Should we supplement zinc in COVID-19 patients? Evidence from meta-analysis.

Szarpak, Lukasz; Pruc, Michal; Gasecka, Aleksandra; Jaguszewski, Milosz J; Michalski, Tomasz; Peacock, Frank W; Smereka, Jacek; Pytkowska, Katarzyna; Filipiak, Krzysztof J

INTRODUCTION Preliminary retrospective reports showed that zinc supplementation may decrease mortality in COVID-19 patients, postulating the potential therapeutic efficacy of zinc in the management of the disease. OBJECTIVES We sought to summarize the studies published to date regarding the antiviral activity of zinc in COVID-19 patients. PATIENTS AND METHODS A meta-analysis was performed to compare the outcomes of hospitalized patients receiving zinc supplementation and those treated with standard care. The primary outcome was survival to hospital discharge. Secondary outcomes were in-hospital mortality and length of stay in hospital or intensive care unit (ICU). RESULTS Data relating to 1474 patients included in four studies were analyzed. Survival to hospital discharge was 56.8% in the zinc group, compared to 75.9% in the non-zinc group (P=0.88). In-hospital mortality was 22.3% in the zinc group, compared to 13.6% for the standard care group (P=0.16). Length of hospital stay was 7.7(3.7) days in the zinc group and 7.2(3.9) days in the standard treatment group (P<0.001). Length of ICU stay was 4.9(1.7) days in the zinc group and 5.8(1.9) days in the standard care group (P=0.009). CONCLUSIONS Zinc supplementation did not have any beneficial impact on the course of COVID-19 evaluated as survival to hospital discharge and in-hospital mortality. The zinc-supplemented group had longer hospital and ICU lengths of stay. There is at present no evidence-based data to support routine zinc supplementation in COVID-19 patients.