A world-first trial will see researchers from Austin Health and the University 
of Melbourne use intravenous zinc to fight the symptoms of coronavirus 
(COVID-19).

The trial will be led by Austin Health's Dr Joseph Ischia and Dr Oneel Patel 
from the Department of Surgery at the University of Melbourne, who has a long 
history of investigating the protective effects of intravenous zinc against 
organ damage induced by lack of oxygen(1).

Dr Ischia, said COVID-19 is especially dangerous because it replicates inside a 
patient's body which can lead to respiratory conditions like bronchitis and 
pneumonia. 

"If COVID-19 enters a patient's lungs then they often need to be placed on a 
ventilator to help their breathing and, in severe cases, COVID-19 can cause 
multiple organ failure and brain injury due to a lack of oxygen," he said.

Dr Patel said studies(2-11) have shown that zinc is very effective at slowing 
the rate that similar viruses such as SARS (Severe Acute Respiratory Syndrome) 
and common cold (a type of coronavirus) replicate in the body.

"Our published studies have also shown that high doses of zinc can protect 
vital organs such as the heart, kidneys and liver against the damage caused by 
a lack of oxygen," he said.

"This clinical trial has been fast-tracked to test whether receiving a daily 
injection of zinc chloride will benefit patients with coronavirus," Dr Ischia 
said.

"There is currently no specific treatment available for patients who have 
COVID-19 and are at high risk of respiratory failure, which means this study 
has the potential to have an enormous positive impact on their clinical 
outcomes."

"Importantly, we hope to show that we can save lives by limiting the impact of 
the symptoms." 

"We are expecting to have preliminary results of the trial available after only 
seven days so we will know very quickly how effective this treatment is," he 
said.

The trial is the culmination of a rapid collaboration between surgeon 
scientists as well as intensive care, infectious diseases and respiratory 
medicine doctors at Austin Health, working with the Australian pharmaceutical 
firm, Phebra.

Phebra Chief Executive Officer, Dr Mal Eutick, said intravenous (iv) zinc 
injections, manufactured at Phebra's multi-purpose sterile injectables plant in 
Sydney, would be used in the trial.

"Zinc has been proven to be effective in treating severe pneumonia and other 
viruses although not COVID-19 to date. This trial is an extraordinary 
opportunity to discover if IV zinc can help us respond to the current 
pandemic," Dr Eutick said

"If successful this could save lives and with this trial we should know in a 
short time frame. In particular, it could be very important for those high risk 
elderly patients and also help reduce the level of general anxiety in the 
community." 

However, both Dr Ischia and Dr Eutick warned of the need to manage the risk of 
zinc overdose for patients.

"Zinc can be toxic and it will be carefully administered as part of the trial 
to ensure patients are safe," Dr Ischia explained

Further information

1.Ischia J, Bolton DM, Patel O: Why is it worth testing the ability of zinc to 
protect against ischaemia reperfusion injury for human application. Metallomics 
2019, 11(8):1330-1343.

2.Hulisz D: Efficacy of zinc against common cold viruses: an overview. J Am 
Pharm Assoc 2004, 44(5):594-603.
 
3.Suara RO, Crowe JE, Jr.: Effect of zinc salts on respiratory syncytial virus 
replication. Antimicrob Agents Chemother 2004, 48(3):783-790.

4.Li D, Wen LZ, H Yu: [Observation on clinical efficacy of combined therapy of 
zinc supplement and jinye baidu granule in treating human cytomegalovirus 
infection]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2005, 25(5):449-451.

5.Femiano F, Gombos F, Scully C: Recurrent herpes labialis: a pilot study of 
the efficacy of zinc therapy. J Oral Pathol Med 2005, 34(7):423-425. 

6.Korant BD, Kauer JC, Butterworth BE: Zinc ions inhibit replication of 
rhinoviruses. Nature 1974, 248(449):588-590.

7.Lanke K, Krenn BM, Melchers WJ, Seipelt J, van Kuppeveld FJ: PDTC inhibits 
picornavirus polyprotein processing and RNA replication by transporting zinc 
ions into cells. J Gen Virol 2007, 88(Pt 4):1206-1217.

8.Si X, McManus BM, Zhang J, Yuan J, Cheung C, Esfandiarei M, Suarez A, Morgan 
A, Luo H: Pyrrolidine dithiocarbamate reduces coxsackievirus B3 replication 
through inhibition of the ubiquitin-proteasome pathway. J Virol 2005, 
79(13):8014-8023. 

9.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, 6(11):e1001176. 

10.Arnold JJ, Ghosh SK, Cameron CE: Poliovirus RNA-dependent RNA polymerase 
(3D(pol)). Divalent cation modulation of primer, template, and nucleotide 
selection. J Biol Chem 1999, 274(52):37060-37069.

11.Butterworth BE, Korant BD: Characterization of the large picornaviral 
polypeptides produced in the presence of zinc ion. J Virol 1974, 14(2):282-291.

SOURCE: Phebra Pharmaceuticals