Can Zinc fight COVID-19?

The Department of Surgery at Austin Health have started recruitment on a world-first trial to investigate whether intravenous zinc can assist in the fight against coronavirus (COVID-19).

Associate Professor Joseph Ischia

The trial will be led by A/Prof Joseph Ischia, along with Prof Damien Bolton and Dr Oneel Patel from the Department of Surgery at the University of Melbourne. They have a long and successful history of investigating the protective effects of intravenous zinc against organ damage induced by lack of oxygen.

One of the strengths of the trial is that the Department of Surgery has formed a strong and productive collaboration with other essential teams at the Austin and University of Melbourne including A/Prof Jason Trubiano (Infectious Diseases and COVID-19 Unit), A/Prof Christine McDonald (Respiratory Medicine Unit), and Prof Rinaldo Bellomo, Dr Stephen Warrilow, and A/Prof Daryl Jones (Intensive Care Unit). They also enjoy the support of their commercial partner, Phebra, who has donated the pharmaceutical grade Zinc suitable for intravenous injection.

Dr Oneel Patel highlights four mechanisms by which zinc may be useful in treating COVID-19:
1. Zinc reduces viral replication of similar coronaviruses including the common cold,
2. Zinc acts as an anti-inflammatory and may protect against the cytokine storm characteristic in COVID-19,
3. Zinc has proven effective in clinical trials of reducing the severity of symptoms in patients with pneumonia and SARS (Severe Acute Respiratory Syndrome)
4. Zinc protects against low oxygen state induced by the microvasculitis that occurs with COVID-19 infection.

Their study aims to evaluate whether the administration of high-dose intravenous zinc (HDIVZn) improves the clinical outcomes of hospitalised patients with COVID19 infection. Patients will be allocated in a 1:1 ratio to either the treatment group receiving intravenous zinc chloride (0.5mg/kg/d) or to control group receiving placebo, once daily for 7 days.

The primary outcome is patient oxygenation levels:

• Mean change in the level of required oxygenation (oxygen flow in litres/min) in non-ventilated patients.
• Mean change in the oxygen levels (Pa02 ratio in mmHg) in ventilated patients.

Currently, the only treatment proven to reduce mortality in COVID-19 is dexamethasone: a cheap, safe and effective anti-inflammatory. Similar to dexamethasone, zinc has anti-inflammatory properties. Furthermore, an added advantage over dexamethasone is that zinc has anti-viral properties identical to the promising anti-viral Remdesivir.

If successful, this could save lives. In particular, zinc could be a safe, cheap and effective treatment for COVID-19 that could be very important for those high-risk elderly patients. Furthermore, not only would it be an enormous benefit for first world countries, but also those with poorly resourced health systems currently overwhelmed by COVID-19 such as India and Brazil.

More to follow soon.