The Minimal Effect of Zinc on the Survival of Hospitalized Patients With COVID-19 An Observational Study

November 2020

Zinc is an investigational agent against coronavirus disease 2019 (COVID-19) and has known preventative and therapeutic roles in other infections. Zinc deficiency is associated with lower survival among older patients with pneumonia and predisposes to other viral infections. Established risk factors for critical COVID-19, including older age, diabetes mellitus, and cardiovascular disease, are also associated with zinc deficiency.

The antiviral and immunomodulatory effects of zinc have made it a candidate against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection.2-4 Zinc may decrease the activity of the angiotensin converting enzyme 2, the receptor for SARS-CoV-2. Zinc T-cell modulation may downregulate the cytokine storm associated with severe COVID-19.2,4 These properties underlie the speculated efficacy of chloroquine, a zinc ionophore, and the derivative hydroxychloroquine, which are investigational agents in the worldwide World Health Organization SOLIDARITY trial.2,5,6 Furthermore, chloroquine may increase cellular zinc uptake, suggesting therapeutic benefit from the combination of the two agents.

Despite zinc’s low risk of adverse effects, zinc’s role in the management of COVID-19 must be supported by clinical data. Therefore, we investigated the role of zinc among hospitalized patients with COVID-19.