Placebo Controlled Trial to Evaluate Zinc for the Treatment of COVID-19 in the Outpatient Setting
Primary Purpose
Corona Virus Infection
Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Zinc Sulfate 220 MG
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Corona Virus Infection focused on measuring COVID-19, Zinc
Eligibility Criteria
Inclusion Criteria:
- Able to read and understand informed consent.
- High initial clinical suspicion by physician based on signs and symptoms (fever, cough, myalgias, fatigue, shortness of breath) followed by confirmation of COVID-19 diagnosis
- Any gender
- Age 60 years and older
Age 30-59 years with one or more of the following:
- abnormal lung exam
- abnormal oxygen saturation <95%
- abnormal Chest X-ray or chest CT
- persistent fever >100.4 degrees Fahrenheit
- one of the following co-morbidities: hypertension, diabetes mellitus, history of coronary artery disease, chronic kidney disease (CKD), asthma, COPD, current or former smoker, or morbid obesity (Body Mass Index ≥35)
Exclusion Criteria:
- Severe COVID-19 requiring admission for inpatient treatment
- Need for any oxygen supplementation
- Need for mechanical ventilatory support
- History of oxygen supplementation dependency
- History of cancer with ongoing chemotherapy or radiation therapy
- Known hypersensitivity to zinc
- Severe renal disease: Glomerular Filtration Rate <30ml/min
Sites / Locations
- St. Francis Hospital - The Heart Center
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Experimental
Arm Label
Experimental Arm #1
Experimental Arm #2
Arm Description
Placebo
Zinc sulfate
Outcomes
Primary Outcome Measures
Number of participants hospitalized and/or requiring repeat emergency room visits
COVID-19 related complications that require the participant to be hospitalized or have an emergency room visit
Number of participants admitted to the Intensive care unit (ICU)
If hospitalized, number of participants admitted to the ICU, and number of days in the ICU
Number of participants on a ventilator
If placed on ventilator, number of days on a ventilator
Secondary Outcome Measures
All-cause mortality
Total number of deaths in the cohort.
Time to resolution of COVID-19 symptoms
Time at which the patient is completely symptom free.
Severity of symptoms
Scored by the participant for feverishness, sore throat, cough, shortness of breath, myalgias. (0 =none; 1 = mild; 2 = moderate; 3 = severe)
Full Information
NCT ID
NCT04621461
First Posted
November 6, 2020
Last Updated
February 8, 2021
Sponsor
St. Francis Hospital, New York
1. Study Identification
Unique Protocol Identification Number
NCT04621461
Brief Title
Placebo Controlled Trial to Evaluate Zinc for the Treatment of COVID-19 in the Outpatient Setting
Official Title
A Randomized, Placebo-Controlled Study Evaluating the Efficacy of Zinc for the Treatment of COVID-19 in the Outpatient Setting
Study Type
Interventional
2. Study Status
Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
December 20, 2020 (Actual)
Primary Completion Date
February 8, 2021 (Actual)
Study Completion Date
February 8, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
St. Francis Hospital, New York
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a randomized, double-blind, placebo-controlled trial to assess the efficacy of zinc in a higher risk COVID-19 positive outpatient population.
Detailed Description
Zinc, a micronutrient, appears to have anti-viral properties with various mechanisms of action depending on the concentration Zinc supplementation has been reviewed extensively for use in the common cold, and has been shown to reduce the duration of symptoms. In-vitro studies have shown zinc can inhibit RNA-dependent RNA polymerase (RdRP) in coronavirus, which is typically a conserved region in the viral genome. In-vitro experiments have also shown that lung epithelium in a zinc depleted state can become susceptible to apoptosis and loss of barrier function, increasing permeability, which can lead to acute respiratory distress syndrome (ARDS).
If a patient can travel to St. Francis Hospital they can have a COVID test on site at a designated St. Francis testing location. The COVID test will be resulted via a rapid Covid (Point of Care device) or at a local lab.
Patients who are unable to travel to St. Francis Hospital or one of the outpatient practices, will be allowed to enroll remotely. Patients are eligible to enroll within 72 hours of a positive Covid-19 test result. Study medications will be mailed to the patient overnight after being enrolled.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Corona Virus Infection
Keywords
COVID-19, Zinc
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Model Description
This is a randomized, double-blind, placebo-controlled trial to assess the efficacy of zinc in a higher risk COVID-19 positive outpatient population. Patients will randomized to zinc or placebo.
Masking
ParticipantInvestigator
Masking Description
Patients will be randomized via a randomization block. Only the research coordinator will know which group the patients belong to. Placebo pills given to the patient will be similar in size and shape to zinc.
Allocation
Randomized
Enrollment
3 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Experimental Arm #1
Arm Type
Placebo Comparator
Arm Description
Placebo
Arm Title
Experimental Arm #2
Arm Type
Experimental
Arm Description
Zinc sulfate
Intervention Type
Dietary Supplement
Intervention Name(s)
Zinc Sulfate 220 MG
Intervention Description
220mg once daily for 5 days
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Once daily for 5 days
Primary Outcome Measure Information:
Title
Number of participants hospitalized and/or requiring repeat emergency room visits
Description
COVID-19 related complications that require the participant to be hospitalized or have an emergency room visit
Time Frame
21 days
Title
Number of participants admitted to the Intensive care unit (ICU)
Description
If hospitalized, number of participants admitted to the ICU, and number of days in the ICU
Time Frame
30 days
Title
Number of participants on a ventilator
Description
If placed on ventilator, number of days on a ventilator
Time Frame
30 days
Secondary Outcome Measure Information:
Title
All-cause mortality
Description
Total number of deaths in the cohort.
