Micronutrient zinc roles in adjunctive therapy for COVID-19 by enhancing patients immunoregulation and tolerance to the pathogen

Abstract

SARS-CoV-2 infection (COVID-19) has caused a high number of hospitalizations and deaths. There are currently no approved antiviral drugs or vaccine options available for treatment. Patients with severe cases of COVID-19 are receiving supportive care to manage life-threatening symptoms of viral pneumonia and acute respiratory distress syndrome (ARDS). Clinical and pathological evidence suggests that patients with severe COVID-19 infections suffer from cytokine storm syndrome, which leads to unfavorable health outcomes. Unfortunately, the conventional pharmacotherapies for cytokine storm syndrome are associated with immunosuppression and various other side effects that may worsen the patients' health status and healing capability. This study is to review the literature on how zinc status may affect susceptibility and outcomes of a viral infection, as well as to explore the possible beneficial effects of supplementing zinc to alleviate COVID-19 duration and severity. We propose zinc supplementation as a viable therapeutic approach when used alone or in combination with other drugs to combat cytokine storm syndrome in COVID-19 patients. The supplementation may be especially effective for elderly patients or patients with co-morbidity already deficient in zinc. More level I randomized controlled studies are needed to determine the clinical efficacy of zinc supplementation as a potential low-cost intervention to reduce morbidity and mortality due to pneumonia and ARDS in COVID-19 patients.