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Zinc study #12 of 18
11/29 Late treatment study
Abd-Elsalam et al., Biological Trace Element Research, doi:10.1007/s12011-020-02512-1 (Peer Reviewed)
Do Zinc Supplements Enhance the Clinical Efficacy of Hydroxychloroquine?: a Randomized, Multicenter Trial
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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 in the zinc group and 6 control. There were 5 deaths in each group.
No information on baseline zinc values was recorded. We note that Egypt has a low rate of zinc deficiency so supplementation is less likely to be helpful in Egypt [1, 2]

Abd-Elsalam et al., 11/29/2020, Randomized Controlled Trial, Egypt, Middle East, peer-reviewed, 10 authors.
risk of death, 1.0% lower, RR 0.99, p = 0.99, treatment 5 of 96 (5.2%), control 5 of 95 (5.3%).
risk of mechanical ventilation, 34.0% lower, RR 0.66, p = 0.54, treatment 4 of 96 (4.2%), control 6 of 95 (6.3%).
risk of no recovery, 5.8% lower, RR 0.94, p = 0.97, treatment 20 of 96 (20.8%), control 21 of 95 (22.1%).
hospitalization time, 3.6% lower, relative time 0.96, p = 0.55, treatment 96, control 95.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. For an individual study the most serious outcome may have a smaller number of events and lower statistical signficance, however this provides the strongest evidence for the most serious outcomes when combining the results of many trials.
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