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Home   COVID-19 treatment studies for Zinc  COVID-19 treatment studies for Zinc  C19 studies: Zinc  Zinc   Select treatmentSelect treatmentTreatmentsTreatments
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Other Adoption [0.03-1.47]death1/14113/377CT​1Improvement, RR [CI]TreatmentControlThomas (RCT)12%0.88 [0.67-1.17]recov. time58 (n)50 (n)CT​1Asimi97%0.03 [0.00-0.44]ventilation0/2709/86CT​1Early treatment75%0.25 [0.04-1.71]1/46922/51375% improvementCarlucci38%0.62 [0.46-0.84]death/HPC54/411119/521Improvement, RR [CI]TreatmentControlKrishnan18%0.82 [0.62-1.09]death31/5861/94Yao34%0.66 [0.41-1.07]death73/19621/46Frontera (PSM)37%0.63 [0.44-0.91]death121/1,006424/2,467CT​1Abd-Elsalam (RCT)1%0.99 [0.30-3.31]death5/965/95Darban (RCT)33%0.67 [0.14-3.17]progression2/103/10CT​1Mulhem46%0.54 [0.43-0.68]death256/1,596260/1,623Gadhiya-41%1.41 [0.69-2.57]death21/5434/229Al Sulaiman (PSM)36%0.64 [0.37-1.10]death23/8232/82Elavarasi65%0.35 [0.24-0.56]death486 (n)1,201 (n)Late treatment35%0.65 [0.54-0.79]586/3,995959/6,36835% improvementZinc COVID-19 treatment Oct 20, 2021Effect extraction pre-specifiedFavors zincFavors control
Database of all zinc COVID-19 studies. Submit updates/corrections.
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Oct 11
Early Majeed et al., Evidence-Based Complementary and Alternative Medicine, doi:10.1155/2021/8447545 (Peer Reviewed) 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.
Sep 22
Levels Laing et al., Nutrients, doi:10.3390/nu13103304 (Peer Reviewed) 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 79 hospitalized patients in Belgium, showing mortality associated with zinc and selenium deficiency.
Sep 3
Levels Jahromi et al., BMC Infectious Diseases, doi:10.1186/s12879-021-06617-3 (Peer Reviewed) 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
PrEP Bagheri et al., Journal of Family & Reproductive Health, doi:10.18502/jfrh.v14i3.4668 (Peer Reviewed) 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 26
Levels Golabi et al., Zenodo, doi:10.5281/zenodo.5266352 (Preprint) The Association between Vitamin D and Zinc Status with the Disease Onset and Progression of Clinical Symptoms among Outpatients Infected with COVID-19 and Non-Infected Participants: A Cross-Sectional Study
Details   Analysis of vitamin D and zinc levels in 53 PCR+ outpatients and 53 controls, showing lower zinc levels in COVID-19 patients, and increased risk of symptomatic cases with vitamin D deficiency. Currently only the abstract is available.
Aug 25
Levels Pour et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.08.053 (Peer Reviewed) 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 (Peer Reviewed) 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 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
PrEP Israel et al., Epidemiology and Global Health Microbiology and Infectious Disease, doi:10.7554/eLife.68165 (Peer Reviewed) hosp., ↓>99.9%, 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 (Peer Reviewed) 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
PrEP Margolin et al., Journal of Evidence-Based Integrative Medicine, doi:10.1177/2515690X211026193 (Peer Reviewed) 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.
Jun 24
Levels Beigmohammadi et al., Nutrition, doi:10.1016/j.nut.2021.111400 (Peer Reviewed) 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 (Peer Reviewed) 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 (Peer Reviewed) (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 n..
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) (Peer Reviewed) 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 (Peer Reviewed) 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 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
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
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
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
Late Gadhiya et al., BMJ Open, doi:10.1136/bmjopen-2020-042549 (Peer Reviewed) 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 (Peer Reviewed) 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..
Feb 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?
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 (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
Details   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 ..
Jan 7
Review Sethuram et al., Reproductive Sciences, doi:10.1007/s43032-020-00400-6 (Review) (Peer Reviewed) 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) (Peer Reviewed) 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) (Peer Reviewed) 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 (Peer Reviewed) 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 (Peer Reviewed) 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.
Nov 30
PrEP Louca et al., BMJ Nutrition, Prevention & Health, doi:10.1136/bmjnph-2021-000250 (preprint 11/30/20) (Peer Reviewed) 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 (Peer Reviewed) 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. 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..
Nov 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
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) (Peer Reviewed) 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 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
Details   79% lower mortality and 82% lower hospitalization with early HCQ+AZ+Z. Retrospective 518 patients (141 treated, 377 control).
Oct 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
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) (Peer Reviewed) 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 (Peer Reviewed) 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 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
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 (Peer Reviewed) 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]. [1] 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 (Peer Reviewed) 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.
Jun 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
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) (Peer Reviewed) 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 (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
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..
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