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Research Article
Khalid Al Sulaiman
King Abdulaziz Medical City
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5547-2043
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background:
Zinc is a trace element that plays a role in stimulating innate and acquired immunity. The role of zinc in critically ill patients with COVID-19 remains unclear. This study aims to evaluate the efficacy and safety of zinc sulfate as adjunctive therapy in critically ill patients with COVID-19.
Methods:
Patients aged ≥ 18 years with a COVID-19 who were admitted to the intensive care unit (ICU) in two tertiary hospitals in Saudi Arabia were retrospectively assessed for zinc use, from 01 March 2020 until 31-December 2020. We assessed the association of zinc use as adjunctive therapy with the in-hospital and 30-day mortality after propensity score matching. Secondary outcomes included mechanical ventilation (MV) duration, ICU length of stay (LOS), hospital LOS, and complication (s) during ICU stay.
Results:
A total of 266 patients were included in this study after using propensity score matching. Zinc sulfate as adjunctive therapy during ICU stay was not associated with statistically significant reduction in 30-day mortality nor in-hospital mortality compared to those who did not receive zinc (HR= 0.65 CI = 0.41,1.01; p= 0.05 and HR= 0.67 CI = 0.45,1.00; p= 0.05; respectively). Moreover, MV duration (Beta coefficient 0.10 CI = -0.19,0.39; p= 0.48), ICU LOS (Beta coefficient 0.19 CI = -0.02,0.40; p=0.08) and hospital LOS (Beta coefficient 0.15 CI = -0.02,0.32; p=0.08) were not statistically significant between the two groups. Patients who received zinc have a higher odds of acute kidney injury (AKI) during ICU stay (OR= 1.80 CI = 1.08-3.0; p= 0.02).
Conclusion:
Zinc sulfate as adjunctive therapy in critically ill patients with COVID-19 may have survival benefit; however, was not statistically significant. Zinc use was linked with an increased risk of AKI development during ICU stay.
Keywords
COVID-19, SARS-CoV-2, Zinc, Supplements, Trace element, Critically ill, Intensive Care Unit (ICU), 30-day mortality
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
- Additionalfile1DemographyandBaselinecharacteristics.docx
Additional file 1: Table e1 (Patients Baseline characteristics before and after propensity-score matching).
- Additionalfile2Coexistingillness.docx
Additional file 2: Table e2 (Co-existing illness for the entire cohort before and after propensity score matching).
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CURRENT STATUS: Under Review
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Version 1
Posted 07 Jun, 2021
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Editorial decision: Major revision
On 09 Aug, 2021
Review #2 received
Received 08 Aug, 2021
Reviewer #2 agreed
On 01 Aug, 2021
Review #1 received
Received 17 Jul, 2021
Reviews received
Received 11 Jul, 2021
Reviewer #1 agreed
On 10 Jul, 2021
Editor assigned
On 03 Jun, 2021
Reviewers invited
Invitations sent on 03 Jun, 2021
Submission checks complete
On 03 Jun, 2021
Editor invited
On 03 Jun, 2021
First submitted
On 28 May, 2021
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Subject Areas
Critical Care & Emergency Medicine
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This preprint is under consideration at Critical Care. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Khalid Al Sulaiman
King Abdulaziz Medical City
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5547-2043
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version (no preprint)
Posted 07 Jun, 2021
This version was not preprinted
Version 1
Posted 07 Jun, 2021
No community comments so far
Editorial decision: Major revision
On 09 Aug, 2021
Review #2 received
Received 08 Aug, 2021
Reviewer #2 agreed
On 01 Aug, 2021
Review #1 received
Received 17 Jul, 2021
Reviews received
Received 11 Jul, 2021
Reviewer #1 agreed
On 10 Jul, 2021
Editor assigned
On 03 Jun, 2021
Reviewers invited
Invitations sent on 03 Jun, 2021
Submission checks complete
On 03 Jun, 2021
Editor invited
On 03 Jun, 2021
First submitted
On 28 May, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background:
Zinc is a trace element that plays a role in stimulating innate and acquired immunity. The role of zinc in critically ill patients with COVID-19 remains unclear. This study aims to evaluate the efficacy and safety of zinc sulfate as adjunctive therapy in critically ill patients with COVID-19.
Methods:
Patients aged ≥ 18 years with a COVID-19 who were admitted to the intensive care unit (ICU) in two tertiary hospitals in Saudi Arabia were retrospectively assessed for zinc use, from 01 March 2020 until 31-December 2020. We assessed the association of zinc use as adjunctive therapy with the in-hospital and 30-day mortality after propensity score matching. Secondary outcomes included mechanical ventilation (MV) duration, ICU length of stay (LOS), hospital LOS, and complication (s) during ICU stay.
Results:
A total of 266 patients were included in this study after using propensity score matching. Zinc sulfate as adjunctive therapy during ICU stay was not associated with statistically significant reduction in 30-day mortality nor in-hospital mortality compared to those who did not receive zinc (HR= 0.65 CI = 0.41,1.01; p= 0.05 and HR= 0.67 CI = 0.45,1.00; p= 0.05; respectively). Moreover, MV duration (Beta coefficient 0.10 CI = -0.19,0.39; p= 0.48), ICU LOS (Beta coefficient 0.19 CI = -0.02,0.40; p=0.08) and hospital LOS (Beta coefficient 0.15 CI = -0.02,0.32; p=0.08) were not statistically significant between the two groups. Patients who received zinc have a higher odds of acute kidney injury (AKI) during ICU stay (OR= 1.80 CI = 1.08-3.0; p= 0.02).
Conclusion:
Zinc sulfate as adjunctive therapy in critically ill patients with COVID-19 may have survival benefit; however, was not statistically significant. Zinc use was linked with an increased risk of AKI development during ICU stay.
Figure 1
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