Authors: Anwar E, Soliman M, Darwish S, Lotfy H, Tolba M.
In the Pandemic of COVID-19 infection caused by SARS-CoV-2, no longer the age and preliminary health status are barriers against this disease-associated morbidity and mortality. In COVID-19 a dysregulated immune response and an exaggerated pro-inflammatory cytokines release are reported. The loss of taste and smell as early alarming
symptoms reflect acute serum zinc deficiency. The pathogenesis can be explained as a redistribution of zinc ion associated with acute immune cellular dysfunction. Zinc deficiency results in multiple immunological changes with a shift towards a predominantly innate immune response, which is not as effective in viral immune clearance as the
adaptive immune response. Notably, micronutrients homeostasis plays a key role in maintaining a healthy immune response especially Vitamin C, Vitamin D, Zinc and Magnesium. Zinc is considered as the gatekeeper of the immune system. Current studies on zinc-ionophores especially, chloroquine and quercetin, reported an effectiveness in the reduction of COVID-19 morbidity and mortality with an early administration. These Zinc-ionophores are able to chelate zinc and concentrate it intra-cellularly. Concerns about chloroquine safety, its pH-dependent efficacy, response polymorphism, and drug-resistance were studied in malaria treatment. Quercetin is a lipid- soluble, naturally occurring flavonoid, available as a dietary supplement with chloroquine-like actions. It is postulated that zinc supplementation combined with zinc-ionophores may offer dual anti-viral and immune-modulatory effects in favor of both the maintenance and the resetting of an effective cell-mediated immune response.