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 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 March 1, 2020 until March 31, 2021. After propensity score matching (1:1 ratio) based on the selected criteria, we assessed the association of zinc used as adjunctive therapy with the 30-day mortality. Secondary outcomes included the in-hospital mortality, ventilator free days, ICU length of stay (LOS), hospital LOS, and complication (s) during ICU stay. Results A total of 164 patients were included, 82 patients received zinc. Patients who received zinc sulfate as adjunctive therapy have a lower 30-day mortality (HR 0.52, CI 0.29, 0.92; p = 0.03). On the other hand, the in-hospital mortality was not statistically significant between the two groups (HR 0.64, CI 0.37–1.10; p = 0.11). Zinc sulfate use was associated with a lower odds of acute kidney injury development during ICU stay (OR 0.46 CI 0.19–1.06; p = 0.07); however, it did not reach statistical significance. Conclusion The use of zinc sulfate as an additional treatment in critically ill COVID-19 patients may improve survival. Furthermore, zinc supplementation may have a protective effect on the kidneys. Supplementary Information The online version contains supplementary material available at 10.1186/s13054-021-03785-1.
【저자키워드】 COVID-19, SARS-CoV-2, Zinc, Trace element, Critically ill, 30-Day mortality, intensive care unit (ICU), Supplements, 【초록키워드】 Treatment, therapy, intensive care, Immunity, hospital, Acute kidney injury, outcome, Saudi Arabia, ICU, survival, Patient, Efficacy and safety, in-hospital mortality, protective effect, association, propensity score matching, COVID-19 patient, criteria, Critically ill patient, LOS, supplementary material, statistical significance, kidneys, zinc supplementation, ventilator free days, secondary, zinc sulfate, IMPROVE, Result, selected, evaluate, two group, statistically significant, 1:1, with COVID-19, 【제목키워드】 therapy,