Time Frame
Up to 30 days
Title
Time to resolution of COVID-19 symptoms
Description
Time at which the patient is completely symptom free.
Time Frame
Evaluated at day 2, 6, day 14, and day 21
Title
Severity of symptoms
Description
Scored by the participant for feverishness, sore throat, cough, shortness of breath, myalgias. (0 =none; 1 = mild; 2 = moderate; 3 = severe)
Time Frame
Evaluated at day 2, 6, day 14, and day 21
10. Eligibility
Sex
All
Minimum Age & Unit of Time
30 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Able to read and understand informed consent.
High initial clinical suspicion by physician based on signs and symptoms (fever, cough, myalgias, fatigue, shortness of breath) followed by confirmation of COVID-19 diagnosis
Any gender
Age 60 years and older
Age 30-59 years with one or more of the following:
abnormal lung exam
abnormal oxygen saturation <95%
abnormal Chest X-ray or chest CT
persistent fever >100.4 degrees Fahrenheit
one of the following co-morbidities: hypertension, diabetes mellitus, history of coronary artery disease, chronic kidney disease (CKD), asthma, COPD, current or former smoker, or morbid obesity (Body Mass Index ≥35)
Exclusion Criteria:
Severe COVID-19 requiring admission for inpatient treatment
Need for any oxygen supplementation
Need for mechanical ventilatory support
History of oxygen supplementation dependency
History of cancer with ongoing chemotherapy or radiation therapy
Known hypersensitivity to zinc
Severe renal disease: Glomerular Filtration Rate <30ml/min
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Avni Thakore, MD
Organizational Affiliation
St. Francis Hospital - The Heart Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
St. Francis Hospital - The Heart Center
City
Roslyn
State/Province
New York
ZIP/Postal Code
11576
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
32292689
Citation
Wu C, Liu Y, Yang Y, Zhang P, Zhong W, Wang Y, Wang Q, Xu Y, Li M, Li X, Zheng M, Chen L, Li H. Analysis of therapeutic targets for SARS-CoV-2 and discovery of potential drugs by computational methods. Acta Pharm Sin B. 2020 May;10(5):766-788. doi: 10.1016/j.apsb.2020.02.008. Epub 2020 Feb 27.
Results Reference
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PubMed Identifier
176466
Citation
Korant BD, Butterworth BE. Inhibition by zinc of rhinovirus protein cleavage: interaction of zinc with capsid polypeptides. J Virol. 1976 Apr;18(1):298-306. doi: 10.1128/JVI.18.1.298-306.1976.
Results Reference
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PubMed Identifier
7347557
Citation
Katz E, Margalith E. Inhibition of vaccinia virus maturation by zinc chloride. Antimicrob Agents Chemother. 1981 Feb;19(2):213-7. doi: 10.1128/AAC.19.2.213.
Results Reference
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PubMed Identifier
2177090
Citation
Kumel G, Schrader S, Zentgraf H, Daus H, Brendel M. The mechanism of the antiherpetic activity of zinc sulphate. J Gen Virol. 1990 Dec;71 ( Pt 12):2989-97. doi: 10.1099/0022-1317-71-12-2989.
Results Reference
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PubMed Identifier
14982765
Citation
Suara RO, Crowe JE Jr. Effect of zinc salts on respiratory syncytial virus replication. Antimicrob Agents Chemother. 2004 Mar;48(3):783-90. doi: 10.1128/AAC.48.3.783-790.2004.
Results Reference
background
PubMed Identifier
6367635
Citation
Eby GA, Davis DR, Halcomb WW. Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study. Antimicrob Agents Chemother. 1984 Jan;25(1):20-4. doi: 10.1128/AAC.25.1.20.
Results Reference
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PubMed Identifier
21079686
Citation
te Velthuis AJ, van den Worm SH, Sims AC, Baric RS, Snijder EJ, van Hemert MJ. Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoS Pathog. 2010 Nov 4;6(11):e1001176. doi: 10.1371/journal.ppat.1001176.
Results Reference
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PubMed Identifier
23775705
Citation
Singh M, Das RR. Zinc for the common cold. Cochrane Database Syst Rev. 2013 Jun 18;(6):CD001364. doi: 10.1002/14651858.CD001364.pub4.
Results Reference
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PubMed Identifier
16284213
Citation
Bao S, Knoell DL. Zinc modulates airway epithelium susceptibility to death receptor-mediated apoptosis. Am J Physiol Lung Cell Mol Physiol. 2006 Mar;290(3):L433-41. doi: 10.1152/ajplung.00341.2005. Epub 2005 Nov 11.
Results Reference
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Placebo Controlled Trial to Evaluate Zinc for the Treatment of COVID-19 in the Outpatient Setting
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