COVID-19 and Zinc

President Trump taking zinc (WSJ)

Low zinc levels at clinical admission associates with poor outcomes in COVID-19, (11th October)

Zinc balances immune responses and also has a proven direct antiviral action against some viruses.

Zinc deficiency (ZD) is a common condition in elderly and individuals with chronic diseases

Increased intracellular zinc concentrations efficiently impair replication

Resulting in a lower number of viruses

Retrospective analysis

Patients admitted in Barcelona

15th March to 30th April 2020

Clinical severity of COVID-19 and PMH assessed

Fasting plasma zinc levels measured routinely at admission

N = 611

Mean age, 63 years

Male 332, (55%)

Total mortality was 87 patients (14%) during study time

But

249 of 611 patients studied

Of the 249, 21 (8%) died

Baseline zinc levels

Died, (21 people) mean plasma zinc = 43 μg/dl

Survived, (228 people) mean plasma zinc = 63.1 μg/dl

Higher zinc levels, associated with lower maximum levels of interleukin-6 during the period of active infection

Zinc level lower than 50 μg/dl at admission, 2.3 times increased risk of in-hospital death

Compared with those of 50 μg/dl or higher

Lower zinc levels at admission correlate with higher inflammation in the course of infection and poorer outcome

Low plasma zinc levels at admission are associated with mortality in COVID-19 in our study

Further studies are needed to assess the therapeutic impact of this association

COVID-19: Poor outcomes in patients with zinc deficiency (International Journal of Infectious Diseases, November 2020)

Chennai, India

Prospective study of fasting zinc levels in COVID-19 patients at the time of hospitalization

Healthy controls median 105.8 μg/dl

Zinc is a trace element with potent immunoregulatory and antiviral properties

Is utilized in the treatment of coronavirus disease 2019 (COVID-19)

Patients with serious COVID-19 had significantly low zinc levels in comparison to healthy controls

Zinc deficient COVID patients developed more complications

Zinc deficient patients 70.4% developed complications

Non zinc deficient patients, 30.0% developed complications, (p = 0.009)

Acute respiratory distress syndrome

More need of steroids

Increased mortality

Zinc deficient COVID patients had a prolonged hospital stay

Zinc deficient patients, 7.9 days

Non zinc deficient patients, 5.7 days, (p = 0.048)

In vitro studies

Reduced zinc levels increase SARS-CoV-2 virus receptor interactions

Increased zinc levels inhibit ACE2 expression

What zinc does

Catalytic activity of approximately 100 enzymes

Plays a role in immune function

Protein synthesis

Wound healing

DNA synthesis

Cell division

Normal growth and development, pregnancy, childhood, adolescence

Required for sense of taste and smell

Zinc and immunity

Severe zinc deficiency depresses immune function

Even mild to moderate degrees of zinc deficiency can impair macrophage and neutrophil functions, natural killer cell activity, and complement activity

Body requires zinc to develop and activate T-lymphocytes

Low zinc levels have shown reduced lymphocyte proliferation

…. that can be corrected by zinc supplementation

Low zinc status has been associated with increased susceptibility to pneumonia and other infections in children in developing countries and the elderly

Foods

Oysters

Sea food

Beef

Pork

Baked beans

Fortified cereals

Pumpkin seeds

Yogurt

Cashew nuts

Chickpeas

Oats

Almonds

Vitamin D and zinc can be made in bulk for essentially nothing