Miles Mayberry, BS,
Wake Forest Baptist Health
Winston Salem, North Carolina
Disclosure information not submitted.
Jonathan Chow, MD
Department of Anesthesiology and Critical Care Medicine
George Washington University School of Medicine, United States
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Paul Park, MD
Department of Anesthesiology
University of Maryland School of Medicine, United States
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Lynnette Harris, BSN, RN, CCRC
Research Nurse Manager
Wake Forest Baptist Medical Center, United States
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Amit Saha, MS, PhD
Assistant Professor, Anesthesiology
Wake Forest Baptist Health, United States
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Andrea Levine, MD
Division of Pulmonary and Critical Care, Department of Medicine
University of Maryland, United States
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Nathan Smischney, BS, MD, MSc
Department of Anesthesiology and Perioperative Medicine
Mayo Clinic, United States
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Patrick Wieruszewski, BCCCP, PharmD
Assistant Professor of Anesthesiology and Pharmacy
Mayo Clinic
Rochester, Minnesota
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Nikhil Meena, MD
Pulmonary and Critical Care Medicine
University of Arkansas For Medical Sciences Medical Center, United States
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David Yamane, BS, MD
Assistant Professor of Emergency Medicine, Anesthesiology, and Critical Care Medicine
George Washington University Hospital, United States
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Amanda Jackson, MD
Division of Gynecologic Oncology, Department of Obstetrics & Gynecology
Walter Reed National Military Medical Center, United States
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Shravan Kethireddy, MD
Associate Staff Physician
University of Manitoba, United States
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Matthew Wiepking, MD
Clinical Assistant Professor of Emergency Medicine and Surgery- Critical Care
University of Southern California Keck School of Medicine, United States
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Ashish Khanna, MD, FCCP, FASA,FCCM
Anesthesiologist & Intensivist, Associate Professor of Anesthesiology
Wake Forest Baptist Medical Center
Winston Salem, North Carolina
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Title: Zinc use is associated with improved outcomes in COVID-19: Results from the CRUSH-COVID registry
Introduction: Previous work has shown correlations of zinc deficiency and poor outcomes in COVID-19 patients.i Little is known, however, about the use of zinc supplementation and its potential benefits in hospitalized COVID-19 positive individuals. We sought to determine the association of the use of zinc and clinical outcomes in patients with COVID-19.
Methods: COVID-19 patient data between March 2020 and April 2021 was abstracted from the multicenter collaborative CRUSH COVID registry. Zinc use was defined as at least one dose one week prior to hospital admission or within 48 hours of admission. The primary outcome was a composite of mortality, mechanical ventilation, or ICU admission. Secondary outcomes were components of the primary composite outcome, progression to ARDS, use of steroids and the risk of in-hospital stroke. A multivariate regression analysis was used to compare outcomes and several relevant confounders were controlled for.
Results: Out of 2028 COVID-19 patients, 938 (46.3%) had used zinc one week prior to, or within 48 hours of, hospital admission while 1090 (53.7%) patients did not receive zinc. The odds of patients in the zinc group meeting the composite primary outcome were .422 (95% CI, .329—.542, P < .001). Odds of mortality, mechanical ventilation or ICU admission were individually .465 (95% CI, .331—.652, P < .001), .358 (95% CI, .271—.475, P < .001), and .400 (95% CI, .310—.516, P < .001). Likelihood of progression to ARDS in the zinc group were also lower with OR = .146 (95% CI, .097—.219, P < .001) and patients on zinc were also significantly less likely to be placed on dexamethasone OR = .617 (95% CI .462—.823, P = .001), methylprednisolone OR = .231 (95% CI, .130—.412, P < .001) or hydrocortisone therapy OR = .228, (95% CI, .119—.438, P < .001). There was no difference in the risk of an in-hospital stroke OR = .945 (95% CI, .557—1.60, P = 0.835).
Conclusions: Zinc use may be associated with improved clinical outcomes in hospitalized COVID-19 patients. These results would need a prospective randomized trial to establish causality and effect a change in clinical practice recommendations.
iJothimani D, Kailasam E, Danielraj S, et al. COVID-19: Poor outcomes in patients with zinc deficiency. Int J Infect Dis. 2020;100:343-349