Details   Retrospective 249 PCR+ hospitalized patients in Spain, 58 with zinc levels on admission <50 μg/dL, showing higher mortality and ICU admission, and slower recovery with low zinc levels.
Sep 10
Levels Jothimani
death, ↓89.7%, p=0.06
COVID-19: Poor outcomes in patients with zinc deficiency
Details   Prospective study of zinc levels in 47 hospitalized COVID-19 patients and 45 healthy controls. COVID-19 patients had significantly lower zinc levels (74.5 vs. 105.8 median μg/dl, p < 0.001). 57.4% of COVID-19 patients were zinc deficient,..
Sep 8
PrEPPEP Galmés et al., Nutrients, doi:10.3390/nu12092738 Current State of Evidence: Influence of Nutritional and Nutrigenetic Factors on Immunity in the COVID-19 Pandemic Framework
Details   Ecological study of European countries analyzing 10 vitamins and minerals endorsed by the European Food Safety Authority as having sufficient evidence for a causal relationship between intake and optimal immune system function: vitamins D..
Sep 7
Levels Yasui et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.09.008
ventilation, ↓92.5%, p=0.001
Analysis of the predictive factors for a critical illness of COVID-19 during treatment - relationship between serum zinc level and critical illness of COVID-19
Details   Retrospective 62 hospitalized patients, 29 with serum zinc data, showing significantly lower serum zinc levels for severe COVID-19 cases (intubation) compared with mild and moderate cases, p = 0.005. Authors recommend zinc supplementation.
Jul 22
Late Yao et al., Chest, doi:10.1016/j.chest.2020.06.082
death, ↓34.0%, p=0.09
The Minimal Effect of Zinc on the Survival of Hospitalized Patients With COVID-19
Details   Retrospective 242 hospitalized patients in the USA showing adjusted hazard ratio for zinc treatment, aHR 0.66 [0.41-1.07]. notes that the study would be more informative if baseline serum zinc levels were known.
Jul 20
Late Krishnan et al., J Clin Anesth., doi:10.1016/j.jclinane.2020.110005
death, ↓17.6%, p=0.18
Clinical comorbidities, characteristics, and outcomes of mechanically ventilated patients in the State of Michigan with SARS-CoV-2 pneumonia
Details   Retrospective 152 mechanically ventilated patients in the USA showing unadjusted lower mortality with vitamin C, vitamin D, HCQ, and zinc treatment, statistically significant only for vitamin C.
Jul 3
Early Derwand et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106214 (preprint 7/3)
death, ↓79.4%, p=0.12
COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study
Details   79% lower mortality and 82% lower hospitalization with early HCQ+AZ+Z. Retrospective 518 patients (141 treated, 377 control).
Jun 6
Late Finzi et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.06.006 Treatment of SARS-CoV-2 with high dose oral zinc salts: A report on four patients
Details   Case report on 4 patients treated with high dose zinc. All patients experienced significant improvement after one day.
May 8
Late Carlucci et al., J. Med. Microbiol., Sep 15, 2020, doi: 10.1099/jmm.0.001250 (preprint 5/8)
death/HPC, ↓37.7%, p=0.002
Zinc sulfate in combination with a zinc ionophore may improve outcomes in hospitalized COVID-19 patients
Details   Retrospective 932 patients showing that the addition of zinc to HCQ+AZ reduced mortality / transfer to hospice, ICU admission, and the need for ventilation.
In Vitro te Velthuis et al., PLOS Pathogens 2010, 6:11, doi:10.1371/journal.ppat.1001176 (In Vitro)
In Vitro
Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture
Details   Shows that the combination of Zn2+ and a zinc ionophore (pyrithione) at low concentrations inhibits the replication of SARS-CoV and equine arteritis virus (EAV) in cell culture. Recommends further study of the use of zinc-ionophores as an..
Please send us corrections, updates, or comments. Vaccines and treatments are both valuable and complementary. All practical, effective, and safe means should be used. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases mortality, morbidity, collateral damage, and the risk of endemic status. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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