The hunt for potential protecting and therapeutic antiviral approaches is very essential and urgent due to the evolving COVID‑19 pandemic worldwide, which is caused by SARS‑CoV‑2 virus, also known as coronavirus. Zinc is identified and considered to modulate antiviral and antibacterial immunity and also regulate the inflammatory response. Regardless of the lack of available clinical data, certain indications do suggest that modulation of zinc status might be beneficial in COVID‑19.

Zinc is involved in a variety of biological processes and also in the regulation of carbohydrate and lipid metabolism, functioning of the reproductive, cardiovascular, and nervous system. The most important role of zinc is demonstrated for the immune system as it regulates proliferation, differentiation, maturation, and functioning of leukocytes and lymphocytes. Zinc plays a signaling role in the modulation of inflammatory responses and is also a factor of nutritional immunity. Alteration of zinc status can significantly affect the immune response resulting in increased susceptibility to inflammatory and infectious diseases such as malaria, tuberculosis, pneumonia and acquired immune deficiency syndrome. Previous data had demonstrated that zinc status is associated with the incidence of respiratory tract infections in children and adults. Infants, especially preterm ones, and elderly, are considered to be at high risk of deficiency of zinc and its adverse effects.

Improved antiviral immunity by zinc occurs through up‑regulation of interferon α production and by increasing its antiviral activity. Zinc possesses anti‑inflammatory activity by preventing NF‑κB signaling and modulating the regulatory T‑cell functions, which can limit the cytokine storm in COVID‑19. Improved Zn status might reduce the risk of bacterial co‑infection by improving the mucociliary clearance and barrier function of the respiratory epithelium. It also has direct antibacterial effects against S. pneumoniae. Zinc status is also associated with risk factors for severe COVID‑19 such as ageing, immune deficiency, diabetes, obesity and atherosclerosis, as these are considered as high risk groups for zinc deficiency.

Thus, zinc might possess protective effects and can be considered as preventive and adjuvant therapy of COVID‑19 through reducing inflammation, improving mucociliary clearance, preventing ventilator‑induced lung injury, and modulation of antiviral and antibacterial immunity.

Source: Skalny AV, Rink L, Ajsuvakova OP, et al. Zinc and respiratory tract infections: Perspectives for COVID‑19 (Review). Int J Mol Med. 2020;46(1):17-26. doi:10.3892/ijmm.2020.4575