Does Zinc Really Help Treat Colds?

The trial was not designed to evaluate zinc for the prevention or treatment of COVID-19.

There is evidence that it has a small preventive benefit and may slightly shorten the duration of RTIs.

A new study published in BMJ Open adds to the evidence that zinc it is effective against respiratory infections viral, such as colds.

Zinc oral or intranasal prevented five RTIs per 100 person-months (95% CI, 1 to 8; numbers needed to treat, 20). There was a 32% lower relative risk (RR) of developing mild to moderate symptoms consistent with a viral RTI.

Zinc use was also associated with an 87% lower risk of developing moderately severe symptoms (incidence rate, 0.13; 95% CI, 0.04 – 0.38) and a 28% lower risk of developing milder symptoms. The largest reductions in RR were for moderately severe symptoms consistent with influenza-like illness.

Symptoms resolved two days earlier with sublingual or intranasal zinc compared to placebo (95% CI 0.61 to 3.50, very low-certainty quality of evidence). There were clinically significant reductions in symptom severity scores on day 3 (mean difference, -1.20 points, 95% CI -0.66 to -1.74, low-certainty quality evidence) but no on the general severity of symptoms. Participants who used zinc sublingual or topical nasal at the onset of the disease were 1.8 times more likely to recover than those who used a placebo.

However, the researchers found no benefit from zinc when the patients were inoculated with rhinovirus; there was no reduction in the risk of developing a cold. When asked about this disparity, Hunter said: “It could well be that by inoculating people to make sure they get infected, I’m giving them a really high dose of the virus. [Esto] It doesn’t really mimic what happens in the real world. “

On the downside of supplemental zinc, there were more side effects among those who used zinc, including nausea or gastrointestinal upset, mouth irritation, or pain from sublingual pills (RR 1.41; 95% CI 1.17-1.69; number needed to harm 7; moderate-certainty quality evidence).

The risk of an adverse event serious, such as loss of smell or copper deficiency, it was low. Although not found in these studies, post-marketing studies have found that there is a risk of severe loss of smell and, in some cases, permanent associated with the use of nasal gels or sprays that contain zinc. Three of these products were recalled.

The trial failed to provide answers on comparative effectiveness from different types of zinc formulations, nor were the researchers able to recommend specific dosages. The trial was not designed to assess zinc for the prevention or treatment of COVID-19.

When asked for independent comment, pediatrician Aamer Imdad, MBBS, assistant professor at the State University of New York Upstate Medical University, Syracuse, New York, told Medscape Medical News: “This is a very comprehensive review of studies related to zinc in adults “, but it was challenging due to” significant clinical heterogeneity in the population “.

Imdad explained that it has been “absolutely” shown that zinc it is effective for children with diarrhea. The World Health Organization has recommended it since 2004. “The way it works in diarrhea is that it helps with the regeneration of the epithelium. It also improves immunity itself, especially cell-mediated immunity.”

He raised the question of whether it could work similarly in the respiratory tract. Imdad has a longstanding interest in the use of zinc for pediatric infections. Regarding this study, he concluded, “I think we still need to know the details of this intervention before we can recommend it more specifically.”

Hunter said, “We don’t have any high-quality studies that have evaluated zinc taken by mouth as a treatment once you are truly infected and have cold, flu, or COVID symptoms. “

When asked about the possible role of zinc, Hunter said: “So I think it gives us a viable alternative. More people are asking ‘What can I do?’ And you know as well as I do that people come to you and [te dicen]: ‘Well, just give me something. Even if it’s a day or a bit of symptom relief, anything that makes me feel better other than is going to hurt me and has no major risks. ‘ So I think in the short term, doctors and consumers may consider trying it. “

Hunter was not interested in giving zinc to family members after they developed an RTI: “Consider it. But I don’t think we have enough evidence to definitively say yes.” But he does see a potential role for “people who are at risk for suboptimal zinc absorption, such as people taking a variety of pharmaceuticals. [en particular, inhibidores de la bomba de protones] that block or reduce zinc absorption, people with a large number of chronic diseases that we know are associated with an increased risk of worse outcomes from respiratory viral infections, and older adults. Yes i think [para] For those high-risk groups, you might consider using zinc, either at a moderate dose for the long term or at a higher dose for very short periods, such as 1 to 2 weeks. “

Hunter concluded: “Until now, we all commonly thought that the role of zinc was only for people who were zinc deficient, and now we have some signs that point towards its potential role as an anti-infective and anti-inflammatory agent in people who are not zinc deficient. zinc”.

But both Hunter and Imdad emphasized that zinc it doesn’t change the rules of the game. There is evidence that it has a small preventive benefit and may slightly shorten the duration of RTIs.

Source consulted here.

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