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00.250.50.7511.251.51.752+Derwand0.21[0.03-1.47]death1/14113/377RRCITreatmentControlThomas (RCT)0.88[0.39-1.99]recov. time5850Tau​2 = 0.44; I​2 = 41.3%Early treatment0.58[0.16-2.11]1/19913/42742% improvementCarlucci0.62[0.45-0.86]death/HPC411521RRCITreatmentControlYao0.66[0.41-1.07]death73/19621/46Frontera0.63[0.44-0.91]death121/1,006424/2,467Abd-Elsalam (RCT)0.99[0.30-3.31]death5/965/95Tau​2 = 0.00; I​2 = 0.0%Late treatment0.64[0.55-0.74]199/1,709450/3,12936% improvementSeet (CLUS. RCT)0.50[0.34-0.75]severe case33/63464/619OT​1RRCITreatmentControlTau​2 = 0.00; I​2 = 0.0%PEP0.50[0.34-0.75]33/63464/61950% improvementYasui0.07[0.01-0.54]ventilation1/206/9RRCITreatmentControlJothimani0.10[0.01-1.76]death0/205/27Berrocal0.55[0.23-1.31]death5/3126/89Tau​2 = 0.88; I​2 = 51.6%Sufficiency0.22[0.05-0.96]6/7137/12578% improvementAll studies0.61[0.52-0.71]239/2,613564/4,30039% improvement10 zinc COVID-19 studiesc19zinc.com 5/15/211 OT: comparison with other treatmentTau​2 = 0.00; I​2 = 6.2%; Z = 6.45 (p < 0.0001)Lower RiskIncreased Risk
 
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4/15
Levels Skalny et al., Metabolites, doi:10.3390/metabo11040244 (Peer Reviewed) Serum Zinc, Copper, and Other Biometals Are Associated with COVID-19 Severity Markers
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.
4/14
PEP Seet et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.04.035 (Peer Reviewed) severe case, ↓49.7%, p=0.03 Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial
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 ..
2/13
Levels Dubourg et al., Journal of Microbiology, Immunology and Infection, doi:10.1016/j.jmii.2021.01.012 (Peer Reviewed) 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?
Retrospective 275 patients showing zinc levels significantly lower in patients with poor outcomes, 840 vs. 970 µg/L, p< 0.0001.
2/12
Early Thomas et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.0369 (Peer Reviewed) recov. time, ↓11.9%, p=0.38 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
Small 214 low-risk outpatient RCT showing non-statistically significant faster recovery with zinc and with vitamin C. The zinc dosage appears low, 50mg zinc glcuonate (7mg elemental zinc). Study performed in the USA where zinc deficiency ..
1/4
Review Joachimiak et al., PLOS Neglected Tropical Diseases, doi:10.1371/journal.pntd.0008895 (Review) (Peer Reviewed) review Zinc against COVID-19? Symptom surveillance and deficiency risk groups
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..
12/30
Review McCullough et al., Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm.2020.04.264 (Review) (Peer Reviewed) review Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19)
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 ..
11/29
Late Abd-Elsalam et al., Biological Trace Element Research, doi:10.1007/s12011-020-02512-1 (Peer Reviewed) death, ↓1.0%, p=0.99 Do Zinc Supplements Enhance the Clinical Efficacy of Hydroxychloroquine?: a Randomized, Multicenter Trial
191 patient RCT in Egypt comparing the addition of zinc to HCQ, not showing a significant difference. Clinical recovery at 28 days was 79.2% in the zinc group and 77.9% control, p = 0.969. Mechanical ventilation was used with 4 patients..
11/18
In Silico Pormohammad et al., International Journal of Molecular Medicine, doi:10.3892/ijmm.2020.4790 (Peer Reviewed) Zinc and SARS‑CoV‑2: A molecular modeling study of Zn interactions with RNA‑dependent RNA‑polymerase and 3C‑like proteinase enzymes
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..
10/26
Late Frontera et al., Research Square, doi:10.21203/rs.3.rs-94509/v1 (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
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
10/26
Levels Berrocal et al., Research Square, doi:10.21203/rs.3.rs-95524/v1 (Preprint) death, ↓44.8%, p=0.23 Zinc and Vitamin A Deficiency Predisposes to the Need for Intubation and ICU Admission in Patients With COVID-19. An Observational Study
Retrospective 120 hospitalized patients showing zinc deficiency associated with a higher ICU admission rate (61.8% vs.29%; p = 0.002) and a higher rate of intubation (87.5% vs. 12.5%; p = 0.002).
10/26
Early Derwand et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106214 (preprint 7/3) (Peer Reviewed) 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
79% lower mortality and 82% lower hospitalization with early HCQ+AZ+Z. Retrospective 518 patients (141 treated, 377 control).
10/20
PrEP Heller et al., Redox Biology, doi:10.1016/j.redox.2020.101764 (Peer Reviewed) Prediction of Survival Odds in COVID-19 by Zinc, Age and Selenoprotein P as Composite Biomarker
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.
10/11
Late Vogel-González et al., medRxiv, doi:10.1101/2020.10.07.20208645 (Preprint) Low zinc levels at clinical admission associates with poor outcomes in COVID-19
Shows a correlation between serum zinc levels and COVID-19 outcome. Almost all patients received HCQ.
9/10
Levels Jothimani (Peer Reviewed) death, ↓89.7%, p=0.06 COVID-19: Poor outcomes in patients with zinc deficiency
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,..
9/7
Levels Yasui et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.09.008 (Peer Reviewed) 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
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.
7/22
Late Yao et al., Chest, doi:10.1016/j.chest.2020.06.082 (Peer Reviewed) death, ↓34.0%, p=0.09 The Minimal Effect of Zinc on the Survival of Hospitalized Patients With COVID-19
Retrospective 242 hospitalized patients in the USA showing adjusted hazard ratio for zinc treatment, aHR 0.66 [0.41-1.07]. [1] notes that the study would be more informative if baseline serum zinc levels were known.
6/6
Late Finzi et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.06.006 (Peer Reviewed) Treatment of SARS-CoV-2 with high dose oral zinc salts: A report on four patients
Case report on 4 patients treated with high dose zinc. All patients experienced significant improvement after one day.
5/8
Late Carlucci et al., J. Med. Microbiol., Sep 15, 2020, doi: 10.1099/jmm.0.001250 (preprint 5/8) (Peer Reviewed) death/HPC, ↓37.8%, p=0.002 Zinc sulfate in combination with a zinc ionophore may improve outcomes in hospitalized COVID-19 patients
Retrospective 932 patients. Addition of Zinc to HCQ+AZ reduces mortality / transfer to hospice, ICU admission, and the need for ventilation. Reduction in mortality or transfer to hospice adjusted odds ratio OR 0.56, p = 0.002; increase i..
2010
In Vitro te Velthuis et al., PLOS Pathogens 2010, 6:11, doi:10.1371/journal.ppat.1001176 (Peer Reviewed) (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
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..
